By Brian Weed, MA
It may seem counter productive at first, but the best option for mothers—especially those who are HIV positive—is to exclusively breast feed their babies for six months. Kate Reinsma, MS, is a Loma Linda University School of Public Health doctoral student whose dissertation project focused on developing an audio program to promote exclusive breastfeeding in Kumbo, Cameroon. "It's important for all women to exclusively breast feed in this region because when they introduce other foods, infant mortality rates increase," Reinsma states, "and due to unhygienic food preparation practices, the risk increases for diarrheal diseases."
Reinsma explained that the gut mucosa gets damaged in babies when they are exposed to other foods and contaminated water. This creates microscopic tears in the intestines that allow for infections and viruses to be transmitted to the infant's bloodstream. If the mother is HIV positive, and provides water, food, and breast milk, the child has a high chance of becoming infected with HIV. But if the mother exclusively feeds the child with breast milk, the chances of the baby becoming infected are dramatically reduced because those microscopic passages are not present and the gut mucosa is not damaged.
"The gold standard for infants born to HIV positive mothers," Reinsma says, "is providing infants formula exclusively, but in resource-poor areas, and where water is contaminated, the recommendation is for the infants to receive only breast milk."
After spending six months in Cameroon working on the qualitative phase of her project, she collected enough data about local practices and learned that women were typically only providing breast milk for three-to-four months. She used the information collected to design an audio program that is comprised of four, 15-minute episodes. The participants came once a week for four weeks to listen to the programs. They had a group discussion after each episode.
"We used an entertainment-education model," Reinsma says. "There were actors who emphasized the benefits of exclusive breastfeeding, corrected misconceptions, and provided ideas for overcoming obstacles, as well as improving their self efficacy," she explained.
Those who were exposed to the audio program statistically improved in knowledge, benefits, self-efficacy, and intention to exclusively breast feed.
Reinsma is returning to Cameroon in June to collect six-month post data. She is hoping to see the women who were recruited when they were pregnant continuing to only provide breast milk to their babies.
The project was originally funded by the Nestle Foundation, and recently received additional funding from the Hulda Crooks grant to translate the audio programming into two local languages: Lamso and Oku.
Reinsma will be graduating this year with a doctor of public health in nutrition. She will go back to Africa having just accepted a position with Samaritan's Purse, a Christian organization in Niger. Reinsma will work in that West African country as the nutrition and health manager. Her primary objective will be to reduce malnutrition in that country by distributing Plumpy'nut, a fortified peanut butter product.