Feeding and nutritional characteristics of infants on PMTCT programs.

Objectives: To compare feeding and nutritional characteristics of infants born to mothers on the prevention of mother to child transmission (PMTCT) programs with infants not in the program.

Design: A hospital-based case-control study was used.

Setting: The study was conducted in Nsambya hospital, Kampala, Uganda.

Subjects: A total of 176 mother/baby pairs were included in the study with 88 from each group. Infants were aged from 3 to 12 months.

Results: The percentage of mothers exclusively breastfeeding was lower in PMTCT mothers (65%) compared to the 98% in non-PMTCT mothers (p < 0.01). The mean duration of breastfeeding was 2.5 months among PMTCT mothers compared to 4.1 months in non-PMTCT mothers (p < 0.01). Dietary diversity score (DDS) was higher among PMTCT babies (4.3) compared to 3.7 among non-PMTCT babies (p < 0.05). The percentage of babies reported ill in the previous month was much higher among the PMTCT infants (79%) compared to the non-PMTCT infants (69%) and the incidence of diarrhoea was almost twice as high among the PMTCT infants (18.1%) compared to the 9.3% in non-PMTCT infants [risk ratio (RR) = 1.94]. In addition, the incidence of respiratory infections was higher among the PMTCT infants (47.7%) compared to 39.5% in the non-PMTCT infants (RR = 1.2). The mean z-scores: [Weight for age z-score (WAZ)] [height for age z-score (HAZ)] and [weight for height z-score (WHZ)] were significantly lower (p < 0.01) for PMTCT infants. The incidence of stunting among PMTCT infants (11.8%) was twice that of the non-PMTCT ones (5.2%) and incidence of underweight was 8.4% in the PMTCT infants compared to 1.2% in the non-PMTCT ones.

Conclusions: The feeding patterns of the PMTCT infants were significantly different from the non-PMTCT ones both in terms of breastfeeding and DDS. Although DDS was higher among the PMTCT infants it did not translate into better nutritional status. The higher incidence of morbidity combined with the lower incidence of breastfeeding among the PMTCT infants are some of the contributing factors to significantly higher levels of malnutrition.