Difficult choices: Infant feeding experiences of HIV-positive mothers in northern Tanzania
Difficult choices: Infant feeding experiences of HIV-positive mothers in northern Tanzania
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艰难的选择：坦桑尼亚北部艾滋病毒阳性母亲的婴儿喂养经历
DOI：
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
K. Moland
中科院分区：
文献类型：
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作者：
S. Leshabari;A. Blystad;K. Moland
婴儿喂养是预防艾滋病毒母婴传播的一个巨大挑战。关于婴儿喂养咨询的国际准则建议采用减少艾滋病毒传播风险的喂养方法，并不鼓励混合喂养（母乳喂养与其他液体和固体相结合）。推荐的喂养方法的可行性和社会可接受性是目前争论的热点。通过记录艾滋病毒阳性妇女的经验，本文的目的是提供经验为基础的知识，建议喂养方法的相关性。借鉴文化理论和观点的婴儿喂养的做法，社会和文化的嵌入式，本文讨论了所谓的“知情选择”的婴儿喂养方法的妇女参加了在基利曼哈罗基督教医疗中心在坦桑尼亚北方的pMTCT方案。这项研究是基于对20名艾滋病毒阳性母亲在怀孕后期、分娩和出生后前六个月的访谈和随访。文章详细介绍了其中四个案例，描述了纯母乳喂养、牛奶喂养和配方奶粉喂养所面临的挑战。这项研究表明，在母乳喂养的社会期望很高，亲属和邻居是婴儿喂养决策团队的一部分的背景下，意图和婴儿喂养实践之间存在差距。它强调了在选择婴儿喂养方法时所涉及的医疗和社会风险的相互竞争的关切之间的紧张关系，并记录了喂养选择可能难以坚持，无论母亲选择纯母乳喂养还是替代喂养。
Infant feeding represents a great challenge in the prevention of mother-to-child transmission of HIV (pMTCT). The international guidelines informing infant feeding counselling suggest feeding methods that reduce the risk of HIV transmission, and discourage mixed feeding (combining breastfeeding with other fluids and solids). The feasibility and the social acceptability of the recommended feeding methods are hotly debated currently. Through the documentation of HIV-positive women's experiences, this article aims to provide empirically grounded knowledge on the relevance of the proposed feeding methods. Drawing upon cultural theory and a view of infant feeding practices as socially and culturally embedded, the article discusses the so-called ‘informed choice’ of infant feeding method among women enrolled in the pMTCT programme at Kilimanjaro Christian Medical Centre in northern Tanzania. The study is based on interviews and follow-up of 20 HIV-positive mothers during the last part of pregnancy, delivery and the first six months after birth. The article details four of these cases describing the challenges linked to exclusive breastfeeding, cow's milk feeding and formula feeding. The study demonstrates the gap between intentions and infant feeding practice in a context where the social expectations to breastfeed are high, and where kin and neighbours are part of the decision-making team surrounding infant feeding. It highlights the tension between the competing concerns of the medical and social risks involved in the choice of infant feeding method, and documents that the feeding options may be difficult to adhere to, whether a mother chooses exclusive breastfeeding or replacement feeding.
DOI：
10.1097/00006254-200008000-00010
发表时间：
2000-03
期刊：
JAMA
影响因子：
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作者：
R. Nduati;G. John;D. Mbori-ngacha;B. Richardson;J. Overbaugh;A. Mwatha;J. Ndinya‐Achola;J. Bwayo;Onyango Fe;J. Hughes;J. Kreiss
通讯作者：
R. Nduati;G. John;D. Mbori-ngacha;B. Richardson;J. Overbaugh;A. Mwatha;J. Ndinya‐Achola;J. Bwayo;Onyango Fe;J. Hughes;J. Kreiss