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Exclusive breastfeeding protects newborns from HIV/AIDS

© Richard Nyamanhindi 04/04/14
HIV infected mother Chipo Tiripano feeds her daughter, Tapiwanashe ... Fortunately, the girl has been born without HIV

By Richard Nyamanhindi

On a summer day in rural Manicaland Province in Zimbabwe, nature vents its power upon the people of Marange village in the form of a thunder storm savage in its fury. But Chipo Tiripano, aged 44, has another explanation for the white lightning fizzling and cracking diabolically across the onyx sky above her.

“It is unusual for the Almighty to be so angry at this time of year,” she mutters, staring at black clouds swollen with electrical venom as they burst and deluge her homestead.

Chipo a mother of six – lives in one of the areas in Zimbabwe worst afflicted by HIV/AIDS. It is estimated that one out of every four people here is HIV-positive. Chipo herself found out she had the virus shortly before she gave birth to her last-born, three-year-old Tapiwanashe.

Chipo says she’s trusting in God to keep her and her children, like little Tapiwanashe, alive.

After visiting Chipfatsura Rural Health Centre and getting advice from nurses there, Chipo says she made the “most important decision” of her life. “I decided to feed my child breast milk and nothing else. I was motivated to do this for my child. I knew that if I did not, she could also get HIV,” she says.

Through a combination of antiretroviral drugs that Chipo took and the safe breastfeeding she practiced saved Tapiwanashe from infection. Today, she’s HIV-free.

Without her mother’s action, Tapiwanashe would probably have joined the ranks of the more than 30,000 Zimbabwean children born every year with HIV. Their infected mothers pass it on to them during birth, or the youngsters are infected during breastfeeding.

Exclusive breastfeeding means the babies are fed only breast milk and no solid foods, or even water. But in Zimbabwe, where discrimination against HIV-infected mothers is rife and the women themselves are malnourished, breastfeeding is constantly threatened.

Culture also plays a role, says Mildred Chikukwa a nurse at Nzvenga Clinic in Marange in Mutare district.

Tendai Gapa, the District Nutrition Assistant with the Ministry of Health and Child Care in Chipinge, agrees that breastfeeding is “one of the major benefits of humankind for children…. It is something natural and it is good for the baby, it is good for the mother, it is good for the family.”

The nutritionist says research, has proven that “breast milk is best” for babies, and that other methods to feed the youngsters should be considered “last resorts.”

Family is the biggest challenge

One hundred per cent exclusive breastfeeding is “alien” to most cultures in Zimbabwe. “The grandmother will say, ‘Oh, it’s too hot today. Let’s give (the baby) some extra water.’ Somebody else will say, ‘Oh, the baby is too thin. Let’s give him/her some solid foods,’” says Shylet Njerere, a volunteer health worker in Chipinge.

Chipo Tiripano says family members tried to “force” her to give her daughter, solid food and water when he was a baby. But she refused.

“HIV-positive mothers have to use their love for their children as motivation. They must not listen to people who tell them to feed their children anything else but breast milk. Don’t give in to the pressure,” Chipo emphasizes.

But Chikukwa says most HIV-infected mothers are not as strong as Chipo and they “surrender” to demands made by family in terms of a baby’s diet. “The family is maybe the biggest challenge to correct breastfeeding practice in Zimbabwe,” she comments.

Chikukwa says men who are aware that their wives or partners are HIV-positive but are ignorant of the benefits of exclusive breastfeeding, demand – often with an accompanying threat of violence – that mothers not breastfeed the baby, fearing transmission of the virus to the child.

But relatives who do not know that the mother is HIV-positive in turn demand that the woman breastfeed her infant. “So there’s a clash, and the woman is torn apart,” Chikukwa says. “A mother-in-law is saying, ‘I want you to give your baby the breast milk!’ And the father is saying, ‘No, you are going to give the virus to my child!’

The nurse says the mothers “do not know which way to turn” and, in a bid to satisfy relatives, end up practicing “mixed feeding” and, in so doing, endangering their babies.

Chikukwa works in a district in Mutare where most people are unemployed. She says poverty and lack of development often result in HIV-positive mothers practicing unsafe breastfeeding. “There is no electricity here. And even if there [was], people cannot afford fridges to cool the breast milk when the weather is hot. So they often end up giving unclean but cool water to their babies, to give the babies some relief from the heat,” Chikukwa says. “In this way, the babies are again in danger of infection.”

What’s being done to change perceptions?
Thanks to the ECHO funded Infant and Young Child Feeding that is being implemented by UNICEF and the Ministries of Health and Child Care and that of Women, Gender and Community Development, Chipo and the other women in Zimbabwe are learning how exclusive breastfeeding can stop the lack of food from having a long-term effect on their children. Already they are signs that the program is having a positive effect with latest results from the Ministry of Health and Child Care showing that more than 53 per cent of mothers in Manicaland are exclusively breastfeeding their children for the first six months from a baseline of zero in 2010.

Chipo and the other mothers say that exclusive breastfeeding has played the most important role in making sure their children grow up healthy and do not become malnourished.





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