Browsing by Author "Koen, Leandri"

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    Macronutrient and energy composition of breastmilk of HIV-infected mothers receiving ARVs in the Nelson Mandela Bay area
    (Stellenbosch : Stellenbosch University, 2022-12) Koen, Leandri; van Niekerk, Evette; Steenkamp, Liana; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.
    ENGLISH SUMMARY: Inadequate nutrition in early life can have a detrimental effect on an infant’s growth and development. South Africa remains the epicentre of HIV and has low exclusive breastfeeding rates, increasing the risk of malnutrition for infants living in South Africa. While antiretroviral medication (ARVs) is recommended for HIV-positive pregnant and breastfeeding mothers to prevent mother-to-child transmission (MTCT), limited information is available on the macronutrient composition of the breastmilk of mothers on ARVs. Aim and objectives: The principle aim of this study was to assess the macronutrient composition of breastmilk from HIV-positive mothers receiving ARV treatment. Method: The researcher conducted a quantitative study using a descriptive, cross-sectional approach, which included HIV-positive mothers (n = 45) on ARVs. Anthropometrical data, a questionnaire and breastmilk samples were collected from the mothers on day 3 (± 2 days; n = 45) and day 14 (± 2 days; n = 37) of the infant’s life. The macronutrients (carbohydrates, fat, and true protein) and energy of the breastmilk were analysed using the Miris Human Milk Analyzer (mid-infrared spectroscopy). Stellenbosch University’s Division of Epidemiology and Biostatistics generated the statistics using Stata 17 software for the analysis. A one-sample t-test was used to report the inferential (numerical) data. The Pearson correlation test was used to determine whether a relationship existed between the variables and the macronutrients in the milk. Ethical approval was granted by the Stellenbosch University Health Research Ethics Committee (S20/10/280) and the Committee of the Eastern Cape (ec_202102_015). Clinic managers functioned as gatekeepers at each of the clinics. Results: The participants were mostly single (n = 38; 84.4%), unemployed (n = 30; 66.7%) with a monthly income of less than R500 (n = 32; 71.1%), and mostly dependent on government grants (n = 30; 66.7%). Most participants lived in a free-standing house (n = 41; 91.1%) where only one or no adults were working (n = 23; 56.1%). The mean maternal postpartum body mass index (BMI) was in the overweight category (29.84 kg/m2 ± 6.17). The macronutrient and energy content per 100 ml of colostrum from HIV-positive mothers was: protein = 2.22 g (± 0.786), fat = 3.39 g (± 1.809), carbohydrates (CHO) = 7.43 g (± 3.441), and energy = 69.20 kcal (± 20.89). The results for mature HIV-positive milk per 100 ml were: protein = 2.11 g (± 1.016), fat = 4.55 g (± 2.111), CHO = 7.322 g (± 1.92) and energy = 79.357 kJ (± 21.131). All the macronutrients and energy values from the study exceeded the values presented in the literature for breastmilk from HIV-negative mothers. Although a relationship exists between the variables, it may not be of clinical importance and could be spurious. Conclusion: All macronutrients in breastmilk from HIV-positive mothers are elevated compared to HIV-negative mothers.