RESUMEN
Aim: To describe infant feeding practices at birth and at 14 weeks post-partum in the Ugu-North Health District; KwaZulu-Natal; South Africa. Methods: A prospective; cohort study design was used. Mothers who delivered over a one-month period were interviewed at birth and 14 weeks later. Results: Initially; 168 mothers were interviewed within 24 hours of delivery; of whom 117 (70) were contactable at 14 weeks post-partum. The vast majority (96) initiated breast-feeding at birth. At birth; less than one-third (55/168 [32.7]) of mothers declared an intention to both breast and formula (mix) feed in the next 14 weeks; but by the 14th week post-partum over three-quarters (89/117 [76.1]) actually practised mixed feeding. At 14 weeks; the prevalence of exclusive breast-feeding was 18: 52of infants were offered water and 73solids. The majority (20/23 [87]) of HIV infected mothers chose to breastfeed their infants at birth. Nevertheless; they were significantly more likely to formula feed their infants compared to HIV negative mothers (3/23 [13.0] vs 2/145 [1.4]; OR 10.73; 95CI 1.34 - 99.16; p = 0.02). By 14 weeks; only 11of HIV positive mothers were still exclusively breast-feeding; while almost two-thirds (12/19 [63]) practised mixed feeding. This change was mainly ascribed to their need to return to school (40) or to work (20). Conclusions: Most infants were fed inappropriately by 14 weeks of age. The failure to maintain exclusive breast-feeding; despite high initiation rates; is of greatest concern. Routine prevention of mother-to-child transmission of HIV services was ineffective in influencing mothers to follow any feeding regimen exclusively