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Flash Heat Method for Breastfeeding Moms with HIV
 

Flash Heat Method for Breastfeeding Moms with HIV

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    Flash Heat Method for Breastfeeding Moms with HIV Flash Heat Method for Breastfeeding Moms with HIV Presentation Transcript

    • ONE OF THE MOST DIFFICULT DILEMA’ S FACED BY WOMEN WITH HIV IS THE DECESION WHETHER TO BREAST FEED THEIR BABIES OR NOT
      • More than 90% of babies with HIV have acquired it through MTCT.
      • It is estimated that 750,000 babies world wide become infected with HIV each year and most of these are in sub-Saharan Africa
      • The rate of MTCT varies
      • In the absence of specific intervention
      • The rate of MTCT is approximately 15 to 20%.
      • With prolong breast feeding over 6 months the rate is doubled 35 to 40 %
      • In developed countries MTCT has been eventual decreased by 1 to 2% through availability of ARV,S and exclusive formula feeding
      • In countries with limited resources the use of formula increase the risk of mortality rate
      • due to severe diarrhoea& malnutrition.
      • According to a WHO report published in 2006, it is estimated that1,45mllion children under 2yrs of age are lost per annum due to suboptimal breastfeeding or infant feeding practices
      • Mothers who are HIV positive with limited resources who do not meet AFASS criteria
      • Feeding option is
      • Exclusive breast feeding for the 1 st 6months or
      • Flash heat expressed breast milk from birth
      • Breast milk has optimal nutrition ,& immunological properties that protect the epithelial lining of the gut ,preventing conditions ,eg necrotising enterocolitis especially premature neonates.
    • Afass criteria
      • Acceptabiity - is eff acceptable for the mother?
      • Feasibilty - is the mother able to begin eff correctly for the required six months period of time?
      • Affordability - is the mother able to afford the cost of eff?
      • sustainabiity- will the mother be able to continue with eff for the recommended 6month period, once she has begun?
      • Safety - will the mother be able to practice eff safely?
      • Eff= excusive formula feeding
      • Refer to SA national PMTCT policy released in Feb 2008 (see page 49)
    • 5 AFASS CRITERIA
    • FLASH HEAT METHOD
      • Quick, simple and safe method of pasteurizing EBM
      • Eliminates viral activity and destroys bacterial contamination.
      • Nutritional losses are significantly less than prolong heating method approximately
      • 20-30 %
      • Has been community tested in Mayville, KZN.
    • FLASH HEAT METHOD
      • Step 1: wash hands with warm water and soap
    • Flash heat method
      • Step 2:
      • breast milk is to be hand expressed
      • into a glass jar(250ml)
      • N.B. not more than 100ml to 120ml expressed breast milk (EBM)
    • FLASH HEAT METHOD
      • STEP 3 :
      • The jar containing EBM, needs to be closed with a lid , until it is ready to be heated
      • when ready to heat the EBM , remove the lid from jar.
      • Place the jar in a small aluminum pot (1,5L).
    • FLASH HEAT METHOD
      • Step 4 :
      • pour cold water into the pot (not the jar).
      • The level of water in the pot must cover the level of the EBM in the jar by 2 fingers widths .
    • FLASH HEAT METHOD
      • Step 5 :
      • Place the pot containing the jar, on the stove/ heat source and bring to boil
    • FLASH HEAT METHOD
      • Step 6 :
      • once the water is rapidly boiling, remove from heat.
    • FLASH HEAT METHOD
      • Step 7 :
      • If for immediate use, then close jar with lid and run under cold water to cool milk.
      • Then leave the jar closed, and keep it for 6-8 hours(at room temperature)
    • FLASH HEAT METHOD
      • STEP 8 :
      • Milk is to be fed per: cup and spoon or per feeding cup or per nasogastric tube
    • PROCEDURE OF FLASH HEATING
    • FLASH HEATING METHOD
      • RVD positive mothers who opt to flash heat EBM from her infants birth, will continue to express and flash heat EBM, upon discharge from hospital.
      • However, if mothers find this too demanding because the milk volume needed will be increasing with the infants increase in age and weight, and if the AFASS criteria are not satisfied, then mothers can return to feeding directly from breast (exclusive breastfeeding) till the baby is 6months, then if the baby is RVD –VE, to continue flash heating EBM.
    • MIXED FEEDING
      • Combination of feeding of breastfeeding and formulae feeding should strictly be avoided
      • If breast milk remains for a prolonged period in the breast, this increases the concentration of HIV in the breast milk, significantly increasing the risk of MTCT.
    • WHEN DO WE START
      • Many of the things we need can wait.
      • The children cannot.
      • To them we cannot answer tomorrow.
      • Their name is today.
      • Gabriela Mistral, Chile
      • Nobel Price For Literature,1945
    • FLASH HEAT METHOD
      • Further reading:
      • Chantry J et al, 2000, JAIDS,24:325-329
      • Israel- Ballard K et al,2007, Acquir Immune Defic Syndr, 45 (3):318-323
      • Israel- Ballard k et al, 2006, J Trop Ped, 52(6): 399-405
      • Thank you