ABSTRACT
The aim of this study was to determine which factors influence choice of breast- versus the formulafeeding of infants. This may help to understand where the focus should lie in the promotion of breastfeeding. A structured questionnaire was completed by a 100 women and focus-group discussions were held with 22 women who delivered babies at the Lower Umfolozi District War Memorial Hospital (LUDWM) in Kwazulu-Natal. Most of the mothers (72) chose breastfeeding and 58intended to breastfeed for only 6 months. One-third (33) were influenced by health care professionals and 44of the mothers made their own decisions in their feeding method. Only one participant stated that she chose formula-feeding due to her HIV-positive status; but in the focusgroup discussions; the fear of transmission of HIV through breast-milk was stated as an important reason why mothers chose replacement-feeding. Significantly more HIV-infected than uninfected mothers chose replacement-feeding as the feeding method and mothers who chose breastfeeding were significantly older than mothers who selected replacement-feeding. They made their infantfeeding decision earlier than those who chose replacement-feeding. Findings showed that the majority of women in this study did not have access to running water and flush toilets in their houses. In these areas where replacement-feeding will not be acceptable; feasible; affordable; sustainable and safe; due to lack of sanitation and poor socio-economic status; health professionals should promote exclusive breastfeeding for 6 months; even though there is a high prevalence of HIV infection