Stillbirth Rates in Singleton Pregnancies in a Stable Population at Karl Bremer and Tygerberg Hospitals Over 50 Years

Objectives. To determine the changes in stillbirth rates in singleton pregnancies in a stable population over a period of 50 years. Methods. Stillbirth rates for singleton pregnancies where the fetus weighed 1 000 g or more were collected from 1962 to 2011. From 1972 to 2011; rates included fetuses weighing 500 g or more at birth. Results. When the birth weight was 1 000 g or more the stillbirth rate declined from 70 to 12.6 per 1 000 births; and when the birth weight was 500 g or more it dropped from 34.2 to 24.5. The decline was very much slower towards the end of the study period. Conclusion. To achieve further sustained reductions in stillbirth rates; healthcare workers should continue to emphasise quality of healthcare; but they should also address and prevent specific conditions associated with stillbirth; such as smoking and drinking during pregnancy

Compliance with Infant Formula Feeding By HIV-Positive Women One Week after Delivery in Khayelitsha; South Africa

When mixed feeding occurs a few days following delivery; the risk of HIV transmission is likely high. The study aim was to assess infant feeding practices; one week following delivery of HIV-positive mothers who intended to formula feed their infants. A consecutive sample of 95 HIV-positive mother-infant pairs was recruited soon after delivery from a midwife obstetric unit in Khayelitsha. Face-to-face interviews were conducted one week after delivery at the clinic to determine the actual infant feeding practices. Sixty-four HIV-positive mother-infant pairs completed the study. The response rate was 67. The median interview day was day 8. Sixty-two mothers (97) (95 CI: 95 to 99) exclusively formula fed their infants. Fifty (78) (95 CI: 73 to 83) mothers gave their infants formula milk only. Two mothers breast-fed their babies. Twelve (19) gave their babies other fluids or food. Eleven gave water; glucose water or gripe water and one gave cereal or porridge. Breast engorgement occurred in 51 (80) mothers. Only five (8) mothers had received advice about breast engorgement from the facility health providers. Compliance with formula feeding of HIV-positive mothers one week following delivery is at an acceptable level. Levels of breast engorgement and lack of counselling on breast engorgement were high. Advice about non-pharmacological methods of managing breast engorgement must be given to women choosing to formula feed their babies. Mothers must be informed about the dangers of mixed feeding during the first week after delivery