Feeding practices and cost of diet of six-month-old HIV exposed uninfected compared to HIV unexposed uninfected infants in a peri-urban community in South Africa

Background The increasing population of HIV-exposed-uninfected (HEU) infants are known to be at risk of poor nutritional status and suboptimal growth, with biological risk factors implicated, yet the cost to families of feeding infants is often overlooked. Objective The study compared the infant feeding practices and costs and macronutrient intake of HEU vs HIV-unexposed-uninfected (HUU) six-month-old infants in the Gauteng Province of South Africa. Methods A cross-sectional study investigated 46 HEU and 55 HUU infants aged six months and utilised a single quantified 24-hr recall and the FoodFinder™ program for meal analysis. The estimation of diet cost utilised supermarket food prices based on the 24-hr recall method. Results Mothers of HEU infants had significantly lower income ( p <0.01) and educational attainment ( p =0.03). The infant feeding practices differed between HEU vs HUU infants ( p =0.05): exclusive breastfeeding (50.0% vs 34.0%) and mixed breastfeeding (38.1% vs 64.2%). Common complementary foods for HEU versus HUU infants included commercial infant cereals (CIC) (48.7% vs 70.9%; p =0.04); fruits and vegetables (33.3% vs 15.7%; p =0.05) and maize meal porridge (25.6% vs 15.7%; p =0.24), respectively. The mean daily cost of diet of HEU vs HUU infants was 8.55±7.35ZAR ($0.68±0.59USD) vs 10.97±7.92ZAR($0.88±0.63 USD); ( p =0.10). Regarding the complementary feeding, there were non-significant differences in protein, fat, and carbohydrate intakes ( p >0.05) and their costs per daily intake ( p >0.05) between the groups. Conclusion There are no significant differences in cost, feeding and macronutrient intakes between HEU and HUU. Suboptimal breastfeeding practices remains an issue within the first six months. More sustained effort is required to support and promote exclusive breastfeeding.