Maternal HIV exposure and intrauterine growth restriction (IUGR) due to placental insufficiency both carry major risks to early child growth. We compared the growth outcomes of children aged 18 months who had abnormal umbilical artery resistance indices (UmA-RI), as a marker of placental insufficiency, with a comparator group of children with normal UmA-RI during pregnancy, as mediated by maternal HIV infection. The cross-sectional study included 271 children, grouped into four subgroups based on HIV exposure and history of normal/abnormal UmA-RI, using available pregnancy and birth information. Standard procedures were followed to collect anthropometric data, and z-scores computed as per World Health Organization growth standards. Lower length-for-age z-scores (LAZ) were observed in children who were HIV-exposed-uninfected (CHEU) (−0.71 ± 1.23; p = 0.004) and who had abnormal UmA-RI findings (−0.68 ± 1.53; p < 0.001). CHEU with abnormal UmA-RI had lower LAZ (−1.3 ± 1.3; p < 0.001) and weight-for-age z-scores (WAZ) (−0.64 ± 0.92; p = 0.014) compared to the control group. The prevalence of stunting was 40.0% in CHEU with abnormal UmA-RI and 16.0% in CHEU with normal UmA-RI (p < 0.001; p = 0.016, respectively). In conclusion, maternal HIV exposure and placental insufficiency are independent risk factors for childhood stunting, with this risk potentiated when these two risk factors overlap.

Undernutrition in children remains a public health concern. Despite the global efforts to address undernutrition, Lesotho continues to bear the highest burden of childhood undernutrition. The study assessed the anthropometric measurements and dietary intake of children aged 6–24 months. A descriptive cross‐sectional study was conducted among 113 mother–child dyads attending clinic visits at Makoanyane Military Hospital (Maseru district); n = 50 and Motebang Hospital (Leribe district); n = 63. A structured sociodemographic and feeding practices questionnaires based on adapted World Health Organization (WHO) questionnaires were used. The usual food consumption was collected using an unquantified food frequency questionnaire. Anthropometric measurements and z scores computation were done as per WHO standard guidelines. Statistics included percentages for categorical variables and means for continuous variables. The percentage of continued breastfeeding was 54.0% in Maseru and 28.6% in Leribe districts. Complementary feeds were introduced at the mean age of 5.3 ± 1.0 (Maseru) and 5.2 ± 1.3 months (Leribe). In Leribe, 84.1% of children were consuming maize porridge every day while in Maseru, 68.0% of children were consuming commercial baby cereal every day. The prevalence of wasting was 10.0% (Maseru) and 20.6% with 14.3% of severe wasting (Leribe). A higher percentage of stunting was observed in Leribe (36.5%) than in Maseru (20.0%) (p < 0.001). The prevalence of moderate and severe stunting was 8.0% and 12.0% in Maseru and 20.6% and 15.9% in Leribe, respectively. The prevalence of stunting is alarmingly high in Leribe. The findings suggest an urgent need to strengthen maternal and child health and nutrition programs to ameliorate feeding practices and nutritional status.

While climate change will impact all aspects of the food system, it is not clear how it will influence the risk of famine: situations of extreme starvation

Breastfeeding is lifesaving against child malnutrition, yet exclusive breastfeeding (EBF) rates remain low, particularly among mothers with HIV. We compared the prevalence of EBF between mothers with and without HIV and explored factors associated with breastfeeding. A cross-sectional design was used to investigate 151 mother-child dyads; mothers with HIV (n = 73) and without HIV: (n = 78). Structured and previously used questionnaire was used to collect sociodemographic and breastfeeding practices data of mothers of children aged 6-12 months, during routine postnatal care at selected primary healthcare facilities in Maseru. All mothers had similar sociodemographic characteristics, with EBF prevalence of 40.4%. Mothers with HIV had lower rates of EBF than their counterparts (28.8% vs. 51.3%, p = 0.005), despite 98.6% achieving viral suppression. Most mothers with HIV introduced complementary feeding as early as 1-3 months (19.2% vs. 9.0%) and above half of them started giving solid foods from 4-5 months (52.1% vs. 39.7%); p = 0.012). Above a quarter of all mothers received EBF support from healthcare facility, spouse and other family members. Only 40.4% of mothers were encouraged to EBF, while 70.9% believed that breastmilk is sufficient during first six months, and a strong positive correlation was found between EBF and mothers' beliefs (mother with HIV: r = 0.5, p < 0.001; mothers without HIV, r = 0.4; p = 0.001). Despite ongoing efforts to promote breastfeeding among mothers with HIV, EBF rates remain low, regardless suppressed viral loads. The belief in breastmilk adequacy during first six months was a key determinant of EBF, underscoring need for targeted education on breastmilk composition and sufficiency.

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 0.05) 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.