ORIGINAL ARTICLE Maternal recall of exclusive breast feeding duration

Background: Both the pattern and duration of breast feeding are important determinants of health out-comes. In vertical HIV transmission research, reliable documentation of early breast feeding practices is important in order to correctly attribute postnatal transmission to feeding pattern. Aims: To validate methods of collecting data on the duration of exclusive breast feeding (EBF) in an area of South Africa with a high HIV prevalence rate. Methods: A total of 130 mothers were interviewed weekly, postnatally. At every interview a 48 hour and a seven day recall breast feeding history were taken. A subset of 70 mothers also received two intermediate visits per week during which additional 48 hour, non-overlapping, recall interviews were conducted. Ninety three infants were revisited at 6–9 months of age when mothers ’ recall of EBF dura-tion from birth was documented. The different methods of recalling EBF status were compared against an a priori “best comparison ” in each case. Results: Reported breast feeding practices over the previous 48 hours did not reflect EBF practices since birth (specificity 65–89%; positive predictive value 31–48%). Six month EBF duration recall was equally poor (sensitivity at 2 weeks 79%; specificity 40%). Seven day recall accurately reflected EBF practices compared with thrice weekly recall over the same time period (sensitivity 96%, specificit