Puleng

Puleng was diagnosed with HIV while pregnant with her first child. As she was diagnosed late in her pregnancy, breastfeeding was not an option at the time. When she was trying for her second baby, her healthcare team told her that breastfeeding could be an option this time. Puleng chose to breastfeed her youngest child and enjoyed the experience.

Puleng was diagnosed with HIV late during her first pregnancy in 2017, after migrating to the UK from southern Africa. Puleng was heartbroke when she learned her diagnosis. Since she was diagnosed during her third trimester and had a high viral load, Puleng was advised to have a caesarean section and formula feed. Puleng’s husband does not have HIV himself and knows about her HIV status, as do a small number of loved ones.

When Puleng was pregnant with her second child, she decided to breastfeed as it was what she had seen growing up. Puleng found the infant feeding advice quite strict and restrictive, but she did feel supported by her medical team and while she was pregnant. Her HIV doctor had kept her informed about latest HIV and breastfeeding studies, although Puleng wishes that there was more research conducted in high income countries on this topic.

When she was on the maternity ward, Puleng felt bullied and not listened to, and she does not know if this was because of her HIV status, race, nationality or all three. Puleng felt isolated on the maternity ward as her husband could not be with her, as he had to care for their eldest child.

Puleng enjoyed breastfeeding and found it difficult to stop. She stopped when her baby was eight months old because she could see him pinin for solid food. Mixed feeding is not advised and Puleng knew she would have to stop breastfeeding once her baby started eating solids. Puleng loved every secon of breastfeeding. She believes she bonded quicker with her second child than her first, and felt she missed this opportunity with her first child. However, she found it difficult to see her baby have regular blood tests.

Puleng had been diagnosed late during her previous pregnancy. She had a caesarean section delivery, and formula fed her baby. However, after this pregnancy she had the chance to breastfeed (played by an actor).

Age at interview 29

Age at diagnosis 25

I had a really smooth ride. That’s why having to stop was so difficult because I was really enjoying it. To be honest with you, I was only meant to stop at six months, but I carried on, so I delayed introducing complementary foods to him. I think I stopped breastfeeding somewhere near around eight months, I think.

If I decided to give him food I needed to stop, that was it. I can’t give him food and then go back to breastfeeding. It needed to just, okay once it’s reached the normal breast, something like that. It had to be one or the other and once food was introduced, I could not go back to breastfeeding.

I did not want to stop breastfeeding first and foremost, but he was pining for food, like he’d see food on a plate, and he’d pine for it. So I have a sense of guilt, you know, that I was because I mean it was time, he was six months and he was a big boy so he really, was really interested in trying, you know, foods off a plate, you know, so I would let him try, I would let him nibble once in a while but yeah I’d let him nibble against advice of my doctor so yeah, yeah I did that.

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Puleng found that breastfeeding helped her connect quickly with her baby.

Age at interview 29

Age at diagnosis 25

When I compare the two experiences, I was better, I don’t know how to put it, but I bonded better and quicker with my son than I did with my daughter.

Oh, I loved breastfeeding, I loved it. I loved every second of it. I did not find it difficult; I mean, at times it was demanding but I really, it, I just loved every second of it to be honest, you know, I did not find it challenging. I had enough breast milk supply at all times, you know, I loved it and my son loved it too.

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Puleng felt the UK BHIVA guidelines seemed to be based more around the availability of clean water (to mix formula milk), than the actual risk of transmission via breastmilk (played by an actor).

Age at interview 29

Age at diagnosis 25

Although, the rationale was that in Africa there’s less cleaner waters so it’s much more safer to breastfeed than to bottle feed. So, I was like, “is it because of water or is it because the risks of transmission is low anyway?” so I was like, “Can I not still, even though there’s no risk of, you know, even though there’s clean water available-?”

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Puleng felt alone and bullied during her childbirth and wonders if her race, nationality and HIV status impacted how she was treated.

Age at interview 29

Age at diagnosis 25

When I was giving birth, I felt a bit bullied during the whole time and I wish I’d spoken up for myself, but I had no support, I had nobody backing me. I had a room full of professionals giving their opinions, others prescribing what needed to happen. I felt like I wasn’t consulted, I was just told. I don’t know if it’s because I’m a woman of colour. I don’t know if it’s because I am not of a British background. I don’t know if it’s because of my diagnosis but I felt kind of bullied at some point during my labour.

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