Infant feeding practice and associated factors of HIV positive mothers attending prevention of mother to child transmission and antiretroviral therapy clinics in Gondar Town health institutions, Northwest Ethiopia

Abstract

BackgroundIt has been estimated that 430,000 children under 15 years of age were newly infected with HIV in 2008, and more than 71% are living in sub-Saharan Africa. In the absence of intervention to prevent mother-to-child transmission, 30-45% of infants born to HIV-positive mothers in developing countries become infected during pregnancy, delivery and breastfeeding. The aim of this study was to assess infant feeding practice and associated factors of HIV positive mothers attending prevention of mother to child transmission and antiretroviral therapy clinics of Northwest Ethiopia.MethodsInstitution based cross sectional study was conducted from January to May 2011 among all HIV positive mothers with less than two years old child attending prevention of mother to child transmission and antiretroviral therapy clinics in Gondar Town health institutions. A structured pre-tested questionnaire using interview technique was used for data collection. The data was entered and analyzed using SPSS version 16 statistical package.ResultsA total of 209 HIV positive mothers were included in the study. Of these, 187 (89.5%) had followed the recommended way of infant feeding practice while significant percentage (10.5%) had practiced mixed breast feeding. In multivariate analysis, disclosure of HIV status with their spouse, insufficient breast milk and occupational status were found to be independently associated (p-value of < 0.05) with recommended infant feeding practice. Lack of resource, stigma of HIV/AIDS, and husband opposition were also obtained as factors that influenced choice of infant feeding options by respondents.ConclusionsHigher proportion of respondents used the recommended way of infant feeding practice by WHO as well as by Ethiopian Ministry of Health. However, mixed feeding in the first 6 months of age, an undesirable practice in infant feeding, were reported in this study. Infant feeding education that is aligned to national policy should be strengthened in primary health care, particularly in situations where prevention of mother to child transmission of HIV is prioritized.

Comparison of infant-feeding practices in two health subdistricts with different baby-friendly status in Mpumalanga province

“…This perception of a mother not having sufficient milk supply to sustain the infant's growth and development was also given by mothers as the primary reason for the early discontinuation of breastfeeding. This is similar to the findings of several studies, 48,49,54,58 confirming that the perception of a mother's milk supply to be insufficient is a common challenge with regards to sustaining exclusive breastfeeding. Community health care workers could play a significant role in overcoming this perception, through providing support to mothers to improve and sustain milk supply.…”

“…Lack of resources, stigma of HIV/AIDS and husband opposition were reported as factors that influenced choice of infant feeding. 48 Although breastfeeding seems to be the infant feeding option of choice to most mothers, EBF is still the exception.…”

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“…The proportion of mixed feeding in this study was 6.3% which is lower than a study done in Ghana (40%), Lusaka(24.1%) and India (29%) [17][18][19] and also study report in Addis Ababa, Ethiopia (15%), Gondar, Ethiopia (10.5%) [12,20]. This might be indicating that the effectiveness of new PMTCT programs.…”

“…A study report from Addis Ababa the proportion of practicing exclusive breast feeding in 2008(30.6%) was comparatively lower than from this study [12]. This might be due to change in guide line the Ethiopian Ministry of Health guideline on infant feeding recommendations of HIV exposed infants recommends exclusive breast feeding for the first 6 months and introducing complementary feeding at 6 months and continues breastfeeding until 12-18 months [9] and Gondar (83.8%) had almost comparable with this study, this might be due to they are using the same PMTCT guide lines [20].…”

“…These finding was lower than compared to a study done in South Africa(60%) of the HIV positive mothers practiced exclusive replacement feeding [21].This might be most of the mothers had low socio economic status so that cannot afford to buy the formula food & they are difference national PMTCT guide lines. The proportion of ERF was also lower than study conducted in Addis Ababa 46.8%, Ethiopia it might due to difference in infant feeding recommendations [12].And comparable with Gondar 5.7%, Ethiopia it might be due to using the same guidelines [20].…”