Adherence to feeding guidelines among HIV-infected and HIV-uninfected mothers in a rural district in Uganda

Abstract

To describe the infant feeding behaviour of HIV-infected and HIV-uninfected mothers, and identify factors influencing adherence to infant feeding guidelines. Analytical cross-sectional study. Bushenyi, rural district in South-western Uganda One hundred and ninety four mothers who had a child less than 12 months of age. About half, 94 (48.5%), of these were HIV-infected. Proportion of mothers who exclusively breastfed, complementary fed, replacement fed, and adhered to feeding guidelines. Most (84.5%, 164/194) of the mothers had ever breastfed their infants, the rest had exclusively replacement fed since birth. Among children less than six months who were breastfeeding, 31.5% (34/108) were exclusively breastfeeding and the rest were mixed feeding. HIV-infected mothers were more likely than HIV-uninfected mothers to exclusively breastfeed (Crude Odds Ratio [COR], 3.61, 95% Confidence Interval [CI] 1.42-9.21). For infants older than six months, complementary feeding was more common among HIV-uninfected (100%) than HIV-infected mothers (41.7%; P < 0.001). Among infants of all ages, none of the HIV-uninfected and 45% of HIV-infected mothers were replacement feeding (p < 0.001). More than a half (59.8%) of the mothers adhered to infant feeding guidelines. The only independent predictor of adherence after multivariate analysis was mother ever attending infant feeding counselling (AOR 9.03; 95% CI 4.03-20.25). Only 35% of mothers reported ever attending infant feeding counselling. Infant feeding counselling was associated with improved adherence to feeding guidelines. Since infant feeding counselling is low in this population there is need for scale-up of this essential service.