Abstract
BackgroundGlobally, exclusive breastfeeding prevents 1.3 million child deaths and has an added benefit for people living with the Human Immune Deficiency Virus (HIV) by preventing mother-to-child transmission of HIV. However, literature is scarce in Ethiopia; therefore this study aimed to assess the rate of continuous exclusive breastfeeding from the end of the first week to 6 months of age, among HIV exposed infants (aged 7–20 months) who were followed up in government hospitals of North Gondar Zone, Ethiopia, and associated factors.MethodsAn institutional based cross-sectional study was conducted from February 21 to March 30, 2016. All mother-child pairs (367) attending the chronic HIV care clinic in government hospitals of North Gondar Zone were included in the study. Exclusive breastfeeding was defined as the practice of feeding only breast milk (including expressed breast milk) during the first 6 months and no other liquids and solid foods except medications. However since prelacteal feeding is a deep rooted norm in the study setting, we report continuous exclusive breastfeeding from the end of first week to 6 months of age of infants, ignoring all prelacteal feeding offered at birth. A binary multivariable logistic regression analysis was employed to identify factors associated with exclusive breastfeeding.ResultsThe overall prevalence of continuous exclusive breastfeeding among HIV exposed infants was 86.4%. According to the multivariable analysis; breastfeeding counseling (Adjusted Odds Ratio [AOR] = 5.1, 95% Confidence Interval [CI] 1.4, 18.2), breastfeeding support (AOR = 3.7, 95% CI 1.3, 10.5), and not experiencing obstetric problems (AOR = 3.4, 95% CI: 1.3, 8.8) were associated with higher odds of continuous breastfeeding.ConclusionsIn this study, most HIV exposed infants were continuously breastfed from the end of first week to 6 months of age. Breastfeeding counseling, breastfeeding support and experiencing obstetric problems were identified as significant determinants of continuous breastfeeding. Therefore, breastfeeding counseling and support should be strengthened to improve the coverage of optimal exclusive breastfeeding practice. Moreover, prompt diagnosis and treatment of obstetric problems should be initiated.
Highlights
Exclusive breastfeeding prevents 1.3 million child deaths and has an added benefit for people living with the Human Immune Deficiency Virus (HIV) by preventing mother-to-child transmission of HIV
All (100%) of the HIV infected children were from mothers who did not receive any breastfeeding support and gave birth virginally
A higher proportion of HIV infection was noted among children who were given prelacteal feeds, whose mothers were illiterate (71.4%) and who experienced an obstetric problem (57.1%) (Table 3)
Summary
Exclusive breastfeeding prevents 1.3 million child deaths and has an added benefit for people living with the Human Immune Deficiency Virus (HIV) by preventing mother-to-child transmission of HIV. Mindful of the growing evidence supporting the benefits of EBF, the WHO recommends HIV positive mothers to exclusively breastfed their infant’s for 6 months, and to take antiretroviral drugs throughout the breastfeeding period and until the child is 12 months of age, to reduce the risk of HIV transmission [6,7,8,9]. In spite of this fact, not exclusively breastfeeding continues as a global public health problem, and only 39% of infants are exclusively breastfed [10, 11]. The prevalence of exclusive breastfeeding in Southern Ethiopia is even lower than the national average of 48% [7]
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