Abstract
BackgroundExclusive breastfeeding (EBF) (breast milk feeding without additional food or drink, except medicine) is associated with deceased risk of postnatal transmission of HIV from mother to child.MethodsThis analysis used data from a household survey in Western Kenya in 2011. Participants were mothers with HIV and uninfected mothers, aged ≥14 years who gave birth in the prior year (ever breastfed) within the Kenya Medical Research Institute/US Centers for Disease Control and Prevention (KEMRI/CDC) Health and Demographic Surveillance System. Data on breastfeeding counseling and knowledge and practices regarding breastfeeding were collected. Rates and correlates of EBF were determined using multivariable logistic regression.ResultsOf 652 mothers enrolled in the study, 435 were included in this analysis. Median age was 28 years among 154 mothers with HIV and 25 years among 281 uninfected mothers. Mothers with HIV were more likely than uninfected mothers to report breastfeeding counseling at a health facility (88.9% vs. 51.6%, respectively, p < 0.001) and EBF for 6-months (64.9% versus 34.5%, p < 0.001). Premastication (pre-chewing of food by adults prior to feeding to children) was less prevalent among mothers with HIV (3.9% vs. 13.2% p = 0.001) who were also more knowledgeable about potential risk of HIV transmission through premastication (83.1% vs 71.2% p = 0.005). Mothers with HIV who EBF for six months were 3.68-fold more likely to report counseling on EBF (aOR 3.68; 95% CI: 1.00,13.70). Uninfected mothers with polygamous marriage, any antenatal care visit, unskilled delivery and delayed breastfeeding initiation (> 1 h) were less likely to practice EBF for six months 62% (aOR 0.38; 95%CI: 0.20,0.94), 72% (aOR 0.28; 95%CI: 0.10,1.00), 54% (aOR 0.46; 95% CI: 0.22,1.00) and 46% (aOR 0.54; 95%CI: 0.30,1.00) respectively.ConclusionsMothers with HIV were more likely to report breastfeeding counseling at a health facility, EBF for six months and less likely to practice premastication than uninfected mothers. Lessons learned from breastfeeding counseling in mothers with HIV could be used to improve awareness and change breastfeeding practices for all mothers.
Highlights
Exclusive breastfeeding (EBF) is associated with deceased risk of postnatal transmission of Human immunodeficiency virus (HIV) from mother to child
We determined EBF practices and breastfeeding counseling among mothers living in a health and demographic surveillance community in rural western Kenya and compared practices among mothers who have HIV and uninfected mothers. This was a secondary analysis utilizing data from a cross-sectional community level survey on knowledge and uptake of prevention of mother-to-child HIV transmission (PMTCT) services among mothers of child-bearing age conducted between March – June, 2011 in rural Western Kenya
We conducted a community level survey assessing barriers to antenatal care and PMTCT service utilization among mothers with HIV and uninfected mothers, aged ≥14 years who had delivered in the previous year within the Kenya Medical Research Institute (KEMRI)/Centers for Disease Control and Prevention (CDC) Health and Demographic Surveillance System (KEMRI/ CDC Health and demographic surveillance system (HDSS)) area in Siaya county, Western Kenya
Summary
Exclusive breastfeeding (EBF) (breast milk feeding without additional food or drink, except medicine) is associated with deceased risk of postnatal transmission of HIV from mother to child. As a global public health recommendation, infants should be exclusively breastfed (fed on breast milk without any additional food or drink, not even water, with the exception of medicine) for the first six months of life [2]. The World Health Organization (WHO) has recommended that mothers with HIV in settings where replacement feeding is not acceptable and safe, should exclusively breastfeed in the first six months of life followed by safe and appropriate complementary foods [4]. Most Kenyan mothers (99%) breastfeed their children but only 42% breastfeed exclusively for four to five months [9] and breastfeeding continues to contribute to mother-to-child HIV transmission (MTCT) [10]. Mothers can decrease the risk of transmitting HIV to their children if they are on combination antiretroviral treatment (ART) and exclusively breastfeed their infants [4]
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