Infant-feeding practices of HIV-positive mothers in the south west region of Cameroon

Abstract

Prevention of Mother to Child Transmission (PMTCT) of HIV is of great importance, because vertical transmission, including breastfeeding, accounts for the majority of pediatric HIV infections. Appropriate infant feeding methods which are affordable, feasible, acceptable, safe and sustainable are therefore crucial to the healthy HIV-free survival of HIV exposed infants. This study aimed at determining the proportions of mothers practising the various feeding methods, determining the various factors influencing these feeding methods, and ascertaining the relationship between these factors and the chosen feeding modes. A cross-sectional observational study was carried out from April 2012 to July 2012; using structured questionnaires administered to one hundred and ten HIV positive mothers attending infant welfare clinics. Exclusive Breastfeeding (EBF) was found to be the predominant mode of feeding chosen (70%), followed by Replacement Feeding (RF) and Mixed Feeding (MF), each representing 15%. EBF and RF practices were highly influenced by mother’s personal choice and secondly, the Health Care Provider (HCP). Choosing EBF during Antenatal Care (ANC) and being married were the main predictors of EBF. RF was associated with disclosure of HIV status to partner. MF commonly resulted from ignorance, financial difficulties and fear of stigmatization. Predictors of MF included maternal age ≤25, having an unemployed partner, non-disclosure of HIV status to family, attending ANC at Health Centre, choosing RF during ANC, and not receiving Anti-retroviral drugs during pregnancy. EBF was the most common mode of feeding, as most mothers stuck to their informed safe choices, despite the fact that good feeding practices were being challenged by social stigma. To discourage unsafe feeding practices, much needs to be done to fight stigmatization amongst HIV-infected mothers, which includes encouraging them to disclose their HIV statuses to close family partner(s), while encouraging comprehensive antenatal care.