Abstract
BackgroundHIV-positive mothers are likely to exclusively breastfeed if they perceive exclusive breastfeeding (EBF) beneficial to them and their infants. Nevertheless, very little is known in Malawi about HIV-positive mothers’ perceptions regarding EBF. In order to effectively promote EBF among these mothers, it is important to first understand their perceptions on benefits of exclusive breastfeeding. This study therefore, explored maternal and health care workers’ perceptions of the effects of exclusive breastfeeding on HIV-positive mothers’ health and that of their infants.MethodsThis was a qualitative study within a larger project. Face-to-face in-depth interviews and focus group discussions using a semi- structured interview and focus group guide were conducted. Sixteen HIV-positive breastfeeding mothers, between 18 and 35 years old, were interviewed and data saturation was achieved. Two focus group discussions (FGDs) comprising of five and six adult women of unknown HIV status who were personal assistants to maternity patients, and one FGD with five nurse-midwives working in the maternity wards of Queen Elizabeth Central Hospital in Blantyre, Malawi, were also conducted. Thematic content data analysis was utilized.ResultsThe study revealed more positive than negative perceived effects of exclusive breastfeeding. However, the fear of transmitting HIV to infants through breast milk featured strongly in the study participants’ reports including those of the nurse-midwives. Only one nurse-midwife and a few HIV-positive mothers believed that EBF prevents mother-to-child transmission of HIV. Furthermore, participants, especially the HIV-positive mothers felt that exclusive breastfeeding leads to maternal ill- health and would accelerate their progression to full blown AIDS.ConclusionWhile most participants considered exclusive breastfeeding as an important component of the wellbeing of their infants’ health, they did not share the worldwide acknowledged benefits of exclusive breastfeeding in the prevention of mother-to-child transmission (PMTCT) of HIV. These results suggest a need for more breastfeeding education for all mothers, communities and nurse-midwives involved in breastfeeding counseling in the context of HIV infection. Maternal wellbeing promotion activities such as nutrition supplementation need to be included in all PMTCT of HIV programs.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2393-14-247) contains supplementary material, which is available to authorized users.
Highlights
HIV-positive mothers are likely to exclusively breastfeed if they perceive exclusive breastfeeding (EBF) beneficial to them and their infants
One focus group (FG) comprised of five female nurse-midwives who had been working in Chatinkha maternity wards for two and half to four years participated in the study
The same demographic health survey shows that 86% of women and 78% of men in Malawi know that the risk of mother-to-child transmission (MTCT) of HIV can be reduced if the mother takes anti-retro viral therapy (ART) during pregnancy
Summary
HIV-positive mothers are likely to exclusively breastfeed if they perceive exclusive breastfeeding (EBF) beneficial to them and their infants. This study explored maternal and health care workers’ perceptions of the effects of exclusive breastfeeding on HIV-positive mothers’ health and that of their infants. Breast milk provides optimal nutrition, contains antibodies that protect infants from infection, and is unlikely to become contaminated [1,2,3] These positive outcomes are more likely when exclusive breastfeeding is practiced [1]. In Malawi, the prevalence of diarrhea among children who are less than five years of age is 18%. For children who are less than two years of age the prevalence is almost double at 33% [5] Most of such childhood diarrhea and subsequently deaths, could be prevented by exclusive breastfeeding [1,3,6]
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