Abstract
BackgroundDespite enormous interventions aimed at preventing mother-to-child transmission (MTCT) of HIV, cultural practices on mixed infant feeding remain prevalent. Complementary food provision to infants seems to be the most common and acceptable form of infant feeding highly endorsed by grandmothers.AimThis study aimed to explore the perceptions of grandmothers and HIV-infected mothers on infant feeding practices in the context of prevention of mother-to-child transmission.SettingThis study was undertaken in two primary healthcare facilities in the Mpumalanga province, South Africa.MethodsA qualitative exploratory narrative design was used to conduct four focus group discussions with 32 purposefully selected grandmothers and 21 in-depth interviews with postnatal HIV-infected women in the two identified health facilities. Data were analysed using an interthematic inductive analysis approach, resulting in major themes and subthemes supported by participants’ excerpts.ResultsFour themes emerged showing (1) high mixed feeding endorsement because of the need to adhere to conventional practices, strengthen the umbilicus and have fuller, fat and calmer babies; (2) infant feeding fallacies and stigma reflected by exclusive breastfeeding period confusion, breastfeeding scepticism and infant feeding stigma; (3) breastfeeding endorsement for other disease prevention and family support for breastfeeding and (4) conflict between traditional and western infant feeding approaches.ConclusionTotal elimination of MTCT of HIV in a rural context calls for targeted education for grandmothers addressing their perceptions and practices of infant feeding. The knowledge of the identified factors encouraging mixed infant feeding can assist in designing programmes to change community beliefs on infant feeding. Cultural, social and psychosocial factors should be addressed when making recommendations for exclusive breastfeeding for HIV-positive mothers.
Highlights
Exclusive breastfeeding is an essential strategy for safeguarding childrens’ survival and good health, whilst benefiting the mothers, irrespective of their HIV status (Mulol & Coutsoudis 2016; Oiye et al 2017; WHO/UNICEF 2014)
South Africa is amongst the 22 countries that have pledged to eliminate mother-to-child transmission (MTCT) of HIV by utilising the prevention of mother-to-child transmission (PMTCT) Option B+, which supports the provision of lifelong antiretroviral therapy to HIV-positive pregnant and lactating women without considering their CD4 count and infant feeding method of choice (Goga et al 2018; WHO and United Nations Children’s Fund 2016)
This study is a subsection of the PhD study conducted in 2011 exploring the ‘intersecting narratives of PMTCT among HIV positive women, grandmothers and healthcare providers in a rural South African district’ (Mlambo 2014)
Summary
Exclusive breastfeeding is an essential strategy for safeguarding childrens’ survival and good health, whilst benefiting the mothers, irrespective of their HIV status (Mulol & Coutsoudis 2016; Oiye et al 2017; WHO/UNICEF 2014). Exclusive breastfeeding for the first 6 months is the most appropriate infant feeding method for both HIV-positive and HIV-negative mothers (National Department of Health, Statistics South Africa, South African Medical Research Council, and ICF 2019; World Health Organization, United Nations Children’s Fund 2016). The benefits of exclusive breastfeeding for the first 6 months is that it lowers HIV transmission risk as compared to mixed infant feeding (World Health Organization, United Nations Children’s Fund 2016). South Africa is amongst the 22 countries that have pledged to eliminate mother-to-child transmission (MTCT) of HIV by utilising the prevention of mother-to-child transmission (PMTCT) Option B+, which supports the provision of lifelong antiretroviral therapy to HIV-positive pregnant and lactating women without considering their CD4 count and infant feeding method of choice (Goga et al 2018; WHO and United Nations Children’s Fund 2016). Complementary food provision to infants seems to be the most common and acceptable form of infant feeding highly endorsed by grandmothers
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
