Acceptability, feasibility and affordability of infant feeding options for HIV‐infected women: a qualitative study in south‐west Nigeria

Abstract

The objective of this study was to explore the acceptability, feasibility, affordability, safety and sustainability of replacement feeding options for HIV-infected mothers in Ile-Ife, in south-west Nigeria. Six focus group discussions were conducted with a purposive sample of mothers, fathers and grandmothers. The HIV status of all participants was unknown to investigators. All text data were analysed using the Text-based Beta Software program. With regard to the acceptability of replacement feeds, respondents perceived the stigma associated with not breastfeeding to be an important consideration. In this community, breastfeeding is the norm--even though it is not necessarily exclusive. For infected mothers who choose to breastfeed exclusively and then to wean their infants before 6 months of age, respondents did not anticipate early cessation of breastfeeding to be problematic. Respondents noted that acceptable replacement foods included infant formula, soy milk and cow's milk. Barriers to replacement feeding that were mentioned included: the high costs of replacement foods and fuel for cooking; an unreliable supply of electrical power; poor access to safe water; and poor access to storage facilities. The research confirms the difficulty of replacement feeding for HIV-infected mothers in sub-Saharan Africa. The results also provide the basis for new issues and hypothesis for future research in other communities with similar socio-cultural and economic characteristics.

Breastfeeding profile and practice of Nigerian mothers: a cross-sectional survey

“…69 Water supplementation of breastfeeding is deeply engrained in Africa, as most infants are given water from birth, in part due to cultural perceptions that infants need water to survive. 70 Similar to the finding of this study, Scariati et al 71 submitted that water supplementation of neonates was a prevalent practice among a cohort of US women.…”

Barriers to the practice of exclusive breastfeeding among HIV-positive mothers in sub-Saharan Africa: A Scoping Review of counselling, socioeconomic and cultural factors

“…Furthermore, mixed feeding is adopted in some instances when colic is associated with hunger and inadequate breast milk (Thairu et al, 2005;Webb-Girard et al, 2012;Madiba et al, 2013). In some parts of Nigeria and Uganda however, breast milk is considered food, however water is considered a necessary supplement (Abiona et al, 2006;Fadnes et al, 2010). There were similar findings in Kenya where water is considered as "necessary for life" (Webb-Girard et al, 2012).…”

“…In Nigeria, participants in one study believed that HIV-positive mothers might be too ill to breastfeed exclusively (Abiona et al, 2006). Studies from South Africa, Malawi and Kenya, also suggest that many women will practice mixed feeding with solids or semi-solid foods because they do not consider breast milk to be food and therefore question its nutritional value (Buskens et al, 2007;Wachira et al, 2009;Mataya et al, 2013).…”

“…When mothers perceive their breast milk as "poisonous" due to HIV infection, they wean their infants early postpartum, believing that such a practice would minimize infant exposure to HIV (Thairu et al, 2005;Koricho et al, 2010;Maman et al, 2012). However, a study from Nigeria revealed a contrary finding: mothers chose EFF not for fear of HIV transmission, but because of the desire to be identified among the upper socio-economic class who could afford infant formula (Abiona et al, 2006).…”

HIV and Lactation

“…It was found that barriers to replacement feeding (instead of breastfeeding) included: the high cost of replacement feeds and fuel for cooking; unreliable supply of electricity; poor access to safe water, and poor access to storage facilities [49] .…”