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

Al-Mujtaba, Maryam; Sam-Agudu, Nadia A.; Khatri, Rosemary

doi:10.5897/jahr2015.0353

Cited by 19 publications

(11 citation statements)

References 55 publications

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“…In the literature, the EBF among HIV infected mothers is affected by inadequate counselling on EBF practice [ 21 , 22 ], cultural and family influence [ 21 , 23 ], socio-economic factors [ 23 ],fear of stigmatization [ 22 , 23 ], maternal lack of decision power [ 21 ] and fear of vertical transmission of HIV to infant [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Exclusive breastfeeding practice among HIV infected mothers in the southern highlands of Tanzania; assessing the prevalence and factors associated with the practice, an analytical cross-sectional survey

Faustine

Moshi

2022

AIDS Res Ther

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Background There is no other better way to safeguard an infant’s health in the first 6 months of life than exclusive breastfeeding (EBF). Breast milk is valuable in all aspects of an infant’s physical and mental growth as well as immune development. The study aimed to assess the prevalence and factors associated with EBF practice among HIV-infected mothers in the Southern Highlands of Tanzania. Method A hospital-based analytical cross-sectional study was conducted among lactating HIV-infected mothers. A random sampling procedure was used to obtain 372 HIV-infected mothers of infants from 6 to 12 months of age who were still breastfeeding at the time of data collection. An interviewer-administered structured questionnaire was used for data collection. Bivariate and multivariable logistic regression was used to assess factors associated with EBF practice. Statistical package for social science (SPSS volume 20) software was used for data entry and analysis. Results The prevalence of EBF practice was 58.1% at 95% Confidence Interval of 52.9% to 63.1%. More than half of the respondents 199 (53.5%) had adequate knowledge while 173(46.5%) had inadequate knowledge about EBF. After adjusting for confounders, factors associated with EBF practice were knowledge about EBF [Adequate knowledge (AOR = 5.11 at 95% CI 3.2–8.17, p < 0.001)], ANC visits [Adequate (AOR = 1.76 at 95% CI 1.09–2.82, p = 0.002)], Income per day [1 0r more USD (AOR = 1.83 at 95% CI 1.14–2.94, p = 0.013)], positive perception of EBF [ positive perception (AOR = 3.51 at 95% CI 2.25–5.47, p < 0.001) and having ever experienced a breast problem AOR = 3.91 at 95% CI 1.89–8.08, p < 0.001. Conclusion More than half of interviewed mothers with HIV practiced EBF. The EBF practice among HIV lactating mothers was significantly influenced by adequate knowledge of EBF, positive perception toward EBF, adequate ANC visits, and having never experienced breast problems. Strengthening adherence to ANC routine visits, counseling on breastfeeding, and improving mothers’ knowledge about exclusive breastfeeding would contribute to the enhancement of EBF practice in this region. An innovative interventional study is recommended to develop more effective strategies to improve EBF knowledge and practice among HIV-infected mothers.

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Section: Introductionmentioning

confidence: 99%

Exclusive breastfeeding practice among HIV infected mothers in the southern highlands of Tanzania; assessing the prevalence and factors associated with the practice, an analytical cross-sectional survey

Faustine

Moshi

2022

AIDS Res Ther

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“…58 A few studies investigated ART exposure and its effect on the health of mothers and the growth of their infants (n = 4; 9.5%). 8,9,61,78 ART exposure appeared to increase infant mortality and negatively affect neurodevelopment in breastfed HE infants, 6 and some studies reported growth deficits in HI and HE infants receiving ART, when compared with the growth of HU infants. Further research investigating the long-term influence of ART on the neurodevelopment of breastfeeding HI and HE infants would be valuable.…”

Section: Hi and He Infant Growth And Developmentmentioning

confidence: 99%

“…64,73,81,83 Additional social factors we found that should be considered by health care professionals were the fear of EBF practice and the feeding practices and beliefs of significant others, for example, replacement mothers' and partners' adherence to EBF. 8 Facilitators to maternal knowledge, attitudes, and practices regarding breastfeeding did not feature predominantly in the reviewed literature. The few facilitators found were social and familial support, economic independence, and material resources.…”

Section: Barriers and Facilitators To Feeding Decisionsmentioning

confidence: 99%

“…Environmental risks, related to low socioeconomic statuses of many families in SSA, include poverty, food insecurity, and malnutrition, making infants exposed to HIV more susceptible to contracting the virus. 8 Breastfeeding difficulties are further exacerbated by mothers' HIV symptoms, and the potential lack of family and maternal education. 9,10 The combination of these factors, together with possible postpartum depression and psychosocial distress, may negatively affect breastfeeding outcomes of HI and HE infants and their mothers.…”

mentioning

confidence: 99%

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Breastfeeding Outcomes and Associated Risks in HIV-Infected and HIV-Exposed Infants: A Systematic Review

Eccles

Toit

Jongh

et al. 2022

Breastfeeding Medicine

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Purpose: To critically appraise recent literature regarding breastfeeding outcomes and associated risks in HIV-infected (HI) and HIV-exposed (HE) infants, using the AU2 c PRISMA-P statement guidelines. Materials and Methods: Five electronic databases were systematically searched to obtain English publications from the last 10 years (2010-2020), pertaining to breastfeeding outcomes and associated risks of HI and HE infants and children. Gray literature sources were also included. Data were extracted according to various data items and were synthesized using thematic synthesis. Results: Of the initial 7,151 sources identified, 42 articles were eligible for final inclusion. The final selection included 19 cohort studies and 2 expert committee reports, classified as gray literature. The remaining 21 studies comprised case-control, cross-sectional, and randomized controlled trial studies. The following themes were identified: breastfeeding outcomes in HI and HE infants, risks for suboptimal breastfeeding, HI and HE infant growth and developmental outcomes, and barriers and facilitators to feeding decisions. Most studies highlighted HE infants' growth and developmental outcomes and did not directly interrogate breastfeeding outcomes. The most prevalent risks for suboptimal breastfeeding were maternal factors affecting decision making for breastfeeding. Conclusions: This systematic review adds to the evidence of breastfeeding in HIV-affected mother-infant dyads. Findings reiterated that exclusive breastfeeding has a positive outcome on growth and development of all infants irrespective of HIV status. The review highlighted a dearth of research on breastfeeding outcomes of HI and HE infants. Large-scale prospective comparative studies should profile breastfeeding and developmental outcomes of infants with HIV infection or exposure and antiretroviral treatment exposure to enable early identification and intervention for this vulnerable population in low-income settings.

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“… 5 Despite these negative consequences, early BF cessation remains prevalent among mothers living with HIV infection in part because of the fear of mother-to-child transmission. 6 – 8 …”

Section: Introductionmentioning

confidence: 99%

Correlates of early breastfeeding cessation and breastmilk expression in Uganda: a case–control study

Du,

Onyango-Makumbi,

Walia

et al. 2024

J Int Med Res

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Objective To identify the correlates of early breastfeeding (BF) cessation and breastmilk expression (BE) among mothers 12 months after childbirth. Methods We used a case-control study design to compare characteristics between mothers who stopped BF and expressed breastmilk 12 months after childbirth in Uganda. BF practices were determined in 12-month follow-up interviews using an adapted World Health Organization infant feeding questionnaire. Univariate and bivariate logistic regression models identified correlates of early BF cessation and BE as distinct but related outcomes. Results The odds of early BF cessation were higher among mothers who expressed breastmilk irrespective of maternal age (adjusted odds ratio: 2.82; 95% confidence interval: 1.39, 5.68). Mothers who stopped BF and did not express breastmilk were more likely to be older than those who continued BF and did not express breastmilk during the first 12 postpartum months. Conclusion Mothers living with human immunodeficiency virus infection have disproportionately high odds of early BF cessation that may contribute to disparities in child health outcomes. Promotion of safe BF practices coupled with family and social support could be a viable preventive strategy for attenuating such disparities, especially among young mothers at risk of early BF cessation.

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

Cited by 19 publications

References 55 publications

Exclusive breastfeeding practice among HIV infected mothers in the southern highlands of Tanzania; assessing the prevalence and factors associated with the practice, an analytical cross-sectional survey

Exclusive breastfeeding practice among HIV infected mothers in the southern highlands of Tanzania; assessing the prevalence and factors associated with the practice, an analytical cross-sectional survey

Breastfeeding Outcomes and Associated Risks in HIV-Infected and HIV-Exposed Infants: A Systematic Review

Correlates of early breastfeeding cessation and breastmilk expression in Uganda: a case–control study

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