Infant feeding practice of HIV positive mothers and its determinants in selected health institutions of Addis Ababa, Ethiopia

Abstract

Background: Avoidance of all breast-feeding by HIV infected mothers is recommended when replacement feeding is acceptable, feasible, affordable, sustainable, and safe. Whereas for women whose HIV status is unknown or negative, exclusive breastfeeding for the first six months is the single infant feeding option recommended. Objective: To assess the infant feeding practice of HIV positive mothers and its determinants. Methods: A cross sectional study with analytical component was conducted in 13 purposively selected health institutions with ART and PMTCT facilities in Addis Ababa during March, 2008. A total of 327 HIV positive mothers with their young infants visiting the respective health institutions were recruited in order of arrival, and assessed for their infant feeding practices. Results: Exclusive replacement feeding (ERF), exclusive breastfeeding (EBF) and mixed feeding (MF) were 46.8%, 30.6%, and 15.3% respectively. The predictors for choosing ERF were mode of delivery (p<0.05), household income (p<0.05) and disclosure of HIV status to spouse (p<0.01). The predictor for EBF, was mode of delivery (p<0.05) while for MF, disclosure of HIV status to spouse (p<0.05), parental infant feeding attitude (p<0.01) and infant illnesses (p<0.01) were the predictors. Furthermore, sticking to mothers' informed safer feeding options is challenged by some social factors. Conclusion: The present study delineated the predictors involved in making safer choices for infant-feeding options.To achieve success in exclusivity of feeding options, mothers' decision should be respected and pressure from the family/neighbors to introduce other food to the infant needs to be discouraged. Furthermore, the risks involved in each infant feeding option should be communicated and advocated to the mother/father during PMTCT to make informed choices. [Ethiop.

Exclusive Breast Feeding Status and its Determinant among HIV Positive Women in West Showa Zone Oromia Region Ethiopia

“…Compared to spontaneous vertex delivery (SVD) those delivered by C/S were more likely to practice EBF. The finding of this study disagree with the study conducted at Addis Ababa in which mothers who had delivered by C/S were more likely to practice replacement feeding than EBF [4].…”

“…This finding is lower than the study conducted in West Oromia 72%, in Nigeria 68.3%, in India 44% and have some similarity with study conducted in Uganda 24% whereas nearly close to study done in Addis Ababa 30.6% of the study members had practiced EBF [4,[11][12][13][14]. The observed comparative difference could be due to the fear of the risk from vertical transmission of HIV/AIDS that is mother to child.…”

“…However, feeding of children being born from HIV-positive woman has unusually difficult circumstances. For those kinds of children formula or replacement feeding (RF) for infants of HIV positive women is the recommended choice to avoid the risk of HIV transmission from mother to child during breastfeeding [1,4,10].…”

“…The rising of HIV/AIDS epidemic and the detection that HIV can transmit from positive mothers to their babies through breast milk create a terrible public health dilemma within countries of high incidences of HIV. In response to this problem in 2003, a guideline was developed by UNICEF, WHO, UNAIDS and UNFPA in the circumstance of infant feeding of women whose HIV status is unknown and HIV positive women [4]. The suggested option for HIV positive women is not giving BF when replacement feeding (RF) is Acceptable, Feasible, Affordable, Sustainable and Safe (AFASS).…”

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“…To determine the sample size we used single population proportion formula with the assumption of 95% confidence level, margin of error of 5% and the proportion of recommended infant breastfeeding (either Exclusive replacement feeding (ERF) or Exclusive Breast Feeding (EBF) was 77.4% from Addis Ababa [12]. 10% of the sample was added to compensate the non-response rate.…”