Towards a Better Understanding of Exclusive Breastfeeding in the Era of HIV/AIDS: A Study of Prevalence and Factors Associated with Exclusive Breastfeeding from Birth, in Rakai,Uganda

Abstract

Exclusive breastfeeding (EBF) is being promoted by WHO/UNICEF as the recommended mode of feeding for all infants from birth to around 6 months of age. It is also recommended for the initial few months, for infants born to HIV-positive mothers in the developing world where conditions may not be ideal for replacement feeding. A cross-sectional study was done to find the prevalence and factors associated with EBF from delivery, amongst mothers of infants 0-6 months of age in a rural Ugandan community with a high HIV/AIDS burden. A prevalence of EBF of 35.1 per cent was found. There was a very high use of prelacteal feeds. Factors positively associated with EBF from birth, after logistic regression, were: delivery from a health unit (OR 2.07; 95 per cent confidence interval, 1.2-3.6); and mother having a normal vaginal delivery (OR 10.54; 95 per cent CI, 3.0-36.6). Factors showing negative association were: male gender of child (OR 0.44; 95 per cent CI, 0.3-0.7); and age of child over 3 months (OR 0.48; 95 per cent CI, 0.3-0.7). Mothers knowledge of her HIV serostatus was not associated with EBF (p = 0.78). Breastfeeding is almost universal in this area but it is rarely exclusive from birth.

Assessment of Infant Feeding Practice Among HIV Positive Mothers and HIV Status of Their Infants in Adama Hospital, Oromia Regional State, Ethiopia, 2016

“…Subjects delivered with cesarean section were less likely to use breast feeding than spontaneous vaginal delivery. The finding is in concordance with the study conducted in Uganda and Cameron [14,15].…”

“…Level N % In this study, nearly half of the respondents were noted to practicing ERF (46.8%) and slightly greater than a quarter of mothers living with HIV practiced EBF (30.6%), This finding concurs with the earlier studies done in Botswana, Zambia, South Africa and Uganda which showed that most HIV positive mothers decided to replacement feed and (30-40%) practiced exclusive breast feeding but it was contrary to finding in Mekelle Town, Tigray Region, North Ethiopia exclusively breastfed; 6.3% were mixed fed and 3.4% were exclusively replacement fed [13][14][15][16].…”

Determinants of suboptimal breast-feeding practices in Pakistan

“…However, the major limitation is the 24 h recall method used for estimating EBF rates in the current survey. Although this method is recommended by WHO, there is a concern that it considerably overestimates EBF rates as it excludes children who were given liquids and foods at infrequent intervals (38)(39)(40)(41)(42)(43) . In Sri Lanka the EBF rate was reported as 77?4 % by using '24 h recall' and as 49?1 % by another method of 'recall since birth' (44) .…”

Determinants of exclusive breastfeeding practices in Ethiopia

“…In resource poor countries, where the negative impact of HIV/AIDS is high, exclusive breastfeeding for the first six months has greater benefit than mixed feeding or formula feeding for the prevention of mother to child transmission of HIV (7).…”

“…Based on several studies done in Ethiopia, breastfeeding is nearly universal but the proportion of exclusively breastfed children up to 6 months is less than the optimal recommendations (13,14). The low prevalence of EBF in most developing countries including Ethiopia is attributed to various maternal and child factors such as place of residence, sex and age of the child, mother working outside home, maternal age and educational level, access to mass media and economical status by several researchers (7,12,(15)(16)(17). The purpose of this article is therefore to document the practice of EBF nationwide and explore whether the previously reported associations elsewhere exist in Ethiopia as well and provide policy makers and NGOs with relevant information for future planning and interventions.…”