“Why Aren't You Breastfeeding?”: How Mothers Living With HIV Talk About Infant Feeding in a “Breast Is Best” World

Abstract

Infant feeding raises unique concerns for mothers living with HIV in Canada, where they are recommended to avoid breastfeeding yet live in a social context of "breast is best." In narrative interviews with HIV-positive mothers from Ontario, Canada, a range of feelings regarding not breastfeeding was expressed, balancing feelings of loss and self-blame with the view of responsibility and "good mothering" under the current Canadian guidelines. Acknowledging responsibility to put their child's health first, participants revealed that their choices were influenced by variations in social and cultural norms, messaging, and guidelines regarding breastfeeding across geographical contexts. This qualitative study raises key questions about the impact of breastfeeding messaging and guidelines for HIV-positive women in Canada.

Perinatal care experiences of mothers living with HIV in Ontario, Canada

“…Only recently, however, has literature highlighted the complexity and uniqueness of this issue for WLWH around the world (Greene et al, 2014;Koricho, Moland, & Blystad, 2010;MacCarthy, Rasanathan, Nunn, & Dourado, 2013;Shah, 2013). WLWH in Ontario have expressed a range of feelings regarding not breastfeeding and balance feelings of loss and self-blame with a sense of responsibility under the current Canadian guidelines (Greene et al, 2014). Despite the growing trend of children being born to WLWH in Canada, WLWH continue to contend with complex medical and psychosocial issues in the perinatal period.…”

“In the United States, we say, ‘No breastfeeding,’ but that is no longer realistic”: provider perspectives towards infant feeding among women living with HIV in the United States

“…The contrast in recommendations between low‐resource and high‐resource settings has created challenges for providers and patients in the U.S. and other high‐resource settings . Indeed, in these high‐resource settings, national public health organizations promote exclusive breastfeeding and continued breastfeeding up to two years among women who are HIV negative.…”

“…Indeed, in these high‐resource settings, national public health organizations promote exclusive breastfeeding and continued breastfeeding up to two years among women who are HIV negative. Although there is limited research from high‐resource settings, investigating perceptions of infant feeding among WLHIV, three qualitative studies (one from the United Kingdom and two from Canada ) illustrate common sentiments. WLHIV reported feeling like they were not fulfilling their role as mothers .…”

Letter to the Editor

“…To: Eleanor Krassen Covan, PhD, Editor-in-Chief, Health Care for Women International, In response to the article by Saara Greene and colleagues describing the challenges faced by Canadian mothers living with HIV, in particular the unwelcome surveillance they experience and their disappointment in not being permitted to breastfeed (Greene et al, 2014), we would like to offer the following observations.…”