The experiences of HIV-positive mothers breastfeeding exclusively in Swaziland

Abstract

In Swaziland, 41.1% of pregnant women live with HIV, while only 32% of Swazi mothers (including HIV negative mothers) currently practice exclusive breastfeeding among infants less than six months of age. The rate of exclusive breastfeeding decreases with an increase in the infant’s age, as only 17% of infants aged four to five months are reported to be exclusively breastfed. Exclusive breastfeeding is recommended by the ministry of health of Swaziland to reduce postnatal HIV transmission of HIV to the infant, through the prevention of mother-to-child transmission of HIV (PMTCT) strategy. However, little is known about HIV-positive mothers’ perspectives and experiences of exclusive breastfeeding in Swaziland. Therefore, a hospital-based explorative, descriptive qualitative study design was employed to describe the experiences of HIV-positive mothers in Swaziland breastfeeding exclusively. Seven exclusive breastfeeding, HIV-positive mothers, aged 21-41 years, married and unemployed, participated during two visits to the study site. Responses to semistructured and in-depth interviews, through purposive sampling, were analyzed in order to generate themes. Five major themes emerged: (i) benefits of breast milk to the mother and the baby; (ii) social support factors; (iii) the role of healthcare workers in promoting exclusive breastfeeding; (iv) psychological relief from a baby’s negative test result; and (v) challenges faced by breastfeeding mothers. Despite pressure from relatives and inlaws for some of the participants, they continued to breastfeed exclusively for the first six months of the baby’s life, stating that breastfeeding benefited themselves and their infants. Continuous teaching and counseling offered by nurses during child-welfare clinic visits motivated the mothers to continue breastfeeding exclusively. In view of the challenges expressed by mothers, there is a need to develop and implement feasible interventions to improve support for HIV-positive mothers, in order to scale up exclusive breastfeeding practices in the country. Counseling on exclusive breastfeeding should also include the in-laws as they play a pivotal role in child feeding. This study contributes to the body of knowledge on infant feeding and provides insights to healthcare professionals and stakeholders working with HIV-positive breastfeeding women.

Key words: Experiences, Exclusive Breastfeeding, HIV-positive, Swaziland.