Adherence to Exclusive Breastfeeding and Associated Factors in Mothers of HIV-Exposed Infants Receiving Care at Kilimanjaro Christian Medical Centre, Tanzania

Abstract

Background: More than 90% of HIV in children occurs through mother-to-child transmission. Breastfeeding is one of several factors associated with transmission of HIV, and, because of this, infant feeding practice is one of the cornerstones in the effort to reduce HIV transmission in children. World Health Organization guidelines from 2012 recommend exclusive breastfeeding to all infants for first 6 months of life. However, many factors contribute to the adherence of mothers to exclusive breastfeeding (EBF) recommendations. The aim of this study was to determine what factors likely influence adherence to exclusive breastfeeding in mothers of HIV-exposed infants receiving care at Kilimanjaro Christian Medical Centre.

Methods: A cross-sectional hospital-based study was conducted from September 2012 to March 2013 at Kilimanjaro Christian Medical Centre in Moshi. All mothers of HIV-exposed infants aged 6 to 12 months receiving care at child-centred family care clinic who consented to participate in the study were included. Data were collected using a pretested structured questionnaire and analysed using SPSS version 16.0 statistical package.

Results: Of the 128 mothers of HIV-exposed infants enrolled in the study, 71 (55.5%) adhered to EBF for 6 months. No statistical significance was seen between adherence status and maternal characteristics in bivariate analysis (P>.05). The mean age and standard deviation of initiating other foods by mothers who did not adhere was 3.32 months ± 1.24. Of 57 (44.5%) non-adherent mothers, one-tenth of them practised mixed breastfeeding and the rest stopped breastfeeding completely. Fear of postnatal transmission of HIV through breastfeeding and inadequate breast milk production were the most common reasons for non-adherence to EBF.

Conclusion: Adherence to the recommended duration for EBF by mothers to their HIV-exposed infants is still a challenge. Ongoing intensive feeding counselling and education on EBF may increase the number of mother who can adhere to EBF in our society.