Mothers' Perception of Infant Feeding Counselling in The Context of Prevention of Mother-to-child Transmission of HIV in Lusaka, Zambia

Abstract

Background: The aim of infant-feeding counselling is to facilitate informed decision on method of feeding in the context of prevention of mother-to-child transmission of HIV. However, HIV-positive mothers are faced with uncertainty on how best to feed their infants. The question we asked for this research was: how does the information provided in counselling on HIV and infant-feeding assist mothers in making decisions for safer feeding practices for their infants?
Methods: This sub-study was part of the larger study conducted on: HIV and infant feeding; choices and decision outcomes in the context of PMTCT among HIVpositive mothers in Zambia. Data were collected through key-informant interviews with health care workers (HCWs) and individual interviews with 30 HIV-positive mothers. Data were collected from January to September 2014. The interviews were digitally recorded and transcribed verbatim. The QRS NVivo 10 version was used for data coding and analysis.
Results: The role of health care workers in PMTCT was to provide information on infant feeding and facilitate informed decision on feeding HIV-exposed infants. Concerning the decision on infant feeding, mothers reported that they chose to practice exclusive breastfeeding because it was an optimal choice for their exposed infants. However, there appeared to be other factors that influenced the decision on how to feed HIVexposed infants: maternal instinct to protect the baby from getting infected with HIV; the perception that a breastfed baby is health; and the cost of formula. Potentially, mothers may have risked to practice mixed feeding due to: late initiation of breastfeeding in respect of cultural norms; the belief that the baby can just stop breastfeeding on its own; and pressure from family and community to practice mixed feeding.
Conclusion: While EBF is now recommended for HIVexposed infants, challenges remain on how to promote EBF and tailor information on infant feeding counselling and assist mothers make an informed decision in settings where formula feeding would not be recommended. Therefore, quality and objective infant feeding counselling should be practiced by HCWs to enhance safer feeding practices.

Keywords: Exclusive breastfeeding, Formula feeding, Infant feeding counselling, Health promotion, Informed decision, Lusaka, Zambia.