WHO 2010 infant feeding guidelines in resource-limited settings: attitudes of human immunodeficiency virus-infected women and other role players in Kampala, Uganda

Abstract

Objective: The objective of the study was to describe the attitudes of human immunodeficiency virus (HIV)-infected women and other role players towards the World Health Organization (WHO) 2010 infant feeding guidelines.
Design: This was formative evaluation research, carried out from September-November 2011.
Setting: The study was conducted at Mulago Hospital, Kampala, Uganda.
Subjects: Focus group discussions (FGDs) were held among five groups: HIV-infected pregnant women (9), HIV-infected postpartum mothers (10), HIV-infected peers (10), male partners (10), family members of the pregnant women (10) and key informants (12).
Outcome measures: Descriptive data were collected through FGDs and key informant interviews.
Results: With the exception of male partners, the majority of FGD participants and key informants who were health workers held a positive attitude towards exclusive breastfeeding. The introduction of complementary foods at six months while HIV-infected lactating mother continued to breastfeed was supported by all of the health workers, but by only a minority of participants from each focus group discussion. The majority of FGD participants and the health workers were in favour of an HIV-infected lactating mother taking antiretroviral (ARV) drugs during the breastfeeding period, rather than the infant.
Conclusion: Three conclusions can be drawn from this study. Firstly, general attitudes towards the WHO 2010 infant feeding guidelines on exclusive breastfeeding were positive. Secondly, there were still fears about an HIV-infected mother introducing complementary foods at six months while continuing to breastfeed. Thirdly, all of the FGD participants and the majority of the health workers recommended that the mother should take ARV drugs in the lactating period.

Keywords: infant feeding, exclusive breastfeeding, HIV-infected lactating mothers, male partners, WHO, resource-limited settings