| dc.description.abstract |
Background: Exclusive breastfeeding (EBF) (breast milk feeding without additional food
or drink, except medicine) is associated with deceased risk of postnatal transmission of
HIV from mother to child.
Methods: This analysis used data from a household survey in Western Kenya in 2011.
Participants were mothers with HIV and uninfected mothers, aged ≥14 years who gave
birth in the prior year (ever breastfed) within the Kenya Medical Research Institute/US
Centers for Disease Control and Prevention (KEMRI/CDC) Health and Demographic
Surveillance System. Data on breastfeeding counseling and knowledge and practices
regarding breastfeeding were collected. Rates and correlates of EBF were determined
using multivariable logistic regression.
Results: Of 652 mothers enrolled in the study, 435 were included in this analysis. Median
age was 28 years among 154 mothers with HIV and 25 years among 281 uninfected
mothers. Mothers with HIV were more likely than uninfected mothers to report
breastfeeding counseling at a health facility (88.9% vs. 51.6%, respectively, p < 0.001)
and EBF for 6-months (64.9% versus 34.5%, p < 0.001). Premastication (pre-chewing of
food by adults prior to feeding to children) was less prevalent among mothers with HIV
(3.9% vs. 13.2% p = 0.001) who were also more knowledgeable about potential risk of
HIV transmission through premastication (83.1% vs 71.2% p = 0.005). Mothers with
HIV who EBF for six months were 3.68-fold more likely to report counseling on EBF
(aOR 3.68; 95% CI: 1.00,13.70). Uninfected mothers with polygamous marriage, any
antenatal care visit, unskilled delivery and delayed breastfeeding initiation (> 1 h) were
less likely to practice EBF for six months 62% (aOR 0.38; 95%CI: 0.20,0.94), 72% (aOR
0.28; 95%CI: 0.10,1.00), 54% (aOR 0.46; 95% CI: 0.22,1.00) and 46% (aOR 0.54;
95%CI: 0.30,1.00) respectively.
Conclusions: Mothers with HIV were more likely to report breastfeeding counseling at a
health facility, EBF for six months and less likely to practice premastication than
uninfected mothers. Lessons learned from breastfeeding counseling in mothers with HIV
could be used to improve awareness and change breastfeeding practices for all mothers. |
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