Adherence to exclusive breastfeeding among HIV-positive women in Nairobi, Kenya

Abstract

In developing countries, exclusive breastfeeding (EBF) remains the best and safest source of nutrition and a recommended method of prevention of mother-to-child transmission of HIV in combination with use of prophylactic anti-retrovirals. Other feeding options could be detrimental to the infant if the mother cannot afford the recommended replacement feeds and expose the infants to diarrhoeal diseases and malnutrition, which could lead to early mortality. Despite this evidence, EBF ranges from 3.2 to 13% in Kenya. The aim of this study was to identify knowledge, attitude and practice in adherence to EBF among 188 HIV-positive women with children aged 6-12 months in Nairobi, Kenya. This was a descriptive crosssectional study using quantitative and qualitative approaches. Participants were interviewed using semi-structured questionnaires. In addition, two focus group discussions were conducted and key informants from the health facility were also interviewed. The results showed that 69.1% of women EBF. The following factors influenced adherence to EBF positively: presence of main breadwinner (OR=3.44, P=0.003), food availability (P=<0.001), mastitis (P=0.002), knowledge of mother-to-child transmission of HIV (P=<0.001), being taught about EBF in antenatal and postnatal classes (OR=7.78, P=0.002), expressing breast milk (P=<0.001), disclosure of HIV status to husband (OR=2.46, P=0.007) and relative (OR=2.29, P=0.033). In conclusion, information sharing of mother-to-child transmission of HIV antenatally and postnatally should be strengthened in the health facilities. Additionally, mothers should also be taught how to express breast milk.