Adherence to infant-feeding choices by HIV-infected mothers at a Nigerian tertiary hospital: the pre-“rapid advice” experience
Keywords: HIV-infected mothers, infant-feeding choice, infant-feeding practices, PMTCT, adherence
AbstractObjectives: The study examined adherence to infant-feeding choices made by human immunodeficiency virus (HIV)-infected mothers at a Nigerian tertiary hospital prior to implementation of the “rapid advice” guideline, i.e. the revised World Health Organisation principles and recommendations on infant feeding in the context of HIV. Design: This was a longitudinal descriptive study. Subjects and settings: The study was conducted on mother-infant pairs recruited from the prevention of mother-to-child transmission (PMTCT) of HIV programme of Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria. Final analyses included 142 mother-infant pairs. Outcome measures: Adherence to a prenatal infant-feeding choice and the infant’s HIV status at six months of age were determined. Results: On enrolment, 73% (n = 103) of the mothers chose exclusive formula feeding (EFF), and 28% (n = 39) exclusive breastfeeding (EBF) for the first six months of life. Of the mothers who chose EBF, the actual practice of EBF declined from 88% at two weeks to 21% at six months, while EFF with correctly reconstituted infant formula decreased from 55% to 8% over the same period. The proportion of mothers who switched over to early complementary feeding increased from 8% at six weeks to 80% at six months in the EBF group, and 2% at two weeks to 92% at six months in the EFF group. Major reasons for nonadherence to their initial choice were fear of the other-to-child transmission (MTCT) of HIV (65%) and non-affordability of the formula (97%) in the EBF and EFF groups, respectively. Factors significantly associated with adherence to their initial choice included having individual prenatal infant-feeding counselling sessions, being married, having a small number of children, being of higher socio-economic status and the mother’s educational status. However, only socio-economic status remained significant after logistic regression analysis was applied. The total MTCT of HIV rate was 1% at six months. Conclusion: Adherence to either EFF or EBF in this study was low, owing to early breastfeeding cessation and the inability to sustain EFF.
How to Cite
Onubogu, C., Ugochukwu, E., Egbuonu, I., & Onyeka, I. (2015). Adherence to infant-feeding choices by HIV-infected mothers at a Nigerian tertiary hospital: the pre-“rapid advice” experience. South African Journal of Clinical Nutrition, 28(4), 180-186. Retrieved from http://sajcn.co.za/index.php/SAJCN/article/view/1015
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