Breastfeeding Practice among HIV Positive Mothers Receiving Care for PMTCT at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria

Main Article Content

Nsirimobu Ichendu Paul
Balafama Abinye Alex-Hart

Abstract

Background: Exclusive Breastfeeding (EBF) is the recommended feeding method for HIV exposed infants in resource limited settings. This study aimed to evaluate the feeding practices and possible determinants among HIV-positive mothers receiving care for prevention of mother-to-child transmission programme (PMTCT) in Port Harcourt, Nigeria.

Methods: This was a cross-sectional study among HIV positive mothers who were receiving care for PMTCT. A structured questionnaire was self-administered to mothers whose babies were at least one year old. Information obtained included the sociodemographic characteristics of the mothers, the choice of feeding practiced by the mothers, reason for the choice of feeding, duration of breastfeeding and reason for breastfeeding. Obtained data was analysed and a p-value of <0.05 was considered statistically significant.

Results:  A total of 234 mothers participated in the study. Exclusive breastfeeding (EBF) was the predominant type of feeding practiced by the mothers with an EBF rate of 91.4%. Prevention of HIV transmission to the child (85.5%) and the nutritional benefits of the milk (70.9%) were the main underlying reason for the mother’s choice of feeding. One hundred and sixty eight (76.4%) breastfed for 7-12 Months, 156 (70.9%) practiced breastfeeding because of personal choice, while 42 (19.9%) breastfed for fear of HIV status being disclosed. Significantly more of the married mothers exclusively breastfed their children than the unmarried counterparts (X 2 = 23.99, p = 0.0001). 

Conclusion: Breastfeeding is the commonest feeding practice among HIV positive mother and the EBF rate among these mothers is high and must be encouraged. Regular and consistent use of ART among HIV positive mothers must be encouraged and supported since the desire to prevent MTCT was the commonest motivation for the feeding choice among these mothers.

Keywords:
Breastfeeding practice, HIV positive mothers, PMTCT, Port Harcourt.

Article Details

How to Cite
Paul, N. I., & Alex-Hart, B. A. (2020). Breastfeeding Practice among HIV Positive Mothers Receiving Care for PMTCT at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria. Archives of Current Research International, 19(3), 1-8. https://doi.org/10.9734/acri/2019/v19i330160
Section
Original Research Article

References

Lawrence PB. Breast milk: Best source of nutrition for term and preterm infants. Pediatric Clinics of North America. 1994;41(5):925-941.

AK, Mbachu C, Uzochukwu BSC, Elias A, Omotowo B, Agunwu C, Obi I. Perception and practice of breastfeeding among HIV positive mothers receiving care for prevention of mother to child transmission in South-East Nigeria. International Breastfeeding Journal. 2018;13:50

Newman J. How breast milk protects newborns. Scientific Amer. 1995;273(6):76-79.

Fewtrell MS. The long-term benefits of having been breast-fed. Current Paediatrics. 2004;14(2): 97-103.

World Health Organisation (WHO). Guideline: Updates on HIV and infant feeding: The duration of breastfeeding and support from health services to improve feeding practices among mothers living with HIV. Geneva, WHO; 2016.
Available:https://apps.who.int/iris/bitstream/handle/10665/246260/9789241549707eng.pdf;
jsessionid=C980274A4993D300092B62180D1D507D?sequence=1
[Accessed 22nd December 2019]

Belay GM, Wubneh CA. Infant feeding practices of HIV positive mothers and its association with counseling and HIV disclosure status in Ethiopia: A systematic review and meta-analysis. AIDS Research and Treatment. 2019;Article ID 3862098:1-13.

Kennedy K, Fortney JA, Bonhomma MG, Potts M, Lamptey P, Carswell W. Trop Doct. 1990;20(1):25-29.

World Health Organisation (WHO). Infant feeding for the prevention of mother-to child transmission of HIV.
Available:https://www.who.int/elena/titles/hiv_infant_feeding/en/
[Accessed 22nd December 2019]

Paul NI, Ugwu RO. Outcome of prevention of mother to child transmission (PMTCT) of HIV Services at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Nigeria. Asian Journal of Medicine and Health. 2019;17(2):1-11.
[Article no. AJMAH.53046]
[ISSN: 2456-8414]

Muluye D, Woldeyohannes D, Gizachew M, Tiruneh M. Infant feeding practice and associated factors of HIV positive mothers attending prevention of mother to child transmission and antiretroviral therapy clinics in Gondar Town health institutions, Northwest Ethiopia. BMC Public Health. 2012;12:240.
Available:http://www.biomedcentral.com/1471-2458/12/240

Umeobieri A, Mbachu C, Uzochukwu BSC, Elias A, Omotowo B, Agunwa C, Obi I. Perception and practice of breastfeeding among HIV positive mothers receiving care for prevention of mother to child transmission in South-East, Nigeria. International Breastfeeding Journal. 2018;13:50.

Mukerem M, Jemal Haidar J. Assessment of the prevalence and factors influencing adherence to exclusive breast feeding among HIV positive mothers in selected health institution of Addis Ababa, Ethiopia Ethiop. J. Health Dev. 2012;26(3):169- 175.

Federal Ministry of Health. National HIV sero-prevalence sentinel survey among pregnant women attending antenatal clinics in Nigeria. Abuja: Federal Ministry of Health; 2014.

UNICEF. Nutrition; HIV and Infant Feeding; 2011.
Available:http://www.unicef.org/nutrition/index_24827.html

Coovadia H, Rollins N, Bland R, Little K, Coutsoudis A, Bennish M, et al. Lancet: Mother-to-child transmission of HIV-1 infection during exclusive breast feeding in the first 6 months of life: An intervention cohort study. Breastfeeding Review. 2008;16(1):30–2.

Ngwende S, Gombe NT, Midzi S, Tshimanga M, Shambira G, Chadambuka A. Factors associated with HIV infection among children born to mothers on the prevention of mother to child transmission programme at Chitungwiza hospital, Zimbabwe. 2008 BMC Public Health. 2013;13(1):1181.

Oladokun RE, Brown BJ, Osunusi K. Infant-feeding pattern of HIV-positive women in a prevention of mother-to-child transmission (PMTCT) programme. AIDS Care. 2010;22(9):1108–14.

Tromp I, Kiefte-de Jong J, Raat H, Jaddoe V, Franco O, Hofman A, et al. Breastfeeding and the risk of respiratory tract infections after infancy: The Generation R Study. PLoS One. 2017; 12(2):e0172763.
Available:https://doi.org/10.1371/journal.pone.0172763

Lamberti LM, Fischer Walker CL, Noiman A. et al. Breastfeeding and the risk for diarrhea morbidity and mortality. BMC Public Health. 2011;11:S15.
DOI: 10.1186/1471-2458-11-S3-S15

Tariq S, Elford J, Tookey P, Anderson J, Annemiek de Ruiter A, O'Connell R, et al. It pains me because as a woman you have to breastfeed your baby: Decision-making about infant feeding among African women living with HIV in the UK. Sex Transm Infect. 2016;92(5):331–6.

Oguta T, Omwega A, Sehmi J. Infant feeding alternatives for HIV positive mothers in Kenya. Field Exch. 2004;22:25.
Available:www.ennonline.net/fex/22/infant

Carpenter LM, Kamali A, Ruberantwari A, Malamba S, Whitworth JA. Rates of HIV-1 transmission within marriage in rural Uganda in relation to the HIV sero-status of the partners. AIDS. 1999;13(9):1083–1089.
[PubMed: 10397539]

De Walque, D. Discordant couples: HIV infection among couples in Burkina Faso, Cameroon, Ghana, Kenya and Tanzania. Washington, D.C: Development Research Group, the World Bank; 2006.

Gray RH, Wawer MJ, Brookmeyer R, Sewankambo NK, Serwadda D, Wabwire-Mangen F, et al. Probability of HIV-1 transmission per coital act in mono-gamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda. Lancet. 2001; 357:1149–1153.
[PubMed: 11323041]

Guthrie BL, De Bruyn G, Farquhar C. HIV-1-discordant couples in Sub-Saharan Africa: Explanations and implications for high rates of discordance. Current HIV Research. 2007;5(4):416–429.
[PubMed: 17627505]

Medley A, Garcia-Moreno C, McGill S, Maman S. Rates, barriers and outcomes of HIV serostatus disclosure among women in developing countries: Implications for prevention of mother-to-child transmission programmes. Bulletin of the World Health Organization. 2004;82(4):299–307.

Pinkerton DS, Galletly LC. Reducing HIV transmission risk by increasing serostatus disclosure: A mathematical modeling analysis. AIDS and Behaviour. 2007;11(5): 698–705.

Allen S, Tice J, Van de Perre P, Serufilira A, Hudes E, Nsengumuremyi F, et al. Effect of serotesting with counselling on condom use and seroconversion among HIV discordant couples in Africa. British Medical Journal. 1992;304(6842):1605–1609.
[PubMed: 1628088]

Kafulafula UK, Hutchinson MK, Gennaro S, Guttmacher S, Kumitawa A. Exclusive breastfeeding prenatal intentions among HIV-positive mothers in Blantyre, Malawi: A correlation study. BMC Pregnancy Childbirth. 2013;13:203.