Abstract
Breastfeeding is usually the best way to feed infants, yet the advent of HIV has complicated this practice. There is enough evidence that exclusively breastfed infants are more protected against childhood morbidity and mortality from malnutrition, respiratory and gastrointestinal infections than those exclusively formula-fed. The aim of the study was to determine the infant feeding practices and factors influencing them among Prevention of Mother to Child Transmission of HIV (PMTCT) mothers at Gulu and Lacor hospitals in Uganda. A descriptive cross-sectional study using both qualitative and quantitative methods of data collection was used. 200 HIV-positive mothers with infants aged 0–12 months were enrolled between July and August 2007. Focus group discussions for mothers and fathers and key informant interviews were conducted. Data entry and analysis were done using EPI Data 3.1 and SPSS 11.0 respectively. Qualitative data was analyzed in themes with direct quotations given. Replacement feeding was practiced by 155 (77.5%) of the mothers. The most important predictors of replacement feeding were: infant feed preparation demonstration by the health workers (OR 25.1 95% CI 7.56–83.60, p value < 0.001); HIV test done on infant (OR 8.65 95% CI 2.25–33.22, p value 0.002); HIV serostatus disclosure to the spouse (OR 5.1 95% CI 1.51–17.24, p value 0.005) and spouse support towards feeding practice (OR 4.9 95% CI 1.62–14.83, p value 0.003). Factors from qualitative data which were negatively associated with replacement feeding included: poverty, lack of serostatus disclosure and spouse support, while need for PMTCT was positively associated with replacement feeding. Replacement feeding was the predominant feeding practice among the study population and was influenced by demonstration of feed preparation, HIV test done on the infant and spouse support. A supportive spouse, male involvement, health education and HIV status disclosure is key to successful replacement-feeding practice according to WHO and country infant feeding recommendations prior to the new recommendations of 2009.
Keywords
PMTCT - replacement feeding - HIV positive mothers - infants
