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Adherence to Optimal Breastfeeding Practices Among HIV-Positive Mothers in Kilimanjaro, Tanzania

Philemon, Rune Nathaniel ; Mmbaga, Blandina T. ; Bartlett, John ; Renju, Jenny ; Mtuy, Tara B. ; Mboya, Innocent B. LU orcid and Msuya, Sia E. (2022) In Patient Preference and Adherence 16. p.841-852
Abstract

Purpose: We sought to assess how HIV-positive mothers enrolled in the PMTCT program adhere to breastfeeding recommendations concerning early initiation of breastfeeding (EIBF), ie, within one hour of birth, pre-lacteal feeds, exclusive breastfeeding until six months (EBF), and continued breastfeeding to one year of age. This study was designed to assess the practices in response to changing recommendations for breastfeeding in HIV, which have differed drastically over the years. Patients and Methods: We recruited 524 mother-child pairs from 37 PMTCT clinics across Kilimanjaro, Tanzania. The 5 clinics with the highest patient load in each of the 7 districts of Kilimanjaro were chosen, plus the zonal and municipal referral hospitals. The... (More)

Purpose: We sought to assess how HIV-positive mothers enrolled in the PMTCT program adhere to breastfeeding recommendations concerning early initiation of breastfeeding (EIBF), ie, within one hour of birth, pre-lacteal feeds, exclusive breastfeeding until six months (EBF), and continued breastfeeding to one year of age. This study was designed to assess the practices in response to changing recommendations for breastfeeding in HIV, which have differed drastically over the years. Patients and Methods: We recruited 524 mother-child pairs from 37 PMTCT clinics across Kilimanjaro, Tanzania. The 5 clinics with the highest patient load in each of the 7 districts of Kilimanjaro were chosen, plus the zonal and municipal referral hospitals. The children were below two years of age and currently in the PMTCT program. We administered a questionnaire to assess the mother’s practices in feeding the child. We used multiple logistic regression models to determine factors associated with EIBF, EBF, and continued breastfeeding. Results: EIBF was achieved for 73.1% of babies. Cesarean delivery, low birth weight, and partner disclosure of HIV status were significant risk factors for not achieving EIBF. About 19% of children did not breastfeed exclusively. Of the 247 children ≥12 months old, 43.3% had stopped breastfeeding before 12 months. Counseling on ARV, having had >2 pregnancies while HIV-positive and EBF were associated with breastfeeding until 12 months old. Using ART for more than two years decreased the odds of EBF and continued breastfeeding to 12 months of age. Conclusion: Adherence to breastfeeding recommendations for HIV-positive women is suboptimal, particularly in aspects of recent changes in recommendations such as continuing breastfeeding for one year. There is a missed opportunity for interventions such as counseling, which has shown to favor adherence. Health education and counseling are needed for providers and mothers to keep them abreast with the frequently changing recommendations.

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Please use this url to cite or link to this publication:
author
; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
continued breastfeeding, early initiation, exclusive breastfeeding, feeding recommendations
in
Patient Preference and Adherence
volume
16
pages
841 - 852
publisher
Dove Medical Press Ltd.
external identifiers
  • scopus:85127830430
  • pmid:35387257
ISSN
1177-889X
DOI
10.2147/PPA.S343213
language
English
LU publication?
no
additional info
Publisher Copyright: © 2022 Philemon et al.
id
bb3edb88-ffa3-41d4-8cdb-660784706907
date added to LUP
2022-09-29 09:59:20
date last changed
2024-05-30 18:51:27
@article{bb3edb88-ffa3-41d4-8cdb-660784706907,
  abstract     = {{<p>Purpose: We sought to assess how HIV-positive mothers enrolled in the PMTCT program adhere to breastfeeding recommendations concerning early initiation of breastfeeding (EIBF), ie, within one hour of birth, pre-lacteal feeds, exclusive breastfeeding until six months (EBF), and continued breastfeeding to one year of age. This study was designed to assess the practices in response to changing recommendations for breastfeeding in HIV, which have differed drastically over the years. Patients and Methods: We recruited 524 mother-child pairs from 37 PMTCT clinics across Kilimanjaro, Tanzania. The 5 clinics with the highest patient load in each of the 7 districts of Kilimanjaro were chosen, plus the zonal and municipal referral hospitals. The children were below two years of age and currently in the PMTCT program. We administered a questionnaire to assess the mother’s practices in feeding the child. We used multiple logistic regression models to determine factors associated with EIBF, EBF, and continued breastfeeding. Results: EIBF was achieved for 73.1% of babies. Cesarean delivery, low birth weight, and partner disclosure of HIV status were significant risk factors for not achieving EIBF. About 19% of children did not breastfeed exclusively. Of the 247 children ≥12 months old, 43.3% had stopped breastfeeding before 12 months. Counseling on ARV, having had &gt;2 pregnancies while HIV-positive and EBF were associated with breastfeeding until 12 months old. Using ART for more than two years decreased the odds of EBF and continued breastfeeding to 12 months of age. Conclusion: Adherence to breastfeeding recommendations for HIV-positive women is suboptimal, particularly in aspects of recent changes in recommendations such as continuing breastfeeding for one year. There is a missed opportunity for interventions such as counseling, which has shown to favor adherence. Health education and counseling are needed for providers and mothers to keep them abreast with the frequently changing recommendations.</p>}},
  author       = {{Philemon, Rune Nathaniel and Mmbaga, Blandina T. and Bartlett, John and Renju, Jenny and Mtuy, Tara B. and Mboya, Innocent B. and Msuya, Sia E.}},
  issn         = {{1177-889X}},
  keywords     = {{continued breastfeeding; early initiation; exclusive breastfeeding; feeding recommendations}},
  language     = {{eng}},
  pages        = {{841--852}},
  publisher    = {{Dove Medical Press Ltd.}},
  series       = {{Patient Preference and Adherence}},
  title        = {{Adherence to Optimal Breastfeeding Practices Among HIV-Positive Mothers in Kilimanjaro, Tanzania}},
  url          = {{http://dx.doi.org/10.2147/PPA.S343213}},
  doi          = {{10.2147/PPA.S343213}},
  volume       = {{16}},
  year         = {{2022}},
}