Infant Feeding Challenges Encountered by HIV Positive Mothers in Korogocho Slums, Nairobi, Kenya

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DOI: 10.21522/TIJPH.2013.04.04.Art027

Authors : Bennadette Mugita Siruri


Mother to child transmission of HIV is the major route of HIV infection in children and is responsible for nearly 90% of childhood infections. International guidelines on infant feeding for HIV- positive mothers promote exclusive replacement feeding (ERF) or exclusive breastfeeding (Laar and Govender, 2013). In spite of these guidelines, poor maternal, infant and young child nutrition (MIYCN) practices are widely documented in Korogocho, with potential detrimental effects on child growth and survival. Rates of exclusive infant feeding, both breast-feeding and formula-feeding, are suboptimal in Korogocho slums with exclusive breastfeeding for the first six months being at about two per cent. (Kimani-Murage et al., 2013). This study was thus carried out with the main objective of assessing the infant feeding challenges of HIV positive mothers in this slum which leads them to practice poor infant feeding. Purposive sampling was used to select the study site and simple random sampling was used to select a sample of 103 calculated using Fischer’s method from a target population of 140. Data was collected using interviewer administered questionnaires and three focus group discussions were conducted. Quantitative data was cleaned, coded, entered and analyzed using SPSS Version 16. Qualitative data was analyzed using a three stage thematic approach through transcription of the tape recordings, summarization, thematical description and direct reporting where necessary. Quantitative data was presented in the form of tables and textual summaries. Results from this study showed poor knowledge of appropriate infant methods as only 46 (44.7%) mothers were satisfied with the infant feeding counseling they had received from the health personnel. Poor clinic attendance by 61(59.2%) of the mothers may have led to short and few sessions and it also affected the time of infant feeding thus the poor quality of counseling. Most of the mothers were aware of mother to child transmission (MTCT) of HIV through breastfeeding and 62(60.2%) knew that it could be prevented through exclusive breastfeeding, 60 (58.3%) through replacement feeding and 54 (52.4%) through early and abrupt cessation of breastfeeding though quite a number lacked this knowledge. The concerns raised by breastfeeding mothers included; 29(56.9%) inability to produce sufficient milk, 23 (45.1%) infections in the baby’s mouth, 19 (37.3%) breast infections and 9(11.8%) inability to control the feeding due to the influence of the extended family. Feelings of guilt 33(94.3%) and cost of replacement feeding 26(74.3%) were the major concerns among replacement feeding mothers. Though 17 (16.5%) had ceased breastfeeding early, up to 15(88.2%) of them lacked advice on the appropriate feeding methods after breastfeeding cessation. Mothers in this study were aware of the WHO recommendations on infant feeding and MTCT through breastfeeding and its prevention. However, they faced several challenges which include poor knowledge on appropriate infant feeding methods, inability to produce sufficient milk, high cost of replacement food and lack of knowledge on appropriate infant feeding practices after cessation of breastfeeding. More emphasis should be put on proper clinic attendance by the mothers as this will provide additional time for the health personnel to provide full information infant feeding. Provision of information on appropriate infant feeding practices after cessation of breastfeeding should be enhanced. Further investigations are required to determine the cause of insufficient milk production by the mothers.


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