Skip to main content
Top
Published in: International Breastfeeding Journal 1/2016

Open Access 01-12-2016 | Research

Breastfeeding counseling and support are associated with continuous exclusive breastfeeding from one week to six months of age among HIV exposed infants in north Gondar zone, Ethiopia: a cross-sectional study

Authors: Haregeweyin Genetu, Melaku Kindie Yenit, Amare Tariku

Published in: International Breastfeeding Journal | Issue 1/2016

Login to get access

Abstract

Background

Globally, exclusive breastfeeding prevents 1.3 million child deaths and has an added benefit for people living with the Human Immune Deficiency Virus (HIV) by preventing mother-to-child transmission of HIV. However, literature is scarce in Ethiopia; therefore this study aimed to assess the rate of continuous exclusive breastfeeding from the end of the first week to 6 months of age, among HIV exposed infants (aged 7–20 months) who were followed up in government hospitals of North Gondar Zone, Ethiopia, and associated factors.

Methods

An institutional based cross-sectional study was conducted from February 21 to March 30, 2016. All mother-child pairs (367) attending the chronic HIV care clinic in government hospitals of North Gondar Zone were included in the study. Exclusive breastfeeding was defined as the practice of feeding only breast milk (including expressed breast milk) during the first 6 months and no other liquids and solid foods except medications. However since prelacteal feeding is a deep rooted norm in the study setting, we report continuous exclusive breastfeeding from the end of first week to 6 months of age of infants, ignoring all prelacteal feeding offered at birth. A binary multivariable logistic regression analysis was employed to identify factors associated with exclusive breastfeeding.

Results

The overall prevalence of continuous exclusive breastfeeding among HIV exposed infants was 86.4%. According to the multivariable analysis; breastfeeding counseling (Adjusted Odds Ratio [AOR] = 5.1, 95% Confidence Interval [CI] 1.4, 18.2), breastfeeding support (AOR = 3.7, 95% CI 1.3, 10.5), and not experiencing obstetric problems (AOR = 3.4, 95% CI: 1.3, 8.8) were associated with higher odds of continuous breastfeeding.

Conclusions

In this study, most HIV exposed infants were continuously breastfed from the end of first week to 6 months of age. Breastfeeding counseling, breastfeeding support and experiencing obstetric problems were identified as significant determinants of continuous breastfeeding. Therefore, breastfeeding counseling and support should be strengthened to improve the coverage of optimal exclusive breastfeeding practice. Moreover, prompt diagnosis and treatment of obstetric problems should be initiated.
Literature
1.
go back to reference Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, Piwoz EG, Richter LM, Victora CG, Group TLBS. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387(10017):491–504.CrossRefPubMed Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, Piwoz EG, Richter LM, Victora CG, Group TLBS. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387(10017):491–504.CrossRefPubMed
2.
3.
go back to reference Kramer MS, Kakuma R. The optimal duration of exclusive breastfeeding. Protecting infants through human milk. Netherland: Springer Publication; 2004. p.63–77. Kramer MS, Kakuma R. The optimal duration of exclusive breastfeeding. Protecting infants through human milk. Netherland: Springer Publication; 2004. p.63–77.
4.
go back to reference Quinn V, Guyon A, Martin L, Neka-Tebeb H, Martines J, Sagoe-Moses C. Nutrition and breastfeeding promotion. Opportunities for Africa’s Newborns: Practical Data, Policy and Programmatic Support for Newborn Care in Africa PMNCH. Cape Town: Partnership for Maternal, Newborn and Child Health; 2006. p. 101–12. Quinn V, Guyon A, Martin L, Neka-Tebeb H, Martines J, Sagoe-Moses C. Nutrition and breastfeeding promotion. Opportunities for Africa’s Newborns: Practical Data, Policy and Programmatic Support for Newborn Care in Africa PMNCH. Cape Town: Partnership for Maternal, Newborn and Child Health; 2006. p. 101–12.
5.
go back to reference Coovadia HM, Rollins NC, Bland RM, Little K, Coutsoudis A, Bennish ML, Newell M-L. Mother-to-child transmission of HIV-1 infection during exclusive breastfeeding in the first 6 months of life. an intervention cohort study. Lancet. 2007;369(9567):1107–16.CrossRefPubMed Coovadia HM, Rollins NC, Bland RM, Little K, Coutsoudis A, Bennish ML, Newell M-L. Mother-to-child transmission of HIV-1 infection during exclusive breastfeeding in the first 6 months of life. an intervention cohort study. Lancet. 2007;369(9567):1107–16.CrossRefPubMed
6.
go back to reference WHO. Guidelines on HIV and Infant Feeding 2010: Principles and Recommendations for Infant Feeding in the Context of HIV and a Summary of Evidence. Geneva: WHO; 2010. WHO. Guidelines on HIV and Infant Feeding 2010: Principles and Recommendations for Infant Feeding in the Context of HIV and a Summary of Evidence. Geneva: WHO; 2010.
7.
go back to reference Raqa T. Breast is always best, even for HIV-positive mothers. Bull World Health Organ. 2010;88:9–10.CrossRef Raqa T. Breast is always best, even for HIV-positive mothers. Bull World Health Organ. 2010;88:9–10.CrossRef
8.
go back to reference Semrau K, Kuhn L, Brooks DR, Cabral H, Sinkala M, Kankasa C, et al. Exclusive breastfeeding, maternal HIV disease, and the risk of clinical breast pathology in HIV-infected, breastfeeding women. Am J Obstet Gynecol. 2011;205(4):344.CrossRefPubMedPubMedCentral Semrau K, Kuhn L, Brooks DR, Cabral H, Sinkala M, Kankasa C, et al. Exclusive breastfeeding, maternal HIV disease, and the risk of clinical breast pathology in HIV-infected, breastfeeding women. Am J Obstet Gynecol. 2011;205(4):344.CrossRefPubMedPubMedCentral
9.
go back to reference 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;13:201.CrossRef 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;13:201.CrossRef
10.
go back to reference Cai X, Wardlaw T, Brown DW. Global trends in exclusive breastfeeding. Int Breastfeed J. 2012;7:1.CrossRef Cai X, Wardlaw T, Brown DW. Global trends in exclusive breastfeeding. Int Breastfeed J. 2012;7:1.CrossRef
12.
go back to reference Saka FJ. Factors influencing exclusive breastfeeding among HIV positive mothers at Ilala Municipality Dar es Salaam. Muhimbili University of Health and Allied Sciences. 2012. Saka FJ. Factors influencing exclusive breastfeeding among HIV positive mothers at Ilala Municipality Dar es Salaam. Muhimbili University of Health and Allied Sciences. 2012.
13.
go back to reference Laar A, Ampofo W, Tuakli J, Quakyi I. Infant feeding choices and experiences of HIV-positive mothers from two Ghanaian districts. J AIDS HIV Res. 2009;1(2):23–33. Laar A, Ampofo W, Tuakli J, Quakyi I. Infant feeding choices and experiences of HIV-positive mothers from two Ghanaian districts. J AIDS HIV Res. 2009;1(2):23–33.
14.
go back to reference Aishat U, David D, Olufunmilayo F. Exclusive breastfeeding and HIV/AIDS: a crossectional survey of mothers attending prevention of mother-to-child transmission of HIV clinics in southwestern Nigeria. Pan Afr Med J. 2015;21:309.CrossRefPubMedPubMedCentral Aishat U, David D, Olufunmilayo F. Exclusive breastfeeding and HIV/AIDS: a crossectional survey of mothers attending prevention of mother-to-child transmission of HIV clinics in southwestern Nigeria. Pan Afr Med J. 2015;21:309.CrossRefPubMedPubMedCentral
15.
go back to reference Okanda JO, Borkowf CB, Girde S, Thomas TK, Lecher SL. Exclusive breastfeeding among women taking HAART for PMTCT of HIV-1 in the Kisumu Breastfeeding Study. BMC Pediatr. 2014;14:280.CrossRefPubMedPubMedCentral Okanda JO, Borkowf CB, Girde S, Thomas TK, Lecher SL. Exclusive breastfeeding among women taking HAART for PMTCT of HIV-1 in the Kisumu Breastfeeding Study. BMC Pediatr. 2014;14:280.CrossRefPubMedPubMedCentral
16.
go back to reference Maonga AR, Mahande MJ, Damian DJ, Msuya SE. Factors affecting exclusive breastfeeding among women in Muheza District Tanga Northeastern Tanzania. A mixed method community based study. Matern Child Health J. 2016;20(1):77–87.CrossRefPubMed Maonga AR, Mahande MJ, Damian DJ, Msuya SE. Factors affecting exclusive breastfeeding among women in Muheza District Tanga Northeastern Tanzania. A mixed method community based study. Matern Child Health J. 2016;20(1):77–87.CrossRefPubMed
17.
go back to reference Jepkogei KW. Determinants of adherence to exclusive breast feeding among HIV positive mothers attending child welfare clinic at Pumwani maternity hospital, Nairobi County, Kenya. Nairobi: Kenyatta University; 2013. Jepkogei KW. Determinants of adherence to exclusive breast feeding among HIV positive mothers attending child welfare clinic at Pumwani maternity hospital, Nairobi County, Kenya. Nairobi: Kenyatta University; 2013.
18.
go back to reference Ladzani R, Peltzer K, Mlambo MG, Phaweni K. Infant‐feeding practices and associated factors of HIV‐positive mothers at Gert Sibande, South Africa. Acta Paediatr. 2011;100(4):538–42.CrossRefPubMed Ladzani R, Peltzer K, Mlambo MG, Phaweni K. Infant‐feeding practices and associated factors of HIV‐positive mothers at Gert Sibande, South Africa. Acta Paediatr. 2011;100(4):538–42.CrossRefPubMed
19.
go back to reference Central Statistical Authority [Ethiopia] and ORC Macro: Ethiopia Demographic and Health Survey 2011. Addis Ababa. Maryland: Ethiopia and Calverton; 2011. Central Statistical Authority [Ethiopia] and ORC Macro: Ethiopia Demographic and Health Survey 2011. Addis Ababa. Maryland: Ethiopia and Calverton; 2011.
20.
go back to reference Demelew MZ, Abdeta G. Assessment of exclusive breastfeeding practice among HIV positive women in Addis Ababa. Afr J Midwifery Womens Health. 2014;8(1):14–20. Demelew MZ, Abdeta G. Assessment of exclusive breastfeeding practice among HIV positive women in Addis Ababa. Afr J Midwifery Womens Health. 2014;8(1):14–20.
21.
go back to reference Bekere A, Garoma W, Beyene F. Exclusive breastfeeding practices of HIV positive mothers and its determinants in selected health institution of West Oromia, Ethiopia. J Nutr Food Sci. 2014;4:6.CrossRef Bekere A, Garoma W, Beyene F. Exclusive breastfeeding practices of HIV positive mothers and its determinants in selected health institution of West Oromia, Ethiopia. J Nutr Food Sci. 2014;4:6.CrossRef
22.
go back to reference 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.CrossRefPubMedPubMedCentral 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.CrossRefPubMedPubMedCentral
23.
go back to reference Matovu S, Kirunda B, Rugamba-Kabagambe G, Tumwesigye N, Nuwaha F. Factors influencing adherence to exclusive breastfeeding among HIV positive mothers in Kabarole District, Uganda. East Afr Med J. 2008;85(4):162–70.CrossRefPubMed Matovu S, Kirunda B, Rugamba-Kabagambe G, Tumwesigye N, Nuwaha F. Factors influencing adherence to exclusive breastfeeding among HIV positive mothers in Kabarole District, Uganda. East Afr Med J. 2008;85(4):162–70.CrossRefPubMed
24.
go back to reference Haile D, Belachew T, Birhanu G, Setegn T, Biadgilign S. Predictors of breastfeeding cessation among HIV infected mothers in southern Ethiopia: a survival analysis. Plos One. 2014;9(3):e90067.CrossRefPubMedPubMedCentral Haile D, Belachew T, Birhanu G, Setegn T, Biadgilign S. Predictors of breastfeeding cessation among HIV infected mothers in southern Ethiopia: a survival analysis. Plos One. 2014;9(3):e90067.CrossRefPubMedPubMedCentral
25.
go back to reference Mataya R, Mathanga D, Chinkhumba J, Chibwana A, Chikaphupha K, Cardiello J. A qualitative study exploring attitudes and perceptions of HIV positive women who stopped breastfeeding at 6 months to prevent transmission of HIV to their children. Malawi Med J. 2013;25(1):15–9.PubMedPubMedCentral Mataya R, Mathanga D, Chinkhumba J, Chibwana A, Chikaphupha K, Cardiello J. A qualitative study exploring attitudes and perceptions of HIV positive women who stopped breastfeeding at 6 months to prevent transmission of HIV to their children. Malawi Med J. 2013;25(1):15–9.PubMedPubMedCentral
26.
go back to reference Aidam BA, Pérez-Escamilla R, Lartey A. Lactation counseling increases exclusive breastfeeding rates in Ghana. J Nutr. 2005;135(7):1691–5.PubMed Aidam BA, Pérez-Escamilla R, Lartey A. Lactation counseling increases exclusive breastfeeding rates in Ghana. J Nutr. 2005;135(7):1691–5.PubMed
27.
go back to reference Maru Y, Haidar J. Infant feeding practice of HIV positive mothers and its determinants in selected health institutions of Addis Ababa, Ethiopia. Ethiop J Health Dev. 2009;23(2):107–14. Maru Y, Haidar J. Infant feeding practice of HIV positive mothers and its determinants in selected health institutions of Addis Ababa, Ethiopia. Ethiop J Health Dev. 2009;23(2):107–14.
28.
go back to reference WHO. Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals. Geneva: WHO Geneva; 2009. WHO. Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals. Geneva: WHO Geneva; 2009.
30.
go back to reference Banteyerga H. Ethiopia’s health extension program: improving health through community involvement. M MEDICC Review. 2011;13(3):46–9.CrossRef Banteyerga H. Ethiopia’s health extension program: improving health through community involvement. M MEDICC Review. 2011;13(3):46–9.CrossRef
31.
go back to reference Wakwoya EB, Zewudie TA, Gebreslasie KZ. Infant feeding practice and associated factors among HIV positive mothers in Debre Markos Referral Hospital East Gojam zone, North West Ethiopia. Pan Afr Med J. 2016;24(300):2–13. Wakwoya EB, Zewudie TA, Gebreslasie KZ. Infant feeding practice and associated factors among HIV positive mothers in Debre Markos Referral Hospital East Gojam zone, North West Ethiopia. Pan Afr Med J. 2016;24(300):2–13.
32.
go back to reference Balcha TT, Lecerof SS, Jeppsson AR. Strategic challenges of PMTCT program implementation in Ethiopia. JInt Assoc Phys AIDS Care. 2011;10(3):187–92. Balcha TT, Lecerof SS, Jeppsson AR. Strategic challenges of PMTCT program implementation in Ethiopia. JInt Assoc Phys AIDS Care. 2011;10(3):187–92.
33.
go back to reference Disha A, Rawat R, Subandoro A, Menon P. Infant and young child feeding (IYCF) practices in Ethiopia and Zambia and their association with child nutrition: Analysis of demographic and health survey data. Afr J Food Agric Nutr Dev. 2012;12(2):5895–914. Disha A, Rawat R, Subandoro A, Menon P. Infant and young child feeding (IYCF) practices in Ethiopia and Zambia and their association with child nutrition: Analysis of demographic and health survey data. Afr J Food Agric Nutr Dev. 2012;12(2):5895–914.
34.
go back to reference Suryavanshi N, Jonnalagadda S, Erande AS, Sastry J, Pisal H, Bharucha KE, et al. Infant feeding practices of HIV-positive mothers in India. J Nutr. 2003;133:1326–31.PubMed Suryavanshi N, Jonnalagadda S, Erande AS, Sastry J, Pisal H, Bharucha KE, et al. Infant feeding practices of HIV-positive mothers in India. J Nutr. 2003;133:1326–31.PubMed
35.
go back to reference Ikeako L, Ezegwui H, Nwafor M, Nwogu-Ikojo E, Okeke T. Infant feeding practices among HIV-Positive Women in Enugu, Nigeria. Br J Med Med Res. 2015;8(1):61–8.CrossRef Ikeako L, Ezegwui H, Nwafor M, Nwogu-Ikojo E, Okeke T. Infant feeding practices among HIV-Positive Women in Enugu, Nigeria. Br J Med Med Res. 2015;8(1):61–8.CrossRef
36.
go back to reference Shongwe MC, Mkhonta N. The experiences of HIV-positive mothers breastfeeding exclusively in Swaziland. Afr J Food Agric Nutr Dev. 2014;15(1):9592–606. Shongwe MC, Mkhonta N. The experiences of HIV-positive mothers breastfeeding exclusively in Swaziland. Afr J Food Agric Nutr Dev. 2014;15(1):9592–606.
37.
go back to reference Arora S, Mcjunkin C, Wehrer J, Kuhn P. Major factors influencing breastfeeding rates: Mother’s perception of father’s attitude and milk supply. Pediatrics. 2000;106(5):e67.CrossRefPubMed Arora S, Mcjunkin C, Wehrer J, Kuhn P. Major factors influencing breastfeeding rates: Mother’s perception of father’s attitude and milk supply. Pediatrics. 2000;106(5):e67.CrossRefPubMed
38.
go back to reference Bilal NK, Herbst CH, Zhao F, Soucat A, Lemiere C. Health extension workers in Ethiopia: improved access and coverage for the rural poor. Yes Africa Can: Success Stories from a Dynamic Continent. 2011; 1–5. Bilal NK, Herbst CH, Zhao F, Soucat A, Lemiere C. Health extension workers in Ethiopia: improved access and coverage for the rural poor. Yes Africa Can: Success Stories from a Dynamic Continent. 2011; 1–5.
39.
go back to reference Zanardo V, Svegliado G, Cavallin F, Giustardi A, Cosmi E, Litta P, Trevisanuto D. Elective cesarean delivery: does it have a negative effect on breastfeeding? Birth. 2010;37(4):275–9.CrossRefPubMed Zanardo V, Svegliado G, Cavallin F, Giustardi A, Cosmi E, Litta P, Trevisanuto D. Elective cesarean delivery: does it have a negative effect on breastfeeding? Birth. 2010;37(4):275–9.CrossRefPubMed
40.
go back to reference Mekuria G, Edris M. Exclusive breastfeeding and associated factors among mothers in Debre Markos, Northwest Ethiopia: a cross-sectional study. Int Breastfeed J. 2015;10:1.CrossRefPubMedPubMedCentral Mekuria G, Edris M. Exclusive breastfeeding and associated factors among mothers in Debre Markos, Northwest Ethiopia: a cross-sectional study. Int Breastfeed J. 2015;10:1.CrossRefPubMedPubMedCentral
Metadata
Title
Breastfeeding counseling and support are associated with continuous exclusive breastfeeding from one week to six months of age among HIV exposed infants in north Gondar zone, Ethiopia: a cross-sectional study
Authors
Haregeweyin Genetu
Melaku Kindie Yenit
Amare Tariku
Publication date
01-12-2016
Publisher
BioMed Central
Published in
International Breastfeeding Journal / Issue 1/2016
Electronic ISSN: 1746-4358
DOI
https://doi.org/10.1186/s13006-017-0113-1

Other articles of this Issue 1/2016

International Breastfeeding Journal 1/2016 Go to the issue