Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2013

Open Access 01-12-2013 | Research article

Exclusive breastfeeding prenatal intentions among HIV-positive mothers in Blantyre, Malawi: a correlation study

Authors: Ursula K Kafulafula, Mary K Hutchinson, Susan Gennaro, Sally Guttmacher, Andrew Kumitawa

Published in: BMC Pregnancy and Childbirth | Issue 1/2013

Login to get access

Abstract

Background

Exclusive breastfeeding is an important component of child survival and prevention of mother-to-child transmission of HIV in resource-poor settings like Malawi. In Malawi, children under the age of six months are exclusively breastfed for an average duration of 3.7 months. This falls short of the recommendations by the World Health Organization as well as the Malawi Ministry of Health that mothers exclusively breastfeed for the first six months of the child’s life. Understanding factors that influence exclusive breastfeeding duration among HIV-positive mothers is important in promoting exclusive breastfeeding among these mothers. An exploratory study was therefore conducted to determine factors that influence HIV-positive mothers’ prenatal intended duration of exclusive breastfeeding and their likelihood to exclusively breastfeed for six months.

Methods

This paper is based on data from a longitudinal, descriptive and correlation study that was conducted at Queen Elizabeth Central Hospital in Blantyre, Malawi between May 12, 2009 and March 22, 2010. Theory of Planned Behavior guided the study. A face-to-face survey was utilized to collect data from a convenience sample of 110 HIV-positive mothers who were at least 36 weeks pregnant at baseline. A modified and pre-tested breastfeeding attrition prediction tool was used to measure exclusive breastfeeding beliefs, intentions and external influences at baseline. Data were analyzed using descriptive and association statistics. Additionally, multiple regressions were run to determine significant predictors of HIV-positive mothers’ prenatal intended duration of exclusive breastfeeding and their likelihood to exclusively breastfeed for six months.

Results

Results revealed high exclusive breastfeeding prenatal intentions among HIV-positive mothers. Prenatal intended duration of exclusive breastfeeding was positively associated with normative, control beliefs and negatively associated with positive beliefs, maternal education and disclosure of HIV status.

Conclusions

Current results suggest that assessment of mothers’ level of education and their positive beliefs towards exclusive breastfeeding may help to identify mothers who are at risk of discontinuing exclusive breastfeeding. Interventions to promote exclusive breastfeeding could include provision of appropriate skills, support and information to help HIV-positive mothers gain control over exclusive breastfeeding.
Appendix
Available only for authorised users
Literature
1.
Black RE, Morris SS, Bryce J: Where and why 10 million children are dying every year?. Lancet. 2003, 361: 2226-2234. 10.1016/S0140-6736(03)13779-8.CrossRefPubMed
2.
Bulterys M, Fowler MG, Rompay KKV, Kourtis A: Prevention of mother-to-child transmission of HIV-1 through breast-feeding: Past, present, and future. J Infect Dis. 2004, 189: 2149-2153. 10.1086/420835.CrossRefPubMed
3.
Coovadia HM, Rollins NC, Bland RM, Little K, Coutsoudis A, Bannish ML, et al: 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: 1107-1116. 10.1016/S0140-6736(07)60283-9.CrossRefPubMed
4.
Iliff PJ, Piwoz EG, Tavengwa NV, Zunguza CD, Marinda ET, Nathoo KJ, et al: Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival. AIDS. 2005, 19: 699-708. 10.1097/01.aids.0000166093.16446.c9.CrossRefPubMed
5.
World Health Organization: A report of the Expert Consultation. The optimal duration of exclusive breastfeeding. 2002, Geneva, Switzerland: World Health Organization
6.
Ministry of Health: (MOH): Infant and young child nutrition policy and guidelines. 2005, Lilongwe, Malawi: Design Printers
7.
National AIDS Commission (NAC) of Malawi: HIV/AIDS research strategy for Malawi 2005-2007. 2005, Lilongwe: Malawi: Design Printers
8.
Maru Y, Haidar J: Infant feeding practices of HIV positive mothers and its determinants in selected health institutions of Addis Ababa, Ethiopia. Ethiop J Health Dev. 2009, 23 (2): 107-114.
9.
Omari AAA, Luo C, Kankasa C, Bhat GJ, Bunn J: Infant-feeding practices of mothers of known HIV status in Lusaka, Zambia. Health Policy Plan. 2003, 18 (2): 156-162. 10.1093/heapol/czg020.CrossRefPubMed
10.
Poggensee G, Schulze K, Moneta I, Mbezi P, Baryomunsi C, Harms G, et al: Infant feeding practices in western Tanzania and Uganda: implications for infant feeding recommendations for HIV-infected mothers. Trop Med Int Health. 2004, 9 (4): 477-485. 10.1111/j.1365-3156.2004.01214.x.CrossRefPubMed
11.
National Statistical Office (NSO) [Malawi], and ORC Macro: Malawi Demographic and Health Survey-2010. 2011, Calverton, Maryland: Nso and ORC Macro
12.
Kalanda BF, Verhoeff FH, Brabin BJ: Breastfeeding and complementary feeding practices in relation to morbidity and growth in Malawian infants. Eur J Clin Nutr. 2006, 60: 401-407. 10.1038/sj.ejcn.1602330.CrossRefPubMed
13.
Kamudoni P, Maleta K, Shi Z, Holmboe-Ottesen G: Infant feeding practices in the first 6 months and associated factors in a rural and semi urban community in Mangochi District, Malawi. J Hum Lact. 2007, 23 (4): 325-332. 10.1177/0890334407307567.CrossRefPubMed
14.
Kerr RB, Berti PR, Chirwa M: Breastfeeding and mixed feeding practices in Malawi: Timing, reasons, decision makers, and child health consequences. Food Nutr Bull. 2007, 28 (1): 90-99.CrossRefPubMed
15.
Vaahtera M, Kulmala T, Hietamen A, Ndekha M, Cullinan T, Salin ML, et al: Breastfeeding and complementary feeding practices in Malawi. Acta Paediatr. 2001, 90: 328-332.CrossRefPubMed
16.
National Statistical Office (NSO) [Malawi], and ORC Macro: Malawi Demographic and Health Survey-2004. 2005, Calverton, Maryland: Nso and ORC Macro
17.
Bentley ME, Corneli AL, Piwoz E, Moses A, Nkhoma J, Tohill BC, et al: Perceptions of the role of maternal nutrition in HIV-positive breastfeeding women in Malawi. J Nutr. 2005, 135: 945-949.PubMed
18.
Jemmott LS, Jemmott JB, Hutchinson MK: From prevention needs and strategies for a public health emergency. Health issues in the Black community. Edited by: Braithwaite R. 2001, San Francisco, California: Jossey-Bass, 309-346. 2
19.
Yovsi RD, Keller H: Breastfeeding: An adaptive process. Ethos. 2003, 31 (2): 147-171. 10.1525/eth.2003.31.2.147.CrossRef
20.
Ajzen I: Attitudes, personality and behavior. 2005, New York: Open University Press
21.
Werner P: From reasoned action and planned behavior. Middle range theories. Application to Nursing research. Edited by: Peterson SJ, Bredow TS. 2004, Philadelphia, PA: Lippincott Williams & Wilkins, 125-147.
22.
Daza P, Banda R, Misoya K, Katsulukuta A, Gessner BD, Katsande R, et al: The impact of routine infant immunisation with haemophilus influenzae type b conjugate vaccine in Malawi, a country with high human immunodeficiency virus prevalence. Vaccine. 2006, 24: 6232-6239. 10.1016/j.vaccine.2006.05.076.CrossRefPubMed
23.
Giles M, Connor S, McClenahan CM, Mallett J, Stewart-Knox B, Wright M: Measuring young people’s attitudes to breastfeeding using the Theory of Planned Behavior. J Publ Health. 2007, 29 (1): 17-26. 10.1093/pubmed/fdl083.CrossRef
24.
Rempel LN: Factors influencing the breastfeeding decisions of long-term breastfeeders. J Hum Lact. 2004, 20 (3): 306-318. 10.1177/0890334404266969.CrossRefPubMed
25.
Saunders-Goldson MS, Edwards CQT: Factors associated with breastfeeding intentions of African-American women at a Military Health Care Facility. Mil Med. 2004, 169 (2): 111-116.CrossRefPubMed
26.
Janke JR: Development of the breast-feeding attrition prediction tool. Nurs Res. 1994, 43 (2): 100-104.CrossRefPubMed
27.
Groves RM, Fowler FJ, Couper MP, Lepkowski JM, Singer E, Tourangean R: Survey methodology. 2004, Hoboken, New Jersey: Wiley-Interscience
28.
Evans ML, Dick MJ, Lewallen LP, Jeffrey C: Modified breastfeeding attrition prediction tool: Prenatal and postnatal tests. J Perinat Educ. 2004, 13 (1): 1-8. 10.1624/105812404826351.CrossRefPubMedPubMedCentral
29.
Gill SL, Reifsnider E, Lucke JF, Mann AR: Predicting breast-feeding attrition. Adapting the breast-feeding attrition tool. J Perinat Nurs. 2007, 21 (3): 216-224. 10.1097/01.JPN.0000285811.21151.37.CrossRef
30.
Lewallen LP, Dick MJ, Wall Y, Zickefoose KT, Hannah SH, Flowers J, et al: Toward a clinically useful method of predicting early breast-feeding attrition. Appl Nurs Res. 2006, 19: 144-148. 10.1016/j.apnr.2005.06.004.CrossRefPubMed
31.
Humphreys AS, Thompson NJ, Miner KR: Intention to breastfeed in low-income pregnant women: The role of social support and previous experience. Birth. 1998, 25 (3): 169-174. 10.1046/j.1523-536X.1998.00169.x.CrossRefPubMed
32.
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: 1326-1331.PubMed
33.
Adejuyigbe E, Orji E, Onayade A, Makinde N, Anyabolu H: Infant feeding intentions and practices of HIV-positive mothers in Southwestern Nigeria. J Hum Lact. 2008, 24 (3): 303-310. 10.1177/0890334408317765.CrossRefPubMed
34.
Doherty T, Besser M, Donohue S: Case study reports on implementation and expansion of the PMTCT programme in the nine Provinces of South Africa. 2003, Health System Trust: Cape Town
35.
Leroy V, Sakarovitch C, Viho I: The ANRS 1201/1202 Ditrane Plus study group. Acceptability of formula feeding to prevent HIV postnatal transmission. Abidjan, Cote d’Ivoire. J Acquir Immune Defic Syndr. 2007, 144: 77-86.CrossRef
36.
Aidam BA, Perez-Escamilla R, Lartey A: Lactation counseling increases exclusive breast-feeding rates in Ghana. J Nutr. 2005, 135: 1691-1695.PubMed
37.
Mattar CN, Chong YS, Chan YS, Chew A, Tan P, Chan YH, et al: Simple antenatal preparation to improve breastfeeding practice. Obstet Gynecol. 2007, 109 (1): 73-80. 10.1097/01.AOG.0000249613.15466.26.CrossRefPubMed
38.
Noel-Weiss J, Rupp A, Cragg B, Bassett V, Woodend AK: Randomization controlled trial to determine effects of prenatal breastfeeding workshop on maternal breastfeeding self-efficacy and breastfeeding duration. J Obstet Gynecol Neonatal Nurs. 2006, 35 (5): 616-624. 10.1111/j.1552-6909.2006.00077.x.CrossRefPubMed
39.
Olayemi O, Aimakhu CO, Bello FA, Motayo VO, Ogunleye AA, Odunukan OW, et al: The influence of social support on the duration of breast-feeding among antenatal patients in Ibadan. J Obstet Gynaecol. 2007, 27 (8): 802-805. 10.1080/01443610701666876.CrossRefPubMed
40.
Wolfberg AJ, Michels KB, Shields W, O’Campo P, Bronner Y, Bienstock J: Dads as breastfeeding advocates: Results from a randomized controlled trial of an educational intervention. Am J Obstet Gynecol. 2004, 191: 708-712. 10.1016/j.ajog.2004.05.019.CrossRefPubMed
Metadata
Title
Exclusive breastfeeding prenatal intentions among HIV-positive mothers in Blantyre, Malawi: a correlation study
Authors
Ursula K Kafulafula
Mary K Hutchinson
Susan Gennaro
Sally Guttmacher
Andrew Kumitawa
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2013
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-13-203

Other articles of this Issue 1/2013

BMC Pregnancy and Childbirth 1/2013 Go to the issue

Research article

Maternity care providers’ perceptions of women’s autonomy and the law

Research article

Perspectives on weight gain and lifestyle practices during pregnancy among women with a history of macrosomia: a qualitative study in the Republic of Ireland

Research article

Green space, social inequalities and neonatal mortality in France

Research article

A structured review and exploration of the healthcare costs associated with stillbirth and a subsequent pregnancy in England and Wales

Research article

A community perspective on the role of fathers during pregnancy: a qualitative study

Research article

Dutch women in midwife-led care at the onset of labour: which pain relief do they prefer and what do they use?