Affiliations: Paediatrics and Child Health Department, Faculty of
Medicine/Gulu Referral and Teaching Hospital, Gulu University, Gulu,
Uganda | Department of Paediatrics, Makerere University,
Uganda | Mulago National Referral Hospital, Uganda
Note: [] Correspondence: Odongkara Beatrice Mpora, Endocrinologist and
Diabetologist/Lecturer/Paediatrician, Department of Paediatrics and Child
Health, Gulu, Uganda. Tel.: +256772896397; E-mail: [email protected],
[email protected]
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
