Factors influencing the infant feeding choices of HIV positive mothers at a level two hospital in Cape Town

Abstract

Background: In 2009, approximately 130 000 children in Southern Africa under the age of 15 were newly infected with HIV, with vertical transmission being the most common cause of HIV infection. HIV positive mothers are therefore faced with a unique dilemma about which infant feeding choice to make. Prior to 2006,formula feeding was the recommended feeding choice in an attempt to minimise vertical transmission of HIV. In 2006, the risks associated with formula feeding necessitated a change in the recommendations to allow for either exclusive formula feeding or exclusive breastfeeding. The clinical guidelines were reviewed in 2010, when research on the effectiveness of prevention of mother to child transmission efforts suggested a decrease in such transmissions, even when exclusive breastfeeding. Currently the recommendations focus on the contextual appropriateness of the infant feeding choice. The imminent withdrawal of free formula is a new development within the prevention efforts. Aims and Objectives: This study aimed to describe the infant feeding choices of HIV positive mothers on discharge from a level two hospital, in Cape Town. The study objectives included determining the infant feeding choice and the factors that influence HIV positive mothers’ infant feeding choice on discharge from the hospital. Research Methodology: A descriptive survey study design was used as it lends itself to the description of the new developments regarding prevention of mother to child transmission and the meaning it has for the infant feeding choices made by HIV positive mothers. A quantitative approach was used to establish the specified factors that currently affect HIV mothers’ infant feeding choices. A nonrandom consecutive sampling technique was used. The data collection method took the form of a questionnaire. Data analysis was performed through SPSS 20 to produce descriptive and inferential statistics to establish relationships between the independent and dependent variables. Results and Recommendations: The number of exclusive breastfeeding participants was higher (54%) than the exclusively formula feeding participants (46%), which is in keeping with the institution’s trends for the previous year (2011). Statistical significance was difficult to establish due to the small scale of the study, but clinical significance with the establishment of the factors influencing infant feeding choices was considered. These led to the following recommendations: reorientation of infant feeding counselling towards the criteria of acceptability, feasibility, affordability,sustainability and safety, in view of the withdrawal of free formula and promotion of exclusive breastfeeding as the single infant feeding strategy. Ethical Considerations: Ethical clearance was sought from the Ethics Committee of the University of the Western Cape, Research Committee of the level two hospital and informed consent was obtained from the participants.