Exclusive Breastfeeding Knowledge, Perceptions, and Practices of Mothers of HIV-Exposed Infants in Eldoret, Kenya

Abstract

Background The World Health Organization (WHO) recommends exclusive breastfeeding (EBF) for the first six months in order to improve baby health outcomes. However, adherence to EBF is not optimal, especially among HIV-positive mothers in Sub-Saharan Africa (SSA), which impacts infant mortality rates. Remarkably, due to cultural preferences for mixed feeding and concerns about HIV transmission, only 59% of children born to HIV-positive mothers in Kenya are exclusively breastfed. The association of HIV with EBF poses difficulties, especially in resource-constrained settings, where safe and affordable infant feeding options are limited. Therefore, this study aimed to explore EBF knowledge, perceptions, and practices among HIV-positive mothers with HIV- exposed infants younger than six months at the Moi Teaching and Referral Hospital in Eldoret, Kenya. Methods This exploratory qualitative study involved in-depth interviews with HIV-positive breastfeeding mothers with infants younger than six months who were purposively recruited from various post- natal clinics at the Moi Teaching and Referral Hospital. Interviews were conducted with a total of 27 consenting mothers who met the inclusion criteria in November 2023. Every interview was audio recorded then transcribed directly from Kiswahili into English. The data was analyzed thematically with the support of MAXQDA 2022. Results Mothers reported different feeding practices based on characteristics such as mode of delivery and number of children. Actual feeding practices were influenced by mixed maternal attitudes resulted from competing knowledge(s) with mothers receiving conflicting information on EBF from biomedical, social, and personal sources. Also, tough economic realities, stigma, and the type of support they receive while breastfeeding influenced their feeding practices. Feeding decisions were greatly influenced by cultural norms and beliefs associated with breastfeeding HIV-exposed infants thus influencing the duration of breastfeeding. The clinic set-up played a vital role in v supporting mothers while breastfeeding, although the environment resulted in accidental disclosure of their HIV status. Conclusion This study highlights the many challenges faced by HIV-positive mothers while feeding their babies, shedding light on some factors that impact these practices. Even while mothers are aware of EBF recommendations, the reality of varying practices highlights the necessity of support that considers individual circumstances. The results highlight the need for a thorough and compassionate strategy combining healthcare, social awareness, and tailored advice to enable HIV-positive mothers to make decisions that are best for the health and well-being of themselves and their babies.