Inappropriate infant feeding practices of HIV-positive mothers attending PMTCT services in Oromia regional state, Ethiopia: a cross-sectional study

Background: Inappropriate infant feeding affects the probability of mother-to-child transmission of HIV and HIV-free survival of infants. However, in Ethiopia limited evidence exists regarding the infant feeding practice of mothers who are HIV-positive. The aim of this study was to determine the prevalence and predictors of inappropriate infant feeding among HIV-positive mothers attending the prevention of mother-to-child transmission (PMTCT) service in Adama and Bushoftu towns, Oromia, central Ethiopia.

Methods: A cross-sectional study was conducted in ten PMTCT service providing health facilities in the towns; 283 mother-infant pairs were enrolled. Appropriate infant feeding practice was defined as exclusive breastfeeding in the first six months of age. Logistic regression was employed to analyze the data and the outputs are presented using adjusted odds ratio (AOR) with 95% confidence intervals (CI).

Results: One hundred thirty of the infants were aged below six months, 103 between 6 and 11 months and 50 were older than 12 months. The prevalence of inappropriate infant feeding was 14.5% (95% CI 10.6, 18.7). About 6.3% and 8.3% practiced exclusive replacement feeding and mixed feeding respectively, in the first six months. Only 1.8% ever expressed their breast milk to feed their baby and none practiced wet nursing. Among 38 mothers who already discontinued breastfeeding 52.6% did so before 12 months of age. Mothers who were HIV-positive and had received antenatal (AOR = 0.05: 0.01, 0.30) and postnatal visits (AOR = 0.18: 0.04, 0.81); received infant feeding counseling (AOR = 0.18: 0.06, 0.55); and disclosed their HIV status to their partners (AOR = 0.28: 0.12, 0.63), showed a reduction of practicing inappropriate infant feeding. Mothers having breast problems (AOR = 4.89: 1.54, 15.60) and infants with mouth ulcers (AOR = 6.41: 2.07, 19.85) were more likely to practice inappropriate feeding.

Conclusion: Prompt management of breast complaints in mothers and mouth ulcer in infants; and provision of nutrition counseling to HIV-positive mothers, especially during antenatal and postnatal care, may help to improve the infant feeding practices for HIV exposed infants.