183206 Factors Affecting Breastfeeding Cessation Among HIV-Positive Mothers in Kisumu, Kenya

Tuesday, October 28, 2008

Melissa C. Morgan, MSc , University of Texas Medical School at Houston, Houston, TX
Mary Nyikuri , Kenya Medical Research Institute, Kisumu, Kenya
Rose O. Masaba, MD , Kenya Medical Research Institute, Kisumu, Kenya
Timothy K. Thomas, MD , Centers for Disease Control and Prevention, Kisumu, Kenya
Background: Approximately 20% of all perinatal HIV transmission occurs during the postpartum period. In the Kisumu Breastfeeding Study, antiretroviral therapy (ART) is provided during the intrauterine and intrapartum periods, and the first six months of the postpartum period. The study staff counsels women to practice exclusive breastfeeding then wean over two weeks before ART is discontinued at six months. ART is continued for women who meet WHO treatment criteria.

Objective: To do a preliminary evaluation of factors which may influence a mother's decision to comply or not comply with the study recommendation to stop breastfeeding when ART is discontinued in order to guide further formative work.

Methods: We used semi-structured interviews of 18 mothers participating in the study. By interviewing 10 mothers who stopped breastfeeding and 8 mothers who continued, it was possible to examine factors that may have influenced the two groups.

Results: Participants who stopped breastfeeding received more family support (100% vs. 0%), were more educated (75% vs. 25% attended high school), and were more likely to disclose their HIV status (80% vs. 63%). All women stated that it was not traditional to stop breastfeeding at six months, and that it could be stigmatizing. More participants who continued breastfeeding were concerned about stigma (50% vs. 10%).

Conclusion: This study has suggested that family support, education, and traditional norms are important factors influencing a mother's decision regarding breastfeeding cessation. Thus, counseling and family support may play integral roles in the promotion of early breastfeeding cessation. Further evaluation is necessary.

Learning Objectives:
1. Recognize the importance of preventing postnatal transmission of HIV through breastfeeding. 2. Identify the most important factors that influence a motherís decision regarding early breastfeeding cessation. 3. Discuss the implications of these factors on development of strategies to improve compliance with breastfeeding recommendations.

Keywords: Breastfeeding, HIV/AIDS

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted this study and I analyzed the findings in my dissertation for the Master of Science in Global Health Science degree at the University of Oxford.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.