Exclusive Breastfeeding Is More Common Among HIV-Infected Than HIV-Uninfected Kenyan Mothers at 6 Weeks and 6 Months Postpartum

May 4, 2017Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine

Exclusive Breastfeeding Is More Common at 6 Weeks and 6 Months After Birth in Kenyan Mothers with HIV Than Those Without

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Abstract

At 6 months postpartum, 43.3% of HIV-positive mothers exclusively breastfed according to the deuterium oxide technique.

HIV-infected mothers reported higher exclusive breastfeeding rates than HIV-uninfected mothers at both 6 weeks (94.1% vs. 76.9%) and 6 months (75% vs. 59.7%) postpartum based on maternal recall.
The deuterium oxide technique indicated much lower exclusive breastfeeding rates, with only 23.5% of HIV-positive and 13.8% of HIV-negative mothers exclusively breastfeeding at 6 weeks postpartum.
At 6 months postpartum, the deuterium oxide technique found exclusive breastfeeding rates of 43.3% for HIV-positive mothers and 24.2% for HIV-negative mothers.
Maternal recall appears to overestimate exclusive breastfeeding rates compared to the objective deuterium oxide dilution technique.
The findings suggest a need for validating maternal recall data using objective measures to improve accuracy in breastfeeding tracking.

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OBJECTIVE: To compare breastfeeding practices determined by mothers' own recall versus a stable isotope technique (deuterium oxide dilution) among human immunodeficiency virus (HIV)-infected and HIV-uninfected mothers at 6 weeks and 6 months postpartum.

METHODS: Exclusive breastfeeding (EBF) rates were assessed cross-sectionally at 6 weeks and 6 months postpartum among 75 HIV-positive and 68 HIV-negative women attending postnatal care. EBF was derived from maternal 24-hour recall of foods that were fed to the infant and by objective measurement of nonhuman milk-water intake using deuterium oxide (DO) dilution technique.

RESULTS: Multivariable logistic analyses were adjusted for infant sex, gravidity, maternal age, marital status, and maternal education. Using recall method, a greater proportion of HIV-infected mothers exclusively breastfed than HIV-uninfected mothers both at 6 weeks postpartum [94.1% versus 76.9%, respectively (adjusted odds ratio [aOR] 7.81; 95% confidence interval [CI] 1.9-31.6, p = 0.004)] and at 6 months postpartum [75% versus 59.7%, respectively (aOR 2.27; 95% CI 1.0-5.3, p = 0.058)]. At 6 weeks postpartum EBF rates from the DO technique were 23.5% and 13.8% for HIV-positive and HIV-negative mothers, respectively (aOR 0.35; 95% CI 0.11-1.04, p = 0.059). At 6 months postpartum, the DO technique determined EBF rates were 43.3% among HIV-positive and 24.2% among HIV-negative mothers, respectively (aOR 2.4; 95% CI 1.0-5.7, p = 0.048).

CONCLUSIONS: HIV-infected mothers are more likely to exclusively breastfeed compared with HIV-uninfected mothers. In this resource-poor setting, maternal recall overestimates EBF rates as compared with the deuterium oxide dilution technique. Validating EBF recall data using the objective DO technique is highly recommended for accurate tracking toward global targets on breastfeeding practices.

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Exclusive Breastfeeding Is More Common Among HIV-Infected Than HIV-Uninfected Kenyan Mothers at 6 Weeks and 6 Months Postpartum

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