Exclusive Breastfeeding in the Era of AIDS

The aim of this study was to describe breastfeeding practices, as well as what pregnant women know about breastfeeding and mother-to-child transmission (MTCT) of HIV, and explore factors associated with exclusive breastfeeding, especially in the presence of HIV/AIDS. A cross-sectional interview survey of 500 pregnant women was conducted in the Kilimanjaro region, supplemented by focus group discussions with pregnant women. Among the 309 mothers having previously breastfed, 85% had initiated breastfeeding within the first few hours postpartum, and 18% of newborns received some prelacteal food. Mean duration of breastfeeding was 23.7 months, but 46% of mothers had introduced other fluids early. Knowledge of HIV-transmission through breastfeeding was not associated with breastfeeding practices. Married women (odds ratio [OR] = .09, 95% confidence interval [CI] = .04-.24) and those having knowledge of exclusive breastfeeding (OR = .08,95% CI = .02-.31) were the least likely to end exclusive breastfeeding early. Exclusive breastfeeding is a rare practice, and MTCT of HIV may further complicate recommendations with regard to this practice.