Sociodemographic and lifestyle correlates of exclusive breastfeeding practices among mothers on antiretroviral therapy in the Eastern Cape, South Africa

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Abstract

Background

Exclusive breastfeeding (EBF) is associated with a reduction of postnatal HIV transmission and optimal infant growth. Given that the factors influencing exclusive breastfeeding are multi-factorial and context-specific, we examined the prevalence and factors associated with exclusive breastfeeding practice in the first 6 months among mothers on antiretroviral therapy in the Eastern Cape, South Africa.

Methods

This was a cross-sectional study conducted between January to May 2018, on 469 parturient women enlisted in the prevention of mother-to-child HIV transmission cohort study in the Eastern Cape. Mothers were asked to recall whether they breastfed their infant exclusively with breast milk from birth and if so, to state how long they did. We collected relevant sociodemographic, lifestyle, and maternal information by interview. Bivariate and multivariable logistic regression analyses were fitted to determine the sociodemographic and lifestyle factors associated with exclusive breastfeeding practice.

Results

The prevalence of six-month exclusive breastfeeding, measured since birth, was 32.0%. E Exclusive breastfeeding’s prevalence was significantly higher among married women (36.8%), unemployed women (36.6%), non-smokers (32.7%), and those who never drank alcohol (37.0%). Unemployed women (adjusted odds ratio [AOR] 1.66, 95% Confidence Interval [CI] 1.08–2.56) and those with grade 12 or less level of education (AOR 2.76, 95% CI 1.02–7.49) had a higher likelihood of practising EBF for 6 months since birth while mothers who consumed alcohol (AOR 0.54, 95% CI 0.34–0.85) were less likely to practice EBF for 6 months.

Conclusions

The prevalence of six-month exclusive breastfeeding in the study, although comparable with sub-Saharan Africa and worldwide prevalence, remains suboptimal. Advocacy campaigns on EBF must target alcohol cessation and the creation of a favourable workplace environment for lactating mothers.

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Most cited references 77

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Maternal and child undernutrition and overweight in low-income and middle-income countries

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Cesar Victora, Rajiv Bahl, Aluísio Barros … (2016)

The importance of breastfeeding in low-income and middle-income countries is well recognised, but less consensus exists about its importance in high-income countries. In low-income and middle-income countries, only 37% of children younger than 6 months of age are exclusively breastfed. With few exceptions, breastfeeding duration is shorter in high-income countries than in those that are resource-poor. Our meta-analyses indicate protection against child infections and malocclusion, increases in intelligence, and probable reductions in overweight and diabetes. We did not find associations with allergic disorders such as asthma or with blood pressure or cholesterol, and we noted an increase in tooth decay with longer periods of breastfeeding. For nursing women, breastfeeding gave protection against breast cancer and it improved birth spacing, and it might also protect against ovarian cancer and type 2 diabetes. The scaling up of breastfeeding to a near universal level could prevent 823,000 annual deaths in children younger than 5 years and 20,000 annual deaths from breast cancer. Recent epidemiological and biological findings from during the past decade expand on the known benefits of breastfeeding for women and children, whether they are rich or poor.

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How many child deaths can we prevent this year?

Gareth Jones, Richard Steketee, Robert E Black … (2003)

This is the second of five papers in the child survival series. The first focused on continuing high rates of child mortality (over 10 million each year) from preventable causes: diarrhoea, pneumonia, measles, malaria, HIV/AIDS, the underlying cause of undernutrition, and a small group of causes leading to neonatal deaths. We review child survival interventions feasible for delivery at high coverage in low-income settings, and classify these as level 1 (sufficient evidence of effect), level 2 (limited evidence), or level 3 (inadequate evidence). Our results show that at least one level-1 intervention is available for preventing or treating each main cause of death among children younger than 5 years, apart from birth asphyxia, for which a level-2 intervention is available. There is also limited evidence for several other interventions. However, global coverage for most interventions is below 50%. If level 1 or 2 interventions were universally available, 63% of child deaths could be prevented. These findings show that the interventions needed to achieve the millennium development goal of reducing child mortality by two-thirds by 2015 are available, but that they are not being delivered to the mothers and children who need them.

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Author and article information

Contributors

Daniel Ter Goon: dgoon@ufh.ac.za

Anthony Idowu Ajayi: ajayianthony@gmail.com , aajayi@aphrc.org

Oladele Vincent Adeniyi:

ORCID: http://orcid.org/0000-0003-0216-6701

vincoladele@gmail.com

Journal

Journal ID (nlm-ta): Int Breastfeed J

Journal ID (iso-abbrev): Int Breastfeed J

Title: International Breastfeeding Journal

Publisher: BioMed Central (London )

ISSN (Electronic): 1746-4358

Publication date (Electronic): 16 February 2021

Publication date PMC-release: 16 February 2021

Publication date Collection: 2021

Volume: 16

Electronic Location Identifier: 18

Affiliations

[1 ]GRID grid.413110.6, ISNI 0000 0001 2152 8048, Department of Public Health, , University of Fort Hare, ; 5 Oxford Street, East London, 5201 South Africa

[2 ]GRID grid.413355.5, ISNI 0000 0001 2221 4219, Population Dynamics and Sexual and Reproductive Health, , African Population and Health Research Centre, ; APHRC Campus, Manga Close, Nairobi, Kenya

[3 ]GRID grid.413110.6, ISNI 0000 0001 2152 8048, Sociology Department, , University of Fort Hare, ; East London, 5201 South Africa

[4 ]GRID grid.461033.3, ISNI 0000 0004 0470 2229, Department of Family Medicine, East London Hospital Complex, , Cecilia Makiwane Hospital, ; East London, South Africa

Author information

Oladele Vincent Adeniyi http://orcid.org/0000-0003-0216-6701

Article

Publisher ID: 366

DOI: 10.1186/s13006-021-00366-4

PMC ID: 7885516

PubMed ID: 33593419

SO-VID: 926a2340-f3b9-4184-b617-686c9473b679

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 3 July 2020

Date accepted : 8 February 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100001322, South African Medical Research Council;

Award ID: SAMRC/03/2017

Custom metadata

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: infants,exclusive breastfeeding,hiv,antiretroviral therapy,south africa

Data availability:

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: infants, exclusive breastfeeding, hiv, antiretroviral therapy, south africa

Sociodemographic and lifestyle correlates of exclusive breastfeeding practices among mothers on antiretroviral therapy in the Eastern Cape, South Africa

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Most cited references 77

Maternal and child undernutrition and overweight in low-income and middle-income countries

Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect.

How many child deaths can we prevent this year?

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