Prevalence of exclusive breastfeeding among peri-urban mothers living with and without HIV in Lesotho.

BACKGROUND

Breastfeeding is lifesaving against child malnutrition, yet exclusive breastfeeding (EBF) rates remain low, particularly among mothers with HIV.

OBJECTIVE

We compared the prevalence of EBF between mothers with and without HIV and explored factors associated with breastfeeding.

METHODS

A cross-sectional design was used to investigate 151 mother-child dyads; mothers with HIV (n = 73) and without HIV: (n = 78). Structured and previously used questionnaire was used to collect sociodemographic and breastfeeding practices data of mothers of children aged 6-12 months, during routine postnatal care at selected primary healthcare facilities in Maseru.

RESULTS

All mothers had similar sociodemographic characteristics, with EBF prevalence of 40.4%. Mothers with HIV had lower rates of EBF than their counterparts (28.8% vs. 51.3%, p = 0.005), despite 98.6% achieving viral suppression. Most mothers with HIV introduced complementary feeding as early as 1-3 months (19.2% vs. 9.0%) and above half of them started giving solid foods from 4-5 months (52.1% vs. 39.7%); p = 0.012). Above a quarter of all mothers received EBF support from healthcare facility, spouse and other family members. Only 40.4% of mothers were encouraged to EBF, while 70.9% believed that breastmilk is sufficient during first six months, and a strong positive correlation was found between EBF and mothers' beliefs (mother with HIV: r = 0.5, p < 0.001; mothers without HIV, r = 0.4; p = 0.001).

CONCLUSION

Despite ongoing efforts to promote breastfeeding among mothers with HIV, EBF rates remain low, regardless suppressed viral loads. The belief in breastmilk adequacy during first six months was a key determinant of EBF, underscoring need for targeted education on breastmilk composition and sufficiency.