Women’s autonomy in infant feeding decision‑making: a qualitative study in Nairobi, Kenya

Duran, Miriana C, Bosire, Rose, Beima‑Sofe, Kristin M, Kageha Igonya, Emmy, Aluisio, Adam R, Gatuguta, Anne, Mbori‑Ngacha, Dorothy, Farquhar, Carey, Stewart, Grace John and Roxby, Alison C (2021) Women’s autonomy in infant feeding decision‑making: a qualitative study in Nairobi, Kenya. Maternal and Child Health Journal. ISSN 1092-7875

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Abstract

Background
Exclusive breastfeeding (EBF) is the optimal way to feed young infants. Guidelines recommend that women living with HIV on antiretroviral therapy should EBF for 6 months and continue breastfeeding for up to 24 months or longer. Parents may face social or logistical barriers creating challenges to EBF.

Objectives
To explore barriers, facilitators and community norms influencing EBF practices in Kenya.

Methods
This qualitative research was nested within a longitudinal study of intensive maternal counseling to increase EBF among HIV-positive mothers. HIV-negative and HIV-positive mothers were recruited from four public clinics in Nairobi. Women participated in focus group discussions (FGDs) that explored beliefs about and experiences with infant feeding. Conventional content analysis was used to describe and compare barriers and facilitators influencing HIV-positive and HIV-negative women’s EBF experiences.

Results
We conducted 17 FGDs with 80 HIV-positive and 53 HIV-negative women between 2009 and 2012. Overall, women agreed that breastmilk is good for infants. However, early mixed feeding was a common cultural practice. HIV-positive women perceived that infant feeding methods and durations were their decision. In contrast, HIV-negative women reported less autonomy and more mixed feeding, citing peer pressure and lack of HIV transmission concerns. Autonomy in decision-making was facilitated by receiving EBF counseling and family support, especially from male partners. Low milk production was a barrier to EBF, regardless of HIV status, and perceived to represent poor maternal nutrition.

Conclusions
Despite challenges, counseling empowered women living with HIV to advocate for EBF with spouses and family.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Global Health and Infection
SWORD Depositor: Mx Elements Account
Depositing User: Mx Elements Account
Date Deposited: 10 Feb 2021 08:12
Last Modified: 12 Mar 2021 09:46
URI: http://sro.sussex.ac.uk/id/eprint/97055

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