Womens autonomy infant feeding decision-making, Final revision_2.pdf (318.95 kB)
Women’s autonomy in infant feeding decision-making: a qualitative study in Nairobi, Kenya
journal contribution
posted on 2023-06-09, 23:01 authored by Miriana C Duran, Rose Bosire, Kristin M Beima-Sofe, Emmy Kageha Igonya, Adam R Aluisio, Anne GatugutaAnne Gatuguta, Dorothy Mbori-Ngacha, Carey Farquhar, Grace John Stewart, Alison C RoxbyBackground 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.
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Publication status
- Published
File Version
- Accepted version
Journal
Maternal and Child Health JournalISSN
1092-7875Publisher
SpringerExternal DOI
Department affiliated with
- Global Health and Infection Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2021-02-10First Open Access (FOA) Date
2022-02-06First Compliant Deposit (FCD) Date
2021-02-10Usage metrics
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