Department of Global Health, University of Washington, 1510 San Juan Rd, Seattle, WA, 98195, USA.
Centre for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya.
Matern Child Health J. 2021 May;25(5):724-730. doi: 10.1007/s10995-021-03119-1. Epub 2021 Feb 5.
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.
To explore barriers, facilitators and community norms influencing EBF practices in Kenya.
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.
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.
Despite challenges, counseling empowered women living with HIV to advocate for EBF with spouses and family.
纯母乳喂养（EBF）是喂养婴幼儿的最佳方式。指南建议接受抗逆转录病毒治疗的 HIV 感染者应进行 6 个月的纯母乳喂养，并持续母乳喂养至 24 个月或更长时间。父母可能面临社会或后勤方面的障碍，这给纯母乳喂养带来了挑战。
探索影响肯尼亚纯母乳喂养实践的障碍、促进因素和社区规范。
这项定性研究嵌套在一项旨在通过强化产妇咨询来增加 HIV 阳性母亲纯母乳喂养率的纵向研究中。在奈洛比的四家公立诊所招募了 HIV 阴性和 HIV 阳性的母亲。女性参与了焦点小组讨论（FGD），探讨了对婴儿喂养的信念和经验。采用常规内容分析来描述和比较影响 HIV 阳性和 HIV 阴性妇女纯母乳喂养体验的障碍和促进因素。
我们在 2009 年至 2012 年间进行了 17 次 FGD，其中包括 80 名 HIV 阳性和 53 名 HIV 阴性女性。总的来说，女性们一致认为母乳对婴儿有益。然而，早期混合喂养是一种常见的文化习俗。HIV 阳性妇女认为婴儿喂养方式和持续时间是她们自己的决定。相比之下，HIV 阴性妇女报告的自主权较少，混合喂养更多，她们提到了同伴压力和缺乏对 HIV 传播的担忧。自主权在决策方面得到了母乳喂养咨询和家庭支持的促进，尤其是来自男性伴侣的支持。无论 HIV 状况如何，母乳产量低都是纯母乳喂养的一个障碍，被认为代表了母亲营养状况不佳。
尽管存在挑战，但咨询使感染 HIV 的妇女能够与配偶和家人一起倡导纯母乳喂养。
