Mother’s adherence to 2010 WHO infant feeding guidelines on HIV and nutrition status of HIV-exposed children aged 6-24 months: a case study of PMTCT/ART clinics in Mbale district, Uganda

Abstract

Introduction: Limited exposure to breast milk to avoid Mother to Child Transmission (MTCT) can lead to increased risk of morbidity, mortality and growth faltering among HIV- exposed children. Thus good feeding practices especially in the first 12 months of Life are essential. The objective of this study was to assess the relationship between mother 's child feeding practices as per the 20 I 0 WHO IYCF guidelines and the nutritional status of their HlV-exposed infants in Uganda. Methods: A facility based cross-sectional survey employing mixed methods of data collection was used. A structured questionnaire was administered to 320 HIV- positive mothers auending PMTCT/ART clinics. with HIV-exposed children 6-24 months. The data were analyzed using SPSS and WHO Anthro. Bivariate analysis using Odds Ratios was used to determine the association between feeding practices with children’s nutrition status (srunti.ng, underweight and wanting). Results: Most children in this study had normal length -for- age 61.9%, weight - for- age 79.l % and weight-for- length 80.6%. About 30.9% of the children were stunted with 10.3% being severely stunted. Another20.9% were underweight and 19.4% were wasted. Most mother’s adhered to the guidelines, with 67.8% mothers initiating breastfeeding within the recommended one hour after birth. Exclusive breastfeeding was practiced by 87% of the mothers. Introduction of complementary foods at 6 months was practiced by 78.3% while 59% of the mothers had breastfed or intended to breastfeed for the recommended 12 months. Feeding practices found to be associated with stunting and underweight among HIV-exposed infants were; exclusive breastfeeding and introduction of complementary foods to infants before six months of age (COR 1.5: 95%Cl 0.8- 2.6) and (COR l.3; 95%Cl 0.7-2.2) respectively. Duration of breastfeeding and age at introduction of complementary foods were the practices associated with wasting (COR 2.0 95%CI 0.9-4.5). Conclusion. The nutritional status of HIV-exposed children was not different from t11e national statistics. There was an above average adherence by H IV-infected mot11ers to t11e 20I 0 WHO infant feeding guidelines for HlV. Mothers' child feeding practices Gave an effect on Ille nutritional status of HIV-exposed infants especially stunting and underweight. Exclusive breastfeeding of HIV exposed children showed a possible protective effect from malnutrition.