Factors associated with the practice of exclusive breastfeeding for six months among mothers on antiretroviral therapy in the Eastern Cape, South Africa

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Abstract Background: Exclusive breast feeding (EBF) is associated with reduction of post-natal HIV transmission and optimal infant growth. Given that the factors influencing EBF are multi-factorial and context-specific, we examined the prevalence and factors associated with EBF practice in the first six months among mothers on antiretroviral therapy (ART) in the Eastern Cape, South Africa. Methods: This was a prospective cross-sectional study conducted between January – May 2018 on 469 parturient women enlisted in the prevention of mother-to-child HIV transmission cohort study in the Eastern Cape. EBF was defined as infant feeding with breast milk only. We collected relevant socio-demographic, lifestyle and maternal information by interview. Bivariate and multivariate logistic regression analyses were fitted to determine the factors associated with EBF practice.Results: EBF for six months was practised by a few women (32.0%). The prevalence of EBF was significantly higher among married women (36.8%), unemployed women (36.6%), non-smokers (32.7%) and those who never drank alcohol (37.0%). Unemployed women (AOR = 1.66, 95% CI: 1.08-2.56) and those with grade 12 or less level of education (AOR =2.76, 95% CI: 1.02-7.49) had a higher likelihood of practising EBF for six months while mothers who consumed alcohol (AOR = 0.54, 95% CI: 0.34-0.85) were less likely to practice EBF for six months. Conclusions: Sub-optimal rate of EBF in this study is comparable with the national (31.6%), sub-Saharan Africa (36%) and WHO global (35%) rates. Advocacy campaign on EBF must target alcohol cessation and the creation of a favourable workplace environment for lactating mothers.

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