Prevalence of exclusive breastfeeding among peri-urban mothers living with and without HIV in Lesotho

Abstract

BACKGROUND : Breastfeeding is lifesaving against child malnutrition, yet exclusive breastfeeding (EBF) rates remain low, particularly among mothers with HIV. OBJECTIVE : We compared the prevalence of EBF between mothers with and without HIV and explored factors associated with breastfeeding. METHODS : A cross-sectional design was used to investigate 151 mother-child dyads; mothers with HIV (n = 73) and without HIV: (n = 78). Structured and previously used questionnaire was used to collect sociodemographic and breastfeeding practices data of mothers of children aged 6-12 months, during routine postnatal care at selected primary healthcare facilities in Maseru. RESULTS : All mothers had similar sociodemographic characteristics, with EBF prevalence of 40.4%. Mothers with HIV had lower rates of EBF than their counterparts (28.8% vs. 51.3%, p = 0.005), despite 98.6% achieving viral suppression. Most mothers with HIV introduced complementary feeding as early as 1-3 months (19.2% vs. 9.0%) and above half of them started giving solid foods from 4-5 months (52.1% vs. 39.7%); p = 0.012). Above a quarter of all mothers received EBF support from healthcare facility, spouse and other family members. Only 40.4% of mothers were encouraged to EBF, while 70.9% believed that breastmilk is sufficient during first six months, and a strong positive correlation was found between EBF and mothers' beliefs (mother with HIV: r = 0.5, p < 0.001; mothers without HIV, r = 0.4; p = 0.001). CONCLUSION : Despite ongoing efforts to promote breastfeeding among mothers with HIV, EBF rates remain low, regardless suppressed viral loads. The belief in breastmilk adequacy during first six months was a key determinant of EBF, underscoring need for targeted education on breastmilk composition and sufficiency.