Sociodemographic and lifestyle correlates of exclusive breastfeeding practices among mothers on antiretroviral therapy in the Eastern Cape, South Africa
Abstract Background: Exclusive breastfeeding is associated with a reduction of postnatal HIV transmission and optimal infant growth. Given that the factors influencing exclusive breastfeeding are multi-factorial and context-specific, we examined the prevalence and factors associated with exclusive breastfeeding practice in the first six months among mothers on antiretroviral therapy 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. Exclusive breastfeeding was defined as infant feeding with breast milk only. We collected relevant sociodemographic, lifestyle and maternal information by interview. Bivariate and multivariable logistic regression analyses were fitted to determine the sociodemographic and lifestyle factors associated with exclusive breastfeeding practice.Results: Exclusive breastfeeding for six months was practised by a few women (32.0%). The prevalence of exclusive breastfeeding 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 [adjusted odds ratio (AOR) = 1.66, 95% Confidence Interval 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: The prevalence of exclusive breastfeeding in the study, although comparable with sub-Saharan Africa and worldwide prevalence, remain suboptimal. Advocacy campaign on exclusive breastfeeding must target alcohol cessation and the creation of a favourable workplace environment for lactating mothers.