Comparative effects of three methods of promoting breastfeeding among human immunodeficiency virus-infected women in Uganda: a parallel randomized clinical trial.

Abstract:

Background:The objective of this study was to evaluate the comparative effects of three breastfeeding promotion interventions on the duration of exclusive breastfeeding (EBF) and any breastfeeding (BF) among human immunodeficiency virus (HIV)-infected women in Uganda. Methods:Between February 2012 and February 2013, 218 HIV-infected pregnant mothers were randomly assigned to (A) standard care (n=73), (B) enhanced family/peer support (n=72) or (C) enhanced nutrition education (n=73). Results:The prevalence (%) of EBF/BF did not differ between intervention arms at the sixth (A, 85/92; B, 84/91; C, 87/89) and ninth (A, 17/91; B, 18/89; C, 16/87) postpartum month assessments (p>0.05). However, the risk of early BF cessation differed between intervention arms depending on the mother's level of formal education (p=0.04). Among women with no formal education, the risk of early BF cessation was 88% (adjusted hazard ratio [aHR] 0.12 [95% confidence interval {CI} 0.05-0.30]) and 93% (aHR 0.07 [95% CI 0.03-0.18]) lower in arms B and C, respectively, than in arm A (p<0.01). HIV status disclosure to a partner was associated with a higher risk of early EBF (p=0.03) and BF (p=0.04) cessation. Conclusions:In resource-limited settings, enhanced (vs standard care) EBF promotion interventions may not differentially influence EBF but reduce the risk of early BF cessation among women with no formal education. Targeted enhanced interventions among women with no formal education and a mother's partner may be critical to reducing the risk of early EBF/BF cessation.

journal_name

Int Health

journal_title

International health

authors

Namale-Matovu J,Owora AH,Onyango-Makumbi C,Mubiru M,Namuli PE,Motevalli-Oliner M,Musoke P,Nolan M,Fowler MG

doi

10.1093/inthealth/ihy041

subject

Has Abstract

pub_date

2018-11-01 00:00:00

pages

430-441

issue

6

eissn

1876-3413

issn

1876-3405

pii

5054665

journal_volume

10

pub_type

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