CHAPTER ONE
INTRODUCTION
- Background to the Study
Infant feeding is essential in the first year of life and a key determinant of child survival and development. Breastfeeding is a universal socio-culturally acceptable, nutritious way to feed infants and enhances children immunity (UNAIDS, 2015). However, research indicates that breast milk contributes about 15% of the risk of HIV transmission from an infected mother to the child, especially when mixed feeding is practiced before weaning (Nduati, Richardson & John, 2011). In sub Saharan Africa, mother to child transmission (MTCT) of HIV is responsible for about 90% of infection in children, and about half of these infection thought have been acquired through breast feeding (Newell, 2016). The dilemma posed between lifesaving benefit and risk of transmission through breastfeeding complicate infant feedings in a communities affected by HIV/AIDS. Globally, it is estimated that 35% of under-five mortality is due to HIV and AIDS (UNAIDS, 2015).
Prevention of mother-to-child transmission (PMTCT) of HIV is an important intervention in the prevention and control of HIV and AIDS to reduce child mortality and increase the rate of child survival (UNAIDS, 2015). A culturally acceptable, low cost approach to infant feeding is essential to prevent HIV transmission through breast milk (Coovadia, Rollins, Bland, Little, Coutsoudi, Bennish & Newell, 2014). In countries not affected by HIV, improving infant feeding can reduce mortality by up to 19%. The impact could be greater in HIV affected populations if interventions that reduce HIV transmission through breastfeeding could be successfully linked to strategies that improve infant feeding practices (Coovadia et al., 2014). However, this is confounded by the complexity of identifying the most appropriate infant feeding practices that fit household and social circumstances of mothers. The World Health Organization recommends that in light of the effectiveness of Anti-retrovirals (ARVs), HIV infected mothers should continue breast feeding their infant until twelve months of age (WHO, 2010).This capitalizes on the maximum benefit of breast feeding to improve the infant’s chances of survival while reducing the risk of HIV transmission.