Feeding Practices And Nutrition Status Of Hiv-Exposed Infants 0-5 Months Of Age Attending Tenwek Hospital In Bomet County, Kenya

ABSTRACT

Out of an annual 15 million pregnancies globally, an estimated overall Human Immunodeficiency Virus prevalence of 0.34% is reported in antenatal women in Kenya. In 2013, there were 13,000 new HIV infections among children. Appropriate feeding practices and good nutrition status are important for the survival, growth, development, health and nutrition of HIV-exposed infants as well as the wellbeing of their mothers. The recommended infant feeding practice is exclusive breastfeeding (EBF) or exclusive replacement feeding (ERF) for the first 6 months of life. There is limited literature in Kenya and Bomet County on feeding practices and nutrition status of HIV-exposed infants 0-5 months of age, particularly after the changes in Infant and Young Child Feeding recommendations for HIV-exposed infants in the year 2010. The purpose of this study was to determine the feeding practices and nutrition status of HIV-exposed infants who are 0-5 months of age attending the Tenwek Hospital‟s paediatric clinic in Bomet County. The study adopted a cross-sectional analytical study design with quantitative and qualitative approaches in data collection, analysis and presentation. A comprehensive sample of 118 mothers/caregivers with HIV-exposed infants 0-5 months of age participated in the study. A researcher-administered questionnaire, focus group discussion guide and key informant interview guide were used to collect data. The data was analysed using SPSS version 22. Nutrition status was analysed using ENA for SMART based the WHO 2006 growth standards‟ Z-scores and then exported to SPSS. Infant feeding was based on the mode of feeding in the previous 24 hours. Statistical significance was set at p values less than 0.05. Exclusive breastfeeding was practiced by the majority of the participants (73.7%), 14.4% practiced exclusive replacement feeding and 11.9% mixed fed their infants. More than half the infants had normal length for age (57.6%), weight for age (60.2%) and weight for length (76.3%). About a third (38.1%) of the infants were moderately and severely stunted, 39% were moderately and severely underweight and 19.5% were moderately wasted. No severe wasting was recorded. Infants on EBF were less likely to be stunted (OR=2.401; p=0.001; 95% CI 0.906-5.806) or underweight (OR=2.001; p=0.001; 95% CI 0.328-6.124) compared to those on mixed feeding. There was however, no significant difference in the likelihood for wasting among infants on EBF, ERF or mixed feeding (OR=1.528; 95% CI 0.294-7.954; p=0.614). Challenges to optimal infant feeding were lack of adequate financial resources, cultural beliefs, HIV-related stigma and conflicting knowledge on current guidelines and recommendations on infant and young child feeding. Based on the findings, it is recommended that the Ministry of Health, National AIDS and STI Control Programme, County Government of Bomet and Tenwek Hospital develop a policy to support infants who qualify for exclusive replacement feeding but mothers/caregivers face financial constraints. In addition, they should organize training for non-nutritionist health workers on the current guidelines for infant and young child feeding in the context of HIV.