Knowledge, perceptions and Practices of Mothers Living with HIV regarding feeding infants aged 0 to 6 Months: A Qualitative Study

Background Appropriat e infant feeding practices among mothers living with HIV (MLWHIV) are critical for preventing mother-to-child transmission (MTCT) of HIV and promoting infant health. We explored the knowledge, perceptions and practices of MLWHIV regarding infant feeding during the first 6 months of infant life in KwaZulu Natal, South Africa. Methods This was an explorative-descriptive qualitative study. We conducted in-depth interviews with a purposive sample of 12 MLWHIV and infants aged below 6 months. We obtained data using a semi-structured interview guide and data were analyzed thematically. Results Three key themes emerged: mothers’ current infant feeding practices, perceptions of feeding infants less than six months, and knowledge of strategies for preventing MTCT of HIV in the context of infant feeding. Exclusive breastfeeding (EBF) was practiced by only three participants, while mixed feeding was the most common (n = 5) and four participants were giving formula plus complementary feeds. EBF choice was informed by perceived benefits of breastfeeding and trust in the education provided by healthcare providers. Work commitments, perceptions of inadequate breastmilk or baby not getting full, fear of MTCT of HIV and influence from relevant others influenced other feeding options. Participants displayed positive perceptions about breastfeeding irrespective of adopted feeding methods. However, poor understanding of infant feeding guidelines (recommended age for introducing complementary foods, the meaning of EBF and mixed feeding) contributed to inappropriate feeding practices including early introduction of complementary feeds. Nonetheless, participants credited healthcare providers for their knowledge on the benefits of breastfeeding and MTCT of HIV prevention strategies. Conclusion Inappropriate infant feeding practices were common despite favourable perceptions about breastfeeding. Thus, targeted community-based interventions including support system to enhance the knowledge and confidence of MLHIV to practice EBF are needed.