INFANT FEEDING DECISIONS AMONG HIV- POSITIVE MOTHERS IN OGOJA, CRISIS RIVER STATE, NIGERIA

INFANT FEEDING DECISIONS AMONG HIV- POSITIVE MOTHERS IN OGOJA, CRISIS RIVER STATE, NIGERIA

Background to the Study

The human immunodeficiency virus, also known as HIV, is a persistent illness that can manifest its symptoms anywhere from a few months to many years after infection. HIV is widespread in all known populations around the world, including the embryonic population (babies who have not yet been born) as well as breastfed infants. According to the World Health Organization (WHO, 2011), more than eleven million individuals throughout the world had passed away as a result of AIDS. In addition, another 3.6 million people are already infected with HIV, and the daily infection rate for HIV is over 16,000 people worldwide (McNaghten, Wolfe, & Onorato, 2021). According to the findings of Anyebe, Whiskey, Ajayi, Garba, Ochigbo, and Lawal (2011), the number of persons infected with HIV/AIDS throughout the world had reached 42 million by the year 2002. Of these 42 million, 38.6 million were adults, and 19.2 million were women. During the same time span, more than 3 million children under the age of 15 were infected around the globe, with approximately 5 million new infections being documented annually. A little under two thirds of these are found in the sub-Saharan region of Africa. It is estimated that 600,000 infants get infected vertically (while they are still in their mothers' wombs) every year around the world. However, in regions where women do not breastfeed, the majority of the transmission takes place during labor and delivery (Meselech, 2022).

There is an increased danger in Nigeria, a country where the majority of women breastfeed their children. Out of the 5.8 million people who were infected in 2003, around 800,000 were newborns and children. Ninety percent of these infants and children became infected through their mothers, which occurred at three different stages: antepartum, intrapartum, and nursing (Okon, 2011). There is presently no cure for HIV, but the prevention of mother-to-child transmission of HIV (also known as PMTCT) looks to be the most essential intervention that can be undertaken (Family Health International, 2004). The American international health alliance (AIHA, 2008) stated in Ajayi, Hellandendu, and Odekunle (2011) that "there is no cure for HIV, but prevention of vertical transmission of HIV to include voluntary counseling and testing, (VCT), ante-retroviral therapy, elective caesarean section; replacement of infant feed or modified breastfeeding, and restrictive use of invasive procedure such as artificial rupture of membrane, (ARM),episiotomies and cleansing of the birth (Minnie, & Greeff, 2021).

According to Sadoh, Adeniran, and Abhulimhen-Iyohas (2008), exclusive breastfeeding is the ideal practice for HIV-positive mothers in the first six months of their child's life, as is currently recommended. This should be followed by replacement feeding (any formula food rather than breast milk), with the choice of which should be based on the acceptability, feasibility, affordability, and sustainability (AFASS) of the latter option (McNaghten, Wolfe, & Onorato, 2021). These suggestions are based on the hypothesis that HIV can be passed from mother to child through breast milk. Infant feeding habits are affected by a number of variables, including an inability to fund the practice, a lack of availability of portable drinking water, and a lack of awareness, particularly among those who are unaware of their HIV status. According to observations made by Chopra, Doherty, and Jackson (2005), HIV-positive mothers' decisions regarding infant feeding options may be influenced by a number of factors, including but not limited to: family income; maternal and paternal education; maternal age; access to storage facilities; access to clean drinking water and adequate sanitation; and cultural values (McNaghten, Wolfe, & Onorato, 2021).

Okelle (2011) came to the conclusion that infants have certain dietary requirements and are born with an immune system that is not fully matured. Because of this, they require nourishment such as breast milk in order to fulfill their requirements. The Federal Ministry of Health (FMOH, 2011) adopted WHO (2010) guidelines that emphasize the values of breastfeeding exclusively for the first six months of life once the mother is on ARVs. After that, with the introduction of appropriate complementary food while continuing breastfeeding for up to two years and beyond with HIV infected mothers, the guidelines recommend that breastfeeding should continue for as long as possible (Meselech, 2022). It also stated that antiretroviral (ARVs) drugs should be made available for HIV positive mothers to reduce the risk of transmission through breastfeeding until one week after the end of breastfeeding, and it strongly recommends that all mothers, including HIV infected mothers, should breastfeed their infants. In addition, it stated that antiretroviral (ARVs) drugs should be made available for HIV positive mothers (Minnie, & Greeff, 2021).

Adejuyigbe, Orji, Onayade, Makinde and Anyabolu (2008) and Maru and Haidar (2009) then recommended that health workers should no longer counsel HIV infected mothers on infant feeding options. Instead, they recommended that health workers should provide information on all the feeding options available, and allow HIV infected mothers to make a choice based on individual circumstances. These recommendations were based on the FMOH standard (Minnie, & Greeff, 2021). In the event that an HIV-positive woman makes the decision not to breastfeed her child, health care professionals are able to offer advice on appropriate and healthy nutrition for the child as well as direct the mother to other resources where she may obtain such advice (McNaghten, Wolfe, & Onorato, 2021). This research was designed to examine the factors that influence the choices of infant feeding options among HIV-positive mothers in the Ogoja Local Government Area of Cross River State. Since the mother's decision to breastfeed or provide complementary feed to her child can be influenced by a number of factors, including HIV status, the scope of this study was limited.

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