Chisenga et al Exclusive Breastfeeding Among HIV-Infected and-Uninfected W omen Factors Affecting the Duration of Exclusive Breastfeeding

Exclusive breastfeeding (EBF) is optimal for infant health and is associated with decreased risk of mother-to-child HIV transmission compared with mixed feeding of breast milk and other foods. To investigate why many women stop EBF before the recommended 6 months, maternal and in-fant health and infant-feeding data were collected from 177 HIV-infected and 177-uninfected Zambian women regularly from 34 weeks gestation to 16 weeks postpartum. Despite strong support for good breastfeeding practice, only 37 % of women were still EBF at week 16. Factors significantly associated with shorter duration of EBF were primiparity, maternal systemic ill-ness, and infant length at 6 weeks. The results suggest that the association of EBF with lower rates of mother-to-child HIV transmission may not be causal but may be secondary to the re-duced duration of EBF associated with poor maternal or infant health. Programs supporting EBF should include support for maternal health. J Hum Lact. 21(3):266-275