World Health Organisation recommends that babies should be exclusively breastfed for at least six months after birth.
Kenya’s breastfeeding rates stand at an impressive 60 per cent, with many experts attributing this high prevalence to initiatives such as the Baby-Friendly Hospital Initiative (BFHI) and Baby-Friendly Community Initiative (BFCI) which aim at creating conducive environments for breastfeeding at the hospital and community levels respectively.
Even with the increased breastfeeding uptake levels, many mothers still find it difficult to sustain the practice up to the recommended six months, with many introducing post-lacteals as early as two months after birth. Many households and communities lack a supportive environment to help a breastfeeding mother cope with the physical and emotional challenges of breastfeeding, especially during the global pandemic that has brought its own constraints.
Exclusive breastfeeding is challenging for most mothers and the psychological challenges that come with living with a chronic condition must make it particularly difficult for mothers living with HIV. The response measures have affected many mothers’ capacity to adhere to the Antiretroviral Therapy (ART) as recommended by doctors. Movement restrictions and loss of jobs must have had devastatingly disproportionate effects on breastfeeding mothers living with HIV.
According to WHO, with proper support to adhere to ART, mothers living with HIV can breastfeed for at least 12 months and may continue breastfeeding for up to 24 months, just like other mothers. Unfortunately, although a lot has been done over the years to create awareness on HIV as a manageable condition, there is still some stigma associated with testing positive. Many people living with HIV keep it a secret even from their own families for fear of being stigmatised. For breastfeeding mothers who may not be willing to disclose their status, trying to exclusively breastfeed can be a very lonely and challenging experience because many times optimum breastfeeding requires sharing of experiences and building each other’s capacity to sustain the practice for the recommended duration.
Part of managing HIV prevalence rates is the provision of supportive environments for breastfeeding, both at household and community levels. Ensuring that mothers living with HIV have the capacity to adhere to their ART provides a breastfeeding baby with the benefits of breastfeeding.
The recent shortage of ARVs across many health facilities posed a big threat to the gains made in the initiatives aimed at prevention of mother-to-child transmission of HIV, especially during breastfeeding. As the country continues to battle Covid-19, it is very easy for other conditions to be overlooked as healthcare providers focus on preventing the spread of coronavirus. Community healthcare workers therefore, should encourage more pregnant mothers to attend their antenatal clinics, get tested for HIV and begin taking medication early enough.
They should also reach out to known breastfeeding mothers living with HIV to ensure that they adhere to the ART to prevent the transmission of the virus to their breastfeeding babies.
Dr Kalangi is a communication trainer and consultant, Kenyatta University