Feeding Experiences of HIV-Exposed Preterm Infants Among Mothers Living with HIV in Addis Ababa, Ethiopia: A Qualitative Study

INTRODUCTION: Providing adequate nutrition to preterm infants who are born to HIV-positive mothers is more challenging due to the mother’s underlying health and nutrition status. The understanding of these issues and active participation of the mothers have a significant role in giving continuous care for HIV-exposed preterm infant. Hence, this study aimed to explore the experience of HIV-positive mothers’ feeding practice of their preterm infants, and health workers to identify barriers and facilitators of feeding HIV-exposed preterm infants. METHODS: A phenomenological qualitative study design was conducted in Addis Ababa, Ethiopia, between May 1, 2016 and March 31, 2017. Mothers who gave birth to HIV-exposed preterm infants at the study sites’ follow-up clinic were traced and invited by the healthcare providers to voluntarily participate in this study. Fifteen in-depth interviews with mothers of HIV-exposed preterm infants and seven key informant interviews with health professionals and policymakers were carried out. The interviews were transcribed and translated and then manually analyzed thematically. RESULTS: The health education given during antenatal care (ANC) did not consider the feeding practice needs for HIV-exposed preterm infants. Child health status, desire to have a healthy infant, financial constraints and family support were among the influential factors in the feeding practice of HIV-exposed preterm infants mentioned by the study participants. HIV-exposed preterm infant feeding procedure neither has a guideline nor is clearly mentioned in the national HIV guidelines. CONCLUSION: The desire to have a healthy infant was a major facilitator for feeding of HIV-exposed premature infants. However, financial constraints majorly limited the option to be only exclusive breastfeeding. This became even more problematic for the mother if the premature infant became ill and could not breastfeed well.