Most Ugandan HIV-Positive Mothers Insist on Breast Feeding

Most HIV-positive mothers in Uganda prefer to breast feed rather than use infant formula. Francis Mmiro, chair of the committee for the prevention of mother-to-child HIV transmission in Uganda, reported that 61 percent of HIV-positive mothers who attend antenatal clinics at the National Referral Hospital choose to breast feed. This is true despite the fact that doctors "have counseled and told [them] that HIV can be transmitted through breast-feeding," he said.

Saul Onyando, the medical officer in charge of prevention of mother-to-child HIV transmission, said that all women who receive antenatal services designated for the prevention of mother-to-child transmission are counseled on the need to take HIV tests. Those who test positive are told of the risk of breast-feeding and of the benefits of using formula, and they are offered free formula from UNICEF.

Many factors seem to contribute to the preference for breast feeding. According to Milly Katana, a member of the National Guidance and Empowerment Network for People Living with HIV/AIDS, the social stigma attached to not breast feeding is the main motivation behind refusing formula feeding. "You have given birth to this baby and your neighbors, brothers, relatives, see you not breast feeding then wonder why. Many women give in and opt for this dangerous route of breast feeding," she said.

According to Onyando, the decision is understandable. "In Europe to wake up at night and mix formula is not a problem because they have electricity, fridges, etc. Here if you are talking about a woman who does not even have paraffin to boil water, it becomes difficult," he said.

In general, the options for Ugandan women are not great. Many women hope that they might be able to breast feed and not infect their children. They are advised that if they do breast feed to do so for three to six months and then to alternate formula feeding with breast feeding.

"There is no easy solution but it shouldn't prevent us from continuing," said Philippa Musoke, a senior lecturer in the pediatrics department at the Faculty of Medicine, Makerere University. "Uganda has done well on HIV in general but prevention of mother-to-child transmission is a new area. So, we really need to mobilize the communities," she said.

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