| dc.description.abstract | Background. Human milk is considered as the ideal for infant nutrition and exclusive breastfeeding is associated with a reduction in many infectious diseases and infant mortality. Globally, improving breastfeeding rates to near 100%, could prevent over 800,000 deaths in children under 5. However, breastfeeding as a clinical intervention is often overlooked, especially regarding sick, premature and HIV-exposed neonates. Aims. Our aims were to 1: determine the baseline rates of breastfeeding initiation and expression of breast milk within one day of birth, 2a: determine the baseline breastfeeding rates at discharge among those initially breastfeeding within one day of birth, 2b: explore feeding methods among HIV-positive mothers. Method. We did a prospective cohort study, including all babies admitted to the Neonatal Unit (NNU) at the Princess Marina Hospital (PMH) in Gaborone, Botswana, between January and March 2019 (n=151). Data collection was done by going through medical records of the participants and interviewing their mothers, structured by data collection forms and an interview guide. Results. We found a baseline rate of breastfeeding and expression of breast milk within one day of birth to be 18.5% and 15.2% respectively. Among those initially breastfeeding, 42.9% were also breastfeeding at discharge. Among HIV-positive mothers, none breastfed their child within one day of birth and only 8 of 35 (22.9%) engaged in lactation stimulating practices at any point while admitted to the NNU. Conclusion. We conclude that the initial breastfeeding and expressing rates at the NNU at PMH remain low and that there is a potential for increasing these rates and thus decrease the neonatal mortality rates. We found an association between breastfeeding rates within one day of birth and breastfeeding rates at discharge. Therefore, we argue that promotion of early breastfeeding and expressing should be the main target for improvement. Since the breastfeeding rates amongst HIV-positive mothers were very low, we suggest the health authorities in Botswana to update its current breastfeeding guidelines which state; that HIV-positive mothers should not breastfeed. By that, medical staff can teach this group of mothers, that it is safe, and even beneficial, to breastfeed their child while on the new generation Anti-Retroviral Therapy (ARV). | eng |