Background Exclusive breastfeeding is recommended for the first six months in HIV-exposed infants in sub-Saharan Africa. This cost-effective and high impact strategy has proven to promote healthy infant growth, development and survival of children in resource poor settings. Despite antenatal and postnatal counselling and support on the choice of feeding for HIV-exposed infants, the practice of EBF emains low in sub-Saharan Africa. Given the paucity of data on the topic in the study setting, we examined the prevalence of six-month exclusive breastfeeding.

Methods We followed up parturient women enrolled in the East London Prospective Cohort Study with the aim of determining the rate and determinants of exclusive breast feeding in the region. Relevant items on demographic, lifestyles and duration of EBF were obtained using stuctured interviews. Binary logistic analysis was fitted to examine the significant determinants of EBF.

Results Six infants died within the first six months in the cohort. Of the parturient women with complete responses (469), the prevalence of exclusive breastfeeding for the recommended six months was 32% (n=150). Women who were unemployed in the past 12 months had a higher likelihood of exclusively breastfeeding their infants for 6 months compared to women who were employed [AOR:1.68, CI:1.08–2.63]. Also, women who did not consume alcohol beverages in the past 12 months had a higher odds of exclusively breastfeeding their infants [AOR:1.77, CI:1.12–2.78]. Adherence to antiretroviral therapy [AOR:0.83; CI:0.53–1.29], disclosure of HIV serostatus to sexual partners [AOR:0.98; CI:0.51–1.94] and marital status [AOR:1.32; CI:0.86–2.02] were not significantly associated with exlusively breastfeeding of infants for six months.

Conclusion Very low rate of exclusive breastfeeding for six months among HIV-infected parturient raises serious concern for mother-to-child transmission, morbidity and mortality of exposed-infants in the study setting. Intervention strategies to promote and monitor compliance with exclusive breastfeeding recommendations require targeted research.

Disclosure No significant relationships.