Title: Exclusive breastfeeding and HIV.

POPLINE Document Number: 314835

Author(s):

Holmes WR
Savage F

Source citation:

Lancet, 2007 Mar 31;369(9567):1065-1066.

Abstract:

Promotion of breastfeeding has been ranked as the most cost-effective intervention for child survival, and could prevent 13-15% of child deaths in low-income countries. But in some circumstances, breastfeeding can transmit HIV, which presents a terrible dilemma for parents and policymakers. UNAIDS estimates that over 300 000 children are infected with HIV through breastfeeding every year. To weigh the risks we need good data, but such research is fraught with difficulties. Hoosen Coovadia and colleagues' meticulous prospective study in KwaZulu--Natal, South Africa, published in today's Lancet, is a breakthrough. It provides crucial confirmatory evidence that when HIV-positive mothers breastfeed exclusively, their babies have only a low risk of infection with HIV. This risk is lower than that in babies who receive other food or liquids in addition to breastmilk before 6 months of age. Mixed feeding before or after 14 weeks nearly doubled transmission risk and the addition of solids increased the risk 11-fold. Importantly, Coovadia and colleagues also re ported that mortality by 3 months of age for replacement-fed babies was more than double that of those who were exclusively breastfed. This result adds to the accumulation of new evidence on the hazards of formula feeding. An investigation of a serious outbreak of diarrhoea in Botswana in 2006 showed that 93% of the infants admitted to hospital were not breastfeeding, and these children had the greatest risk of dying. (excerpt)

Keywords:

Developing Countries
Critique
Clinical Research
Mothers
HIV Positive Persons
Infant
HIV Prevention
Breastfeeding, Exclusive
Prevention of Mother-to-Child Transmission
Milk Substitutes
Supplementary Feeding
Age Factors
Diarrhea, Infantile
Research Methodology
Parents
Family Relationships
Family Characteristics
Family and Household
Sociocultural Factors
Persons Living With HIV/AIDS
HIV Infections
Viral Diseases
Diseases
Youth
Population Characteristics
Demographic Factors
Population
Breastfeeding
Infant Nutrition
Nutrition
Health
Disease Transmission Control
Prevention and Control
Diarrhea