Two-Year Morbidity-Mortality and Alternatives to Prolonged Breast-Feeding Among Children Born to HIV-Infected Mothers in Cote d'Ivoire
January 19, 2007
Renaud Becquet of the Institut National de la Sante et de la Recherche Medicale Unite in France and colleagues conducted the study from 2001 through 2005 among 557 infants born to HIV-positive women in Abidjan, Cote d'Ivoire. After their infants were born, the women, who underwent prenatal antiretroviral prophylaxis, either received breastmilk substitutes or exclusively breast-fed for four months. Nutritional counseling and clinical management were provided for two years, and breastmilk substitutes were provided at no cost. Thirty-four percent of the 262 infants who were breast-fed for an average of four months during the two-year follow-up period did not experience any adverse health outcomes -- which the researchers defined as diarrhea, acute respiratory infections or malnutrition -- compared with 37% of the infants who received breastmilk substitutes. The two-year probability of presenting with a severe health event -- which the researchers defined as hospitalization or death -- was 14% among the breastmilk substitute group, compared with 15% among the breast-fed infants. The researchers concluded that breastmilk substitutes and short-term breast-feeding can be safe interventions aimed at preventing mother-to-child HIV transmission in urban African settings where adequate nutritional counseling and care, access to clean water and breastmilk substitutes are available (Becquet et al., PLoS Medicine, January 2007). In a related opinion piece, Grace John-Stewart of the University of Washington writes that the researchers "provide good data to suggest that with appropriate provisos, replacement feeding can be a safe option to consider" for HIV-positive women in urban African settings (John-Stewart, PLoS Medicine, January 2007).
This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.