Prechewed Infant Food May Transmit AIDS Virus

A new medical report offers evidence of infants being infected with HIV by eating premasticated food chewed by HIV-positive caregivers. Prechewing food for infants, usually during the weaning period, has been documented in various parts of the world, including the United States.

The new study involves three babies with HIV, ages nine, 15, and 39 months. The mothers of two of the children were known to be HIV-infected and had not breastfed: Mother-to-child transmission had been ruled out. In the third case, the mother was uninfected but the baby's caregivers included a great aunt who was HIV-positive.

All three babies had been fed, on multiple occasions, food prechewed by a caregiver with the virus. The researchers, Dr. Aditya H. Baur from St. Jude Children's Hospital in Memphis, Tenn., and colleagues, ruled out other ways the babies might have contracted HIV. Their investigation suggested that in two cases, the source of HIV infection was likely bleeding in the mouth of the adult who prechewed food for the baby.

"The reported cases provide compelling evidence linking premastication to HIV infection, a route of transmission not previously reported that has important global implications including being a possible explanation for some of the reported cases of 'late' HIV transmission in infants, so far attributed to breastfeeding," the authors concluded.

"Until the risk of premastication and modifying factors (e.g., periodontal disease) are better understood, we recommend that health care providers routinely query children's caregivers and expecting parents who are infected with HIV or at risk of HIV infection about this feeding practice and direct them to safer, locally available, feeding options," they wrote.

The full report, "Practice of Feeding Premasticated Food to Infants: A Potential Risk Factor for HIV Transmission," was published in Pediatrics (2009;124(2):658-666).

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