Breastfeeding in HIV Exposed Infants Significantly Improves Child Health: A Prospective Study

Abstract

Breastfeeding has been shown to benefit both maternal and child immune status. The impact of exclusive breastfeeding in the presence of HIV infection on maternal and child health is still unclear. Socio-economic factors make breast-feeding an important source of nutrition for an infant 6 months and under in the developing world. A prospective study was conducted to examine the impact of feeding mode on various maternal indices including anthropometry; body composition indicators (using FTIR); haematology and biochemical markers; as well as incidence rates of opportunistic infections and clinical disease progression. In infants we examined the impact on growth, development and morbidity. AFASS criteria (affordable, feasible, accessible, sustainable and safe) were fulfilled by 38.7% of the formula feeding mothers. No significant differences between the formula feeding and breastfeeding groups in terms of haematological, immunological and body composition changes were seen. Breastfeeding mothers had significantly lower events with high depression scores (P = 0.043). Breastfeeding infants had a significantly lower risk of diarrhoea and hospitalisation at 3 months (P = 0.006 and 0.014 respectively). Breastfeeding was significantly associated with better development scores and growth parameters. Breastfeeding is not harmful to the mother in the presence of HIV infection. Mothers are still choosing formula feeding inappropriately despite counselling about the AFASS criteria. Breastfeeding is beneficial to the infants especially in the first 3 months of life.

Breastfeeding Is Associated with Decreased Risk of Hospitalization among HIV-Exposed, Uninfected Kenyan Infants

“…In a South African study in which mothers self-selected feeding method, a lower risk of hospitalization was observed among breastfed infants in the first 14 weeks of life, but this difference was no longer significant by 6 months 18 . The BAN study in Malawi, in which all infants breastfed, found increased risk of morbidity after weaning 4 ; the same effect was observed in a Zambian trial of early abrupt weaning 19,20 .…”

Morbidity in relation to feeding mode in African HIV-exposed, uninfected infants during the first 6 mo of life: the Kesho Bora study

“…In Tanzania, full breastfeeding (i.e., exclusive or predominant as compared with partial or none) was associated with a strong reduction in incidences of reported cough, acute diarrhea, fever, and outpatient visits between 0 and 6 mo of age but not of hospitalizations (27). In a clinic in South Africa, the incidence rate ratio of clinically diagnosed diarrhea was greatly reduced in 0-3-mo-old infants if they were breastfed (28). However, both of these analyses included both HIV-uninfected and -infected infants, and the latter infants are known to be very vulnerable to the absence of breastfeeding.…”

Comparison of infant-feeding practices in two health subdistricts with different baby-friendly status in Mpumalanga province

“…63 Although breastfeeding is a route of acquisition of HIV in the infant, breastfed infants had a significantly lower risk of diarrhoea and hospitalisation at 3 months. Breastfeeding was also significantly associated with better development scores and growth parameters in infants 64 and reduced mortality among infants and children. 65 …”