Growth faltering due to breastfeeding cessation in uninfected children born to HIV-infected mothers in Zambia

Arpadi, Stephen M.; Fawzy, Ashraf; Aldrovandi, Grace M.; Kankasa, Chipepo; Sinkala, Moses; Mwiya, Mwiya; Thea, Donald M.; Kuhn, Louise

doi:10.3945/ajcn.2009.27745

Cited by 91 publications

(103 citation statements)

References 53 publications

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“…Previous to availability of antiretroviral drugs, several studies showed poor growth outcomes in HEU children compared with HIVunexposed children [41,42]. However, reports in which antiretroviral drugs for PMTCT were used either found no differences in growth outcomes between HEU and HIV-unexposed children or if they existed were most likely due to different feeding practices rather than to HIV exposure [43,44].…”

Section: Discussionmentioning

confidence: 99%

Maternal HIV infection is an important health determinant in non-HIV-infected infants

Rosario

González

Maculuve

et al. 2017

Aids

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Objective: To assess morbidity and mortality in HIV-exposed uninfected (HEU) children to help guiding appropriate clinical care and effective preventive interventions.Design: This is a longitudinal study comparing two cohorts of children; one born to HIV-infected women and the other born to HIV-uninfected women. Methods:We have analyzed prospectively obtained information on nutritional status, morbidity and mortality from 966 HEU and 909 HIV-unexposed infants followed up until their first 18 months of life at a referral health facility in southern Mozambique. Determinants for adverse health outcomes in HEU children were also assessed using multivariate logistic regression.Results: Increased incidence of hospital admissions (P ¼ 0.0015), shorter survival in the first 18 months of life (P ¼ 0.0510) and moderate and severe malnutrition (P ¼ 0.0006 and 0.0014, respectively) were observed among HEU children compared with HIVunexposed children. Incidence of outpatient attendance in HEU children was associated with being men, older age and the mother being on antiretroviral treatment. Among HEU children, those who were never breastfed, or who were weaned or were partially breastfed, had an increased incidence of hospital admissions compared with children who were exclusively breastfed. Conclusion:Maternal HIV infection has important health consequences in non-HIVinfected children. As the prevalence of HIV-infected pregnant women is maintained and the proportion of HIV-infected children declines because of the scale-up of antiretroviral treatment during pregnancy and breastfeeding, more focus should be given to the health needs of HEU children to ensure that the post-2015 sustainable development goals are met.

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Section: Discussionmentioning

confidence: 99%

Maternal HIV infection is an important health determinant in non-HIV-infected infants

Rosario

González

Maculuve

et al. 2017

Aids

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“…Similarly, cessation of breastfeeding by 6 mo of age compared to prolonged breastfeeding in Malawi resulted in greater rates of hospitalization for gastroenteritis (2.9 vs. 0.1% at 7-9 mo and 1.6 vs. 0.2% at 10-12 mo; P < 0.001) and higher gastroenteritis related mortality (19 vs. 7/1000 infants at 9 mo and 24 vs. 12/1000 infants at 12 mo; P = 0.0002) (46). In Zambia, a significantly greater decrease in weight-for-age Z-scores between 4 and 16 mo was reported among HIV-exposed, uninfected infants who stopped breastfeeding at 4 mo compared to those who continued (47). In Zimbabwe, infants whose mothers opted to cease breastfeeding at 9 mo after receipt of an HIV-PCRnegative result were fed grossly inadequate diets compared to those who continued to receive breast milk (48).…”

Section: Current Knowledge and Recommendationsmentioning

confidence: 90%

“…Although the risk of HIV transmission continues for as long as breastfeeding continues (32), HIV-free survival of HIV-exposed infants who breastfed beyond 6 mo was similar to that of infants who received no breast milk after 6 mo (86,87). Infants given replacement foods after a period of breastfeeding also suffered increased serious infections, including diarrhea and pneumonia, growth faltering, and death (45)(46)(47)50,51,58). The importance placed on maximizing an infant's continued access to breast milk in the 2010 recommendations reflects the immunological benefits of breast milk as well as the importance of breast milk in providing adequate nutrition to infants > 6 mo of age.…”

Section: Current Knowledge and Recommendationsmentioning

confidence: 99%

Current Knowledge and Future Research on Infant Feeding in the Context of HIV: Basic, Clinical, Behavioral, and Programmatic Perspectives

Young

Mbuya

Chantry

et al. 2011

Advances in Nutrition

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In 2008, between 129,000 and 194,000 of the 430,000 pediatric HIV infections worldwide were attributable to breastfeeding. Yet in many settings, the health, economic, and social consequences of not breastfeeding would have dire consequences for many more children. In the first part of this review we provide an overview of current knowledge about infant feeding in the context of HIV. Namely, we describe the benefits and risks of breastmilk, the evolution of recommended infant feeding modalities in high-income and low-income countries in the last two decades, and contextualize the recently revised guidelines for infant feeding in the context of HIV current knowledge. In the second section, we suggest areas for future research on the postnatal prevention of mother-to-child transmission of HIV (PMTCT) in developing and industrialized countries. We suggest two shifts in perspective. The first is to evaluate PMTCT interventions more holistically, to include the psychosocial and economic consequences as well as the biomedical ones. The second shift in perspective should be one that contextualizes postnatal PMTCT efforts in the cascade of maternal health services. We conclude by discussing basic, clinical, behavioral, and programmatic research questions pertaining to a number of PMTCT efforts, including extended postnatal ARV prophylaxis, exclusive breastfeeding promotion, counseling, breast milk pasteurization, breast milk banking, novel techniques for making breast milk safer, and optimal breastfeeding practices. We believe the research efforts outlined here will maximize the number of healthy, thriving, HIV-free children around the world. Adv. Nutr. 2: 225-243, 2011.

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“…In Pune, India, breastfed infants were significantly less stunted at age 12 mo than their never-breastfed counterparts (9). In Zambia breastfeeding was associated with greater weight-forage z score from 5 to 15 mo of age in adjusted analyses with no difference in height-for-age z score (10). Breastfed South African infants had greater weight-for-age z score and marginally greater length-for-age z score (LAZ) 11 than formula-feeding (FF) infants at age 3 mo but no longer at 6 or 9 mo (11).…”

Section: Introductionmentioning

confidence: 90%

Formula-Feeding of HIV-Exposed Uninfected African Children Is Associated with Faster Growth in Length during the First 6 Months of Life in the Kesho Bora Study

et al. 2017

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Growth faltering due to breastfeeding cessation in uninfected children born to HIV-infected mothers in Zambia

Cited by 91 publications

References 53 publications

Maternal HIV infection is an important health determinant in non-HIV-infected infants

Maternal HIV infection is an important health determinant in non-HIV-infected infants

Current Knowledge and Future Research on Infant Feeding in the Context of HIV: Basic, Clinical, Behavioral, and Programmatic Perspectives

Formula-Feeding of HIV-Exposed Uninfected African Children Is Associated with Faster Growth in Length during the First 6 Months of Life in the Kesho Bora Study

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