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

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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 develo** 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.

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Acknowledgments

We would like to thank the mothers and infants on our study for their participation; the staff of the MTCT Plus program (especially Sphindile Nzuza and Gcinile Maphanga); the staff of Umkhumbane clinic, the Family Clinic (KEH) and the departments of Paediatrics and Obstetrics and Gynaecology (UKZN) for their support. We thank Professor Andrew Kindness, Letitia Pillay and the department of Analytical Chemistry at University of KwaZulu-Natal for assistance with deuterium analyses in the salvia samples. We would like to thank IAEA (International Atomic Energy Agency) for donating the equipment used in the study and for providing technical training for body composition methodology. The MTCT Plus Initiative provided funding for programme staff and ARV drugs. The study running costs were provided by the Hasso Plattner Trust fund.

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Authors and Affiliations

  1. Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Room 257, DDMRI Building, Congella, Durban, 4013, South Africa

    Gurpreet Kindra, Anna Coutsoudis & Francesca Esposito

  2. Programme of Biostatistics, Research Ethics and Medical Law, School of Family and Public Health, University of KwaZulu-Natal, Durban, South Africa

    Tonya Esterhuizen

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  1. Gurpreet Kindra
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Correspondence to Gurpreet Kindra.

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Parts of this article were submitted towards a PhD thesis to the University of KwaZulu-Natal entitled “Effect of nutritional supplements on lean body mass, general health and disease progression of HIV positive lactating mothers and the ensuing effects on their infants including the impact of feeding mode on disease progression in the infected infants”.

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Kindra, G., Coutsoudis, A., Esposito, F. et al. Breastfeeding in HIV Exposed Infants Significantly Improves Child Health: A Prospective Study. Matern Child Health J 16, 632–640 (2012). https://doi.org/10.1007/s10995-011-0795-8

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