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Taha TE, Bandala-Jacques A, Yende-Zuma N, Violari A, Stranix-Chibanda L, Atuhaire P, Hanley S, Gadama L, Chinula L, Dadabhai S, Aizire J, Brummel SS, Fowler MG. Breastfeeding Among Women Living With HIV in the Era of Lifelong ART: An Observational Multicountry Study in Eastern and Southern Africa. J Acquir Immune Defic Syndr 2024; 95:10-17. [PMID: 37732877 PMCID: PMC10840656 DOI: 10.1097/qai.0000000000003306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 08/30/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Lifelong antiretroviral treatment (ART) use is recommended for pregnant and breastfeeding (BF) women living with HIV (WLWH) to prevent perinatal HIV transmission and improve maternal health. We address 2 objectives in this analysis: (1) determine timing and factors associated with BF cessation and (2) assess the impact of BF on health of WLWH on ART. SETTING This multicountry study included 8 sites in Uganda, Malawi, Zimbabwe, and South Africa. METHODS This was a prospective study of WLWH on lifelong ART. These women initially participated from 2011 to 2016 in a randomized clinical trial (PROMISE) to prevent perinatal HIV transmission and subsequently reenrolled in an observational study (PROMOTE, 2016-2021) to assess ART adherence, safety, and impact. RESULTS The PROMOTE cohort included 1987 women on ART. Of them, 752 breastfed and were included in analyses of objective 1; all women were included in analyses of objective 2. The median time to BF cessation varied by country (11.2-19.7 months). Country of residence, age, and health status of women were significantly associated with time to BF cessation (compared with Zimbabwe: Malawi, adjusted hazard ratio [aHR] 0.50, 95% confidence interval [95% CI]: 0.40 to 0.62, P < 0.001; South Africa, aHR 1.49, 95% CI: 1.11 to 2.00, P = 0.008; and Uganda, aHR 1.77, 95% CI: 1.37 to 2.29, P < 0.001). Women who breastfed had lower risk of being "unwell" compared with women who never breastfed (adjusted rate ratio 0.87, 95% CI: 0.81 to 0.95 P = 0.030). CONCLUSION Women on lifelong ART should be encouraged to continue BF with no concern for their health. Time to BF cessation should be monitored for proper counseling in each country.
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Affiliation(s)
- Taha E. Taha
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD, USA
| | - Antonio Bandala-Jacques
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD, USA
| | - Nonhlanhla Yende-Zuma
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- SAMRC-CAPRISA HIV-TB Pathogenesis and Treatment Research Unit, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | - Avy Violari
- University of the Witwatersrand, Perinatal HIV Research Unit, Johannesburg, South Africa
| | | | - Patience Atuhaire
- Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration, Kampala, Uganda
| | - Sherika Hanley
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), Umlazi Clinical Research Site, University of Kwazulu-Natal, Durban, South Africa and University of Kwazulu-Natal, Department of Family Medicine, Durban, South Africa
| | - Luis Gadama
- Kamuzu University of Health Sciences - Johns Hopkins Research Project, Blantyre, Malawi
| | - Lameck Chinula
- University of North Carolina Project-Malawi, Lilongwe, Malawi
- University of North Carolina, Department of Obstetrics and Gynecology, Chapel-Hill, NC, USA
| | - Sufia Dadabhai
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD, USA
| | - Jim Aizire
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD, USA
| | - Sean S. Brummel
- Harvard T.H. Chan School of Public Health, Center for Biostatistics in AIDS Research, Boston MA, USA
| | - Mary Glenn Fowler
- Johns Hopkins School of Medicine, Department of Pathology, Baltimore, MD, USA
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Bengtson AM, Phillips TK, le Roux SM, Brittain K, Buba A, Abrams EJ, Myer L. Postpartum obesity and weight gain among human immunodeficiency virus-infected and human immunodeficiency virus-uninfected women in South Africa. MATERNAL & CHILD NUTRITION 2020; 16:e12949. [PMID: 31943774 PMCID: PMC7296802 DOI: 10.1111/mcn.12949] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 11/26/2019] [Accepted: 12/29/2019] [Indexed: 02/06/2023]
Abstract
In South Africa, up to 40% of pregnant women are living with human immunodeficiency virus (HIV), and 30-45% are obese. However, little is known about the dual burden of HIV and obesity in the postpartum period. In a cohort of HIV-uninfected and HIV-infected pregnant women initiating antiretroviral therapy in Cape Town, South Africa, we examined maternal anthropometry (weight and body mass index [BMI]) from 6 weeks through 12 months postpartum. Using multinomial logistic regression, we estimated associations between baseline sociodemographic, clinical, behavioural, and HIV factors and being overweight-obese I (BMI 25 to <35), or obese II-III (BMI >35), compared with being underweight or normal weight (BMI <25), at 12 months postpartum. Among 877 women, we estimated that 43% of HIV-infected women and 51% of HIV-uninfected women were obese I-III at enrollment into antenatal care, and 51% of women were obese I-III by 12 months postpartum. On average, both HIV-infected and HIV-uninfected women gained, rather than lost, weight between 6 weeks and 12 months postpartum, but HIV-uninfected women gained more weight (3.3 kg vs. 1.7 kg). Women who were obese I-III pre-pregnancy were more likely to gain weight postpartum. In multivariable analyses, HIV-infection status, being married/cohabitating, higher gravidity, and high blood pressure were independently associated with being obese II-III at 12 months postpartum. Obesity during pregnancy is a growing public health concern in low- and middle-income countries, including South Africa. Additional research to understand how obesity and HIV infection affect maternal and child health outcomes is urgently needed.
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Affiliation(s)
- Angela M. Bengtson
- Department of EpidemiologyBrown University School of Public HealthRhode Island
| | - Tamsin K. Phillips
- Division of Epidemiology and Biostatistics, School of Public Health and Family MedicineUniversity of Cape TownCape TownSouth Africa
| | - Stanzi M. le Roux
- Division of Epidemiology and Biostatistics, School of Public Health and Family MedicineUniversity of Cape TownCape TownSouth Africa
| | - Kirsty Brittain
- Division of Epidemiology and Biostatistics, School of Public Health and Family MedicineUniversity of Cape TownCape TownSouth Africa
| | - Allison Buba
- ICAP, Mailman School of Public Health and Department of Pediatrics, Vagelos College of Physicians & SurgeonsColumbia UniversityNew York CityNew YorkUSA
| | - Elaine J. Abrams
- ICAP, Mailman School of Public Health and Department of Pediatrics, Vagelos College of Physicians & SurgeonsColumbia UniversityNew York CityNew YorkUSA
| | - Landon Myer
- Division of Epidemiology and Biostatistics, School of Public Health and Family MedicineUniversity of Cape TownCape TownSouth Africa
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Widen EM, Tsai I, Collins SM, Wekesa P, China J, Krumdieck N, Miller JD, Weiser SD, Onono M, Young SL. HIV infection and increased food insecurity are associated with adverse body composition changes among pregnant and lactating Kenyan women. Eur J Clin Nutr 2018; 73:474-482. [PMID: 30185898 DOI: 10.1038/s41430-018-0285-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 07/25/2018] [Accepted: 07/30/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Body composition changes markedly during reproduction. In sub-Saharan Africa, impacts of HIV infection on body composition across pregnancy and lactation in the context of Option B+ antiretroviral therapy are unknown. Therefore, we sought to evaluate the role of HIV infection on body composition during pregnancy and lactation among Kenyan women. SUBJECTS/METHODS A cohort of pregnant women (n = 333; 50.5% HIV+, receiving ART) were enrolled at seven clinics in western Kenya. Two prenatal (mean ± SD: 23.6 ± 4.4 and 33.4 ± 2.0 weeks gestation) and three postpartum (6, 14, and 36 weeks) measurements included: individual-level food insecurity, height, weight, fat mass (FM), and fat-free mass (FFM) by bioimpedance analysis (BIA), mid-upper arm circumference (MUAC), and triceps skinfold (TSF), allowing for AMA (arm muscle area) and AFA (arm fat area) derivation. Multivariable longitudinal regression models were used to relate HIV to body composition changes. RESULTS In longitudinal models, HIV-infected women had lower weight (ß = -3.0 kg, p = 0.003), fat mass (ß = -1.5 kg, p = 0.02), fat-free mass (ß = -1.5 kg, p = 0.01), TSF (ß = -2.6 mm, p < 0.001), AFA (ß = -3.9 cm3, p < 0.001), and MUAC (ß = -1.0 cm, p = 0.001), but not AMA (p = 0.34), across all observations. Food insecurity was inversely associated with AMA and MUAC postpartum (AMA ß-range = -0.47 to -0.92 cm3; MUAC ß-range = -0.09 to -0.15 cm, all p < 0.05). CONCLUSIONS HIV infection was associated with lower weight, fat mass, fat-free mass, TSF, AFA, and MUAC values during pregnancy and lactation, while food insecurity was intermittently associated with body composition. This suggests that pregnant and lactating women living with HIV and food insecurity could benefit from nutritional support.
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Affiliation(s)
- Elizabeth M Widen
- Department of Nutritional Sciences, University of Texas at Austin, Austin, TX, USA
| | - Irene Tsai
- School of General Studies, Columbia University, New York, NY, USA
| | - Shalean M Collins
- Department of Anthropology, Northwestern University, Evanston, IL, USA
| | | | - Joy China
- Kenya Medical Research Institute, Nairobi, Kenya
| | | | - Joshua D Miller
- Department of Anthropology, Northwestern University, Evanston, IL, USA
| | - Sheri D Weiser
- School of Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | - Sera L Young
- Department of Anthropology, Northwestern University, Evanston, IL, USA. .,Institute for Policy Research, Northwestern University, Evanston, IL, USA.
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Somé EN, Engebretsen IMS, Nagot N, Meda NY, Vallo R, Kankasa C, Tumwine JK, Singata M, Hofmeyr JG, Van de Perre P, Tylleskär T. Changes in body mass index and hemoglobin concentration in breastfeeding women living with HIV with a CD4 count over 350: Results from 4 African countries (The ANRS 12174 trial). PLoS One 2017; 12:e0177259. [PMID: 28486519 PMCID: PMC5423645 DOI: 10.1371/journal.pone.0177259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 04/25/2017] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Breastfeeding is recommended for infants born to HIV-infected women in low-income settings. Both breastfeeding and HIV-infection are energy demanding. Our objective was to explore how exclusive and predominant breastfeeding changes body mass index (BMI) among breastfeeding HIV1-positive women participating in the ANRS12174 trial (clinical trial no NCT0064026). METHODS HIV-positive women (n = 1 267) with CD4 count >350, intending to breastfeed HIV-negative infants were enrolled from Burkina Faso, South Africa, Uganda and Zambia and counselled on breastfeeding. N = 1 216 were included in the analysis. The trial compared Lamivudine and Lopinavir/Ritonavir as a peri-exposure prophylaxis. We ran a linear mixed-effect model with BMI as the dependent variable and exclusive or predominant breastfeeding duration as the key explanatory variable. RESULTS Any breastfeeding or exclusive/predominant) breastfeeding was initiated by 99.6% and 98.6% of the mothers respectively in the first week after birth. The median (interquartile range: IQR) duration of the group that did any breastfeeding or the group that did exclusive /predominant breastfeeding were 9.5 (7.5; 10.6) and 5.8 (5.6; 5.9)) months, respectively. The median (IQR) age, BMI, CD4 count, and HIV viral load at baseline (day 7) were 27 (23.3; 31) years, 23.7 (21.3; 27.0) kg/m2, 530 (432.5; 668.5) cells/μl and 0.1 (0.8; 13.7)1000 copies/mL, respectively. No major change in mean BMI was seen in this cohort over a 50-week period during lactation. The mean change between 26 and 50 weeks after birth was 0.7 kg/m2. Baseline mean BMI (measured on day 7 postpartum) and CD4 count were positively associated with maternal BMI change, with a mean increase of 1.0 kg/m2 (0.9; 1.0) per each additional baseline-BMI kilogram and 0.3 kg/m2 (0.2; 0.5) for each additional CD4 cell/μl, respectively. CONCLUSION Breastfeeding was not negatively correlated with the BMI of HIV-1 infected Sub-Saharan African mothers. However, a higher baseline BMI and a CD4 count >500 cells/μl were associated with maternal BMI during the exclusive/ predominant breastfeeding period. Considering the benefits of breast milk for the infants and the recurrent results from different studies that breastfeeding is not harmful to the HIV-1-infected mothers, this study also supports the WHO 2016 guidelines on infant feeding that mothers living with HIV should breastfeed where formula is not safe for at least 12 months and up to 24 months, given that the right treatment or prophylaxis for the infection is administered. These findings and conclusions cannot be extrapolated to women who are immune-compromised or have AIDS.
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Affiliation(s)
- Eric Nagaonlé Somé
- Centre for International Health, University of Bergen, Bergen, Norway
- National Health Research Institute, Centre National pour la Recherche Scientifique et Technologique, Ouagadougou, Burkina Faso
| | | | - Nicolas Nagot
- INSERM UMR 1058, Pathogenesis and control of chronic infections, Montpellier, France
- Université de Montpellier, Montpellier, France
- Centre Hospitalier Universitaire, Montpellier, France
| | - Nicolas Y. Meda
- University of Ouagadougou, Faculty of Health Sciences, Centre de Recherche International en Santé (CRIS) Ouagadougou, Burkina Faso
| | - Roselyne Vallo
- INSERM UMR 1058, Pathogenesis and control of chronic infections, Montpellier, France
- Université de Montpellier, Montpellier, France
| | - Chipepo Kankasa
- University of Zambia, School of Medicine, Department of Paediatrics and Child Health, University Teaching Hospital, Lusaka, Zambia
| | - James K. Tumwine
- Makerere University, Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Kampala, Uganda
| | - Mandisa Singata
- University of Fort Hare, Effective Care Research Unit, Eastern Cape, South Africa
| | - Justus G. Hofmeyr
- University of Fort Hare, Effective Care Research Unit, Eastern Cape, South Africa
| | - Philippe Van de Perre
- INSERM UMR 1058, Pathogenesis and control of chronic infections, Montpellier, France
- Université de Montpellier, Montpellier, France
- Centre Hospitalier Universitaire, Montpellier, France
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Widen EM, Collins SM, Khan H, Biribawa C, Acidri D, Achoko W, Achola H, Ghosh S, Griffiths JK, Young SL. Food insecurity, but not HIV-infection status, is associated with adverse changes in body composition during lactation in Ugandan women of mixed HIV status. Am J Clin Nutr 2017; 105:361-368. [PMID: 28052888 PMCID: PMC5267304 DOI: 10.3945/ajcn.116.142513] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 11/28/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Body composition is an important indicator of nutritional status and health. How body composition changes during 12 mo of breastfeeding in HIV-infected women receiving antiretroviral therapy (ART) is unknown. OBJECTIVE We assessed whether HIV or food insecurity was associated with adverse postpartum body-composition changes in Ugandan women. DESIGN A cohort of 246 women [36.5% of whom were HIV positive (HIV+) and were receiving ART] were followed to 12 mo postpartum. Repeated measures included weight, fat mass, fat-free mass, midupper arm circumference, triceps skinfold thickness [which allowed for the derivation of arm muscle area (AMA) and arm fat area (AFA)], breastfeeding, and individual food insecurity. Longitudinal regression models were constructed to assess associations between HIV and food insecurity and changes in body composition over time. RESULTS At baseline, HIV+ women compared with HIV-negative women had a higher mean ± SD food-insecurity score (11.3 ± 5.5 compared with 8.6 ± 5.5, respectively; P < 0.001) and lower AMA (40.6 ± 5.7 compared with 42.9 ± 6.9 cm3, respectively; P = 0.03). Participants were thin at 1 wk postpartum [body mass index (BMI; in kg/m2): 22.9 ± 2.9]. From 1 wk to 12 mo, the weight change was -1.4 ± 4.4 kg. In longitudinal models of body-composition outcomes, HIV was not associated with body composition (all P > 0.05), whereas food insecurity was inversely associated with body weight and BMI at 6, 9, and 12 mo and with AFA at 6 and 12 mo (all P < 0.05). At 6 mo, every 1-unit increase in the food-insecurity score was associated with a 0.13-kg lower body weight (P < 0.001) and a 0.26-cm3 lower AFA (P < 0.01). CONCLUSIONS Body-composition changes are minimal during lactation. HIV is not associated with body composition; however, food insecurity is associated with changes in body composition during lactation. This trial was registered at clinicaltrials.gov as NCT02922829 and NCT02925429.
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Affiliation(s)
- Elizabeth M Widen
- Institute of Human Nutrition, Department of Epidemiology and Medicine, New York Obesity Research Center, Columbia University Medical Center, New York, NY
| | - Shalean M Collins
- Department of Population Medicine, Program in International Nutrition, Cornell University, Ithaca, NY;,Department of Anthropology, Northwestern University, Evanston, IL
| | - Hijab Khan
- Department of Biology, Cornell University, Ithaca, NY
| | - Claire Biribawa
- Prenatal Nutrition and Psychosocial Health Outcomes Study Uganda, Gulu, Uganda; and
| | - Daniel Acidri
- Prenatal Nutrition and Psychosocial Health Outcomes Study Uganda, Gulu, Uganda; and
| | - Winifred Achoko
- Prenatal Nutrition and Psychosocial Health Outcomes Study Uganda, Gulu, Uganda; and
| | - Harriet Achola
- Prenatal Nutrition and Psychosocial Health Outcomes Study Uganda, Gulu, Uganda; and
| | | | - Jeffrey K Griffiths
- Friedman School of Nutrition Science and Policy and,School of Medicine, Tufts University, Medford, MA
| | - Sera L Young
- Department of Population Medicine, Program in International Nutrition, Cornell University, Ithaca, NY; .,Department of Anthropology, Northwestern University, Evanston, IL
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Bork KA, Cames C, Newell ML, Read JS, Ayassou K, Musyoka F, Mbatia G, Cournil A. 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. J Nutr 2017; 147:453-461. [PMID: 28122933 DOI: 10.3945/jn.116.242339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 11/17/2016] [Accepted: 12/21/2016] [Indexed: 11/14/2022] Open
Abstract
Background: Early feeding patterns may affect the growth of HIV-exposed children and thus their subsequent health and cognition.Objective: We assessed the association of infant feeding (IF) mode with length-for-age z score (LAZ) and stunting from age 2 d to 18 mo in HIV-exposed African children within a controlled randomized trial, which evaluated triple antiretrovirals initiated during pregnancy and continued for 6 mo postpartum to prevent HIV transmission.Methods: HIV-infected pregnant women with CD4+ counts of 200-500 cells/mm3 from Burkina Faso, Kenya, and South Africa were advised to exclusively breastfeed for up to 6 mo or to formula-feed from birth. Factors associated with LAZ were investigated in all uninfected children by using mixed-effects linear models; those associated with stunting (LAZ <-2) at 6 or 12 mo were assessed in multiple logistic regression after exclusion of children stunted at age 2 d. Independent variables were IF mode: formula feeding (FF), exclusive breastfeeding (EBF) <3 mo, or EBF ≥3 mo (reference); sex; trial arm; maternal characteristics; and site.Results: Among 728 children, FF was associated with a greater increase in LAZ from 2 d to 6 mo (+0.07 z score/mo, P < 0.001). Between 6 and 18 mo, FF and EBF <3 mo were both associated with greater mean LAZ than was EBF ≥3 mo (+0.52 z scores and +0.43 z scores, respectively, P < 0.001). Among children not stunted at 2 d, FF was independently associated with a reduced risk of stunting at 6 mo (OR: 0.24; 95% CI: 0.07, 0.81; P = 0.021), whereas EBF <3 mo was not (OR: 0.49; 95% CI: 0.22, 1.10; P = 0.09).Conclusions: In this observational study of HIV-exposed uninfected infants, growth in length in the first 6 mo of life was faster in formula-fed infants than in exclusively breastfed infants. The plausibility of residual confounding and reverse causality is discussed. This trial was registered at www.controlled-trials.com as ISRCTN71468401.
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Affiliation(s)
- Kirsten A Bork
- Institut de Recherche pour le Développement UMI233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France;
| | - Cécile Cames
- Institut de Recherche pour le Développement UMI233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
| | - Marie-Louise Newell
- Global Health Research Institute, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Jennifer S Read
- University of California at San Francisco, San Francisco, CA
| | | | - Faith Musyoka
- International Centre for Reproductive Health, Mombasa, Kenya; and
| | - Grace Mbatia
- Kenyatta National Hospital and University of Nairobi, Nairobi, Kenya
| | - Amandine Cournil
- Institut de Recherche pour le Développement UMI233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
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Mulol H, Coutsoudis A. Breastmilk Output in a Disadvantaged Community with High HIV Prevalence as Determined by the Deuterium Oxide Dose-to-Mother Technique. Breastfeed Med 2016; 11:64-9. [PMID: 26862660 DOI: 10.1089/bfm.2015.0139] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION World Health Organization breastfeeding guidelines for HIV-infected mothers are exclusive breastfeeding for 6 months and then continued breastfeeding for 12 months, provided the mother is receiving antiretroviral prophylaxis. Many African women perceive that breastmilk alone is not sufficient for their infant's nutritional requirements for the first 6 months of life, and mixed feeding is a common practice. METHODOLOGY A stable isotope technique was used to determine breastmilk output volumes and maternal body composition objectively at five different time points in the first year of the infant's life. RESULTS Breastmilk output volumes were high for HIV-infected mothers: 831 ± 185 g/day at 6 weeks; 899 ± 188 g/day at 3 months; 871 ± 293 g/day at 6 months; 679 ± 281 g/day at 9 months; and 755 ± 287 g/day at 12 months. These high output volumes had no negative impact on the mother's fat-free mass. The breastmilk output volumes for HIV-uninfected mothers were not significantly different to the outputs for HIV-infected mothers at any of the time points (p > 0.05): 948 ± 223 g/day at 6 weeks; 925 ± 227 g/day at 3 months; 902 ± 286 g/day at 6 months; 746 ± 263 g/day at 9 months; and 713 ± 264 g/day at 12 months. CONCLUSION This study using objective methodology shows that breastmilk outputs of HIV-infected mothers were relatively high (and within published reference ranges), and mothers are able to provide sufficient breastmilk for their infants without compromising their own fat-free mass.
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Affiliation(s)
- Helen Mulol
- Department of Pediatrics and Child Health, University of KwaZulu-Natal , Durban, South Africa
| | - Anna Coutsoudis
- Department of Pediatrics and Child Health, University of KwaZulu-Natal , Durban, South Africa
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Giuliano M, Guidotti G, Andreotti M, Scarcella P, Amici R, Jere H, Sagno JB, Buonomo E, Mancinelli S, Marazzi MC, Vella S, Palombi L. Weight changes during and after 6 months of breastfeeding in HIV-infected mothers receiving antiretroviral therapy in Malawi. AIDS Res Hum Retroviruses 2014; 30:1155-7. [PMID: 25205387 DOI: 10.1089/aid.2014.0019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Marina Giuliano
- Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | | | - Mauro Andreotti
- Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Paola Scarcella
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Italy
| | - Roberta Amici
- Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Haswell Jere
- DREAM Program, Community of S. Egidio, Blantyre, Malawi
| | | | - Ersilia Buonomo
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Italy
| | - Sandro Mancinelli
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Italy
| | | | - Stefano Vella
- Department of Therapeutic Research and Medicines Evaluation, Istituto Superiore di Sanità, Rome, Italy
| | - Leonardo Palombi
- Department of Biomedicine and Prevention, University of Rome, Tor Vergata, Italy
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