Exclusive Breastfeeding, Maternal HIV Disease, and the Risk of Clinical Breast Pathology in HIV-infected, Breastfeeding Women

Overview

Journal Am J Obstet Gynecol

Publisher Elsevier

Specialty Gynecology & Obstetrics

Date 2011 Jul 26

PMID 21784403

Citations 8

Authors

Katherine Semrau

Louise Kuhn

Daniel R Brooks

Howard Cabral

Moses Sinkala

Chipepo Kankasa

Donald M Thea

Grace M Aldrovandi

Affiliations

Soon will be listed here.

Abstract

Objective: The objective of the study was to examine the relationship between breastfeeding patterns, markers of maternal human immunodeficiency virus (HIV) disease, and woman's breast pathology.

Study Design: Secondary data analysis from a randomized breastfeeding trial including 947 HIV-infected women (n = 5982 visits) from breastfeeding initiation until 6 months postpartum; 1 month after breastfeeding cessation; or loss to follow-up or death. Generalized estimating equations assessed the effects of breastfeeding pattern and maternal HIV status on breast pathology.

Results: One hundred ninety women (20.1%) had a breast problem; 86 (9.1%) had mastitis; and 31 (3.3%) had abscess. After confounder adjustment, nonexclusively breastfeeding women had an increased risk of breast problems (odds ratio, 1.98; 95% confidence interval, 1.33-2.95) and mastitis (odds ratio, 2.87, 95% confidence interval, 1.69-4.88) compared with exclusive breastfeeders. Women with a CD4 count less than 200 cells/μL tended to have an increased risk of abscess.

Conclusion: Nonexclusive breastfeeding significantly increased the risk of breast pathology. Exclusive breastfeeding is not only optimal for infant health but it also benefits mothers by reducing breast problems.

Citing Articles

Mother and newborn skin-to-skin contact and timely initiation of breastfeeding in sub-Saharan Africa.

Aboagye R, Ahinkorah B, Seidu A, Anin S, Frimpong J, Hagan Jr J PLoS One. 2023; 18(1):e0280053.

PMID: 36626377 PMC: 9831337. DOI: 10.1371/journal.pone.0280053.

Understanding Viral and Immune Interplay During Vertical Transmission of HIV: Implications for Cure.

Amin O, Powers J, Bricker K, Chahroudi A Front Immunol. 2021; 12:757400.

PMID: 34745130 PMC: 8566974. DOI: 10.3389/fimmu.2021.757400.

Interventions for preventing mother-to-child HIV transmission: protocol of an overview of systematic reviews.

Wariki W, Ota E, Mori R, Wiysonge C, Horvath H, Read J BMJ Open. 2017; 7(6):e014332.

PMID: 28637726 PMC: 5623404. DOI: 10.1136/bmjopen-2016-014332.

Breastfeeding counseling and support are associated with continuous exclusive breastfeeding from one week to six months of age among HIV exposed infants in north Gondar zone, Ethiopia: a cross-sectional study.

Genetu H, Yenit M, Tariku A Int Breastfeed J. 2017; 12:21.

PMID: 28439291 PMC: 5401345. DOI: 10.1186/s13006-017-0113-1.

Effect of Postnatal HIV Treatment on Clinical Mastitis and Breast Inflammation in HIV-Infected Breast-feeding Women.

Zadrozny S, Westreich D, Hudgens M, Chasela C, Jamieson D, Martinson F Paediatr Perinat Epidemiol. 2017; 31(2):134-143.

PMID: 28205255 PMC: 6029881. DOI: 10.1111/ppe.12337.

References

Becquet R, Bequet L, Ekouevi D, Viho I, Sakarovitch C, Fassinou P . Two-year morbidity-mortality and alternatives to prolonged breast-feeding among children born to HIV-infected mothers in Côte d'Ivoire. PLoS Med. 2007; 4(1):e17. PMC: 1769413. DOI: 10.1371/journal.pmed.0040017. View

Flores M, Filteau S . Effect of lactation counselling on subclinical mastitis among Bangladeshi women. Ann Trop Paediatr. 2002; 22(1):85-8. DOI: 10.1179/027249302125000210. View

Semba R, Kumwenda N, Taha T, Hoover D, Quinn T, Lan Y . Mastitis and immunological factors in breast milk of human immunodeficiency virus-infected women. J Hum Lact. 2000; 15(4):301-6. DOI: 10.1177/089033449901500407. View

Bland R, Becquet R, Rollins N, Coutsoudis A, Coovadia H, Newell M . Breast health problems are rare in both HIV-infected and HIV-uninfected women who receive counseling and support for breast-feeding in South Africa. Clin Infect Dis. 2007; 45(11):1502-10. DOI: 10.1086/523320. View

Nussenblatt V, Lema V, Kumwenda N, Broadhead R, Neville M, Taha T . Epidemiology and microbiology of subclinical mastitis among HIV-infected women in Malawi. Int J STD AIDS. 2005; 16(3):227-32. DOI: 10.1258/0956462053420248. View

Kinlay J, OConnell D, Kinlay S . Incidence of mastitis in breastfeeding women during the six months after delivery: a prospective cohort study. Med J Aust. 1998; 169(6):310-2. DOI: 10.5694/j.1326-5377.1998.tb140282.x. View

Embree J, Njenga S, Datta P, Nagelkerke N, Ndinya-Achola J, Mohammed Z . Risk factors for postnatal mother-child transmission of HIV-1. AIDS. 2000; 14(16):2535-41. DOI: 10.1097/00002030-200011100-00016. View

Lunney K, Iliff P, Mutasa K, Ntozini R, Magder L, Moulton L . Associations between breast milk viral load, mastitis, exclusive breast-feeding, and postnatal transmission of HIV. Clin Infect Dis. 2010; 50(5):762-9. DOI: 10.1086/650535. View

Kuhn L, Aldrovandi G, Sinkala M, Kankasa C, Semrau K, Mwiya M . Effects of early, abrupt weaning on HIV-free survival of children in Zambia. N Engl J Med. 2008; 359(2):130-41. PMC: 2577610. DOI: 10.1056/NEJMoa073788. View

10.

Semba R, Kumwenda N, Taha T, Hoover D, Lan Y, Eisinger W . Mastitis and immunological factors in breast milk of lactating women in Malawi. Clin Diagn Lab Immunol. 1999; 6(5):671-4. PMC: 95752. DOI: 10.1128/CDLI.6.5.671-674.1999. View

11.

Fawzi W, Msamanga G, Spiegelman D, Renjifo B, Bang H, Kapiga S . Transmission of HIV-1 through breastfeeding among women in Dar es Salaam, Tanzania. J Acquir Immune Defic Syndr. 2002; 31(3):331-8. DOI: 10.1097/00126334-200211010-00010. View

12.

Bonuck K, Trombley M, Freeman K, McKee D . Randomized, controlled trial of a prenatal and postnatal lactation consultant intervention on duration and intensity of breastfeeding up to 12 months. Pediatrics. 2005; 116(6):1413-26. DOI: 10.1542/peds.2005-0435. View

13.

Peltier C, Ndayisaba G, Lepage P, van Griensven J, Leroy V, Pharm C . Breastfeeding with maternal antiretroviral therapy or formula feeding to prevent HIV postnatal mother-to-child transmission in Rwanda. AIDS. 2009; 23(18):2415-23. PMC: 3305463. DOI: 10.1097/QAD.0b013e32832ec20d. View

14.

Michie C, Lockie F, Lynn W . The challenge of mastitis. Arch Dis Child. 2003; 88(9):818-21. PMC: 1719627. DOI: 10.1136/adc.88.9.818. View

15.

Willumsen J, Filteau S, Coutsoudis A, Newell M, Rollins N, Coovadia H . Breastmilk RNA viral load in HIV-infected South African women: effects of subclinical mastitis and infant feeding. AIDS. 2003; 17(3):407-14. DOI: 10.1097/00002030-200302140-00015. View

16.

Wockel A, Abou-Dakn M, Beggel A, Arck P . Inflammatory breast diseases during lactation: health effects on the newborn-a literature review. Mediators Inflamm. 2008; 2008:298760. PMC: 2324165. DOI: 10.1155/2008/298760. View

17.

Moore R, Chaisson R . Natural history of opportunistic disease in an HIV-infected urban clinical cohort. Ann Intern Med. 1996; 124(7):633-42. DOI: 10.7326/0003-4819-124-7-199604010-00003. View

18.

Vogel A, Hutchison B, Mitchell E . Mastitis in the first year postpartum. Birth. 2000; 26(4):218-25. DOI: 10.1046/j.1523-536x.1999.00218.x. View

19.

Jones G, Steketee R, Black R, Bhutta Z, Morris S . How many child deaths can we prevent this year?. Lancet. 2003; 362(9377):65-71. DOI: 10.1016/S0140-6736(03)13811-1. View

20.

Georgeson J, Filteau S . Physiology, immunology, and disease transmission in human breast milk. AIDS Patient Care STDS. 2000; 14(10):533-9. DOI: 10.1089/108729100750018290. View