Care of the HIV-exposed Child--to Breast Feed or Not?

Overview

Journal Indian J Pediatr

Specialty Pediatrics

Date 2012 Mar 3

PMID 22382511

Authors

Anju Seth

Affiliations

Soon will be listed here.

Abstract

Breast milk is the best form of nutrition for infants. However, it places infants born to HIV infected women at risk of acquiring HIV infection. Total avoidance of breastfeeding is the only way of completely avoiding HIV transmission through breast milk. However, this strategy has not proved to be viable in resource constrained nations. A high infection related mortality and morbidity, and a high prevalence of malnutrition have been observed in HIV exposed infants on replacement feeding. Exclusive breastfeeding for the first six months followed by rapid weaning has also not proved to be a good strategy, with a surge in infection related morbidity and malnutrition reported after weaning. Current evidence indicates that continued use of ARV prophylaxis to mother/infant starting during pregnancy and continued to cover the entire duration of breastfeeding offers the infant best chance of HIV free survival, combining the benefits of breast milk with safety induced by ARV prophylaxis.

References

Preidis G, McCollum E, Mwansambo C, Kazembe P, Schutze G, Kline M . Pneumonia and malnutrition are highly predictive of mortality among African children hospitalized with human immunodeficiency virus infection or exposure in the era of antiretroviral therapy. J Pediatr. 2011; 159(3):484-9. PMC: 4423795. DOI: 10.1016/j.jpeds.2011.02.033. View

Arpadi S, Fawzy A, Aldrovandi G, Kankasa C, Sinkala M, Mwiya M . Growth faltering due to breastfeeding cessation in uninfected children born to HIV-infected mothers in Zambia. Am J Clin Nutr. 2009; 90(2):344-53. PMC: 2709311. DOI: 10.3945/ajcn.2009.27745. View

Dunn D, Newell M, Ades A, Peckham C . Risk of human immunodeficiency virus type 1 transmission through breastfeeding. Lancet. 1992; 340(8819):585-8. DOI: 10.1016/0140-6736(92)92115-v. View

De Vincenzi I . Triple antiretroviral compared with zidovudine and single-dose nevirapine prophylaxis during pregnancy and breastfeeding for prevention of mother-to-child transmission of HIV-1 (Kesho Bora study): a randomised controlled trial. Lancet Infect Dis. 2011; 11(3):171-80. DOI: 10.1016/S1473-3099(10)70288-7. View

De Martino M, Tovo P, Tozzi A, Pezzotti P, Galli L, Livadiotti S . HIV-1 transmission through breast-milk: appraisal of risk according to duration of feeding. AIDS. 1992; 6(9):991-7. View

Miotti P, Taha T, Kumwenda N, Broadhead R, MTIMAVALYE L, VAN DER HOEVEN L . HIV transmission through breastfeeding: a study in Malawi. JAMA. 1999; 282(8):744-9. DOI: 10.1001/jama.282.8.744. View

Palasanthiran P, Ziegler J, Stewart G, Stuckey M, Armstrong J, Cooper D . Breast-feeding during primary maternal human immunodeficiency virus infection and risk of transmission from mother to infant. J Infect Dis. 1993; 167(2):441-4. DOI: 10.1093/infdis/167.2.441. View

Coovadia H, Rollins N, Bland R, Little K, Coutsoudis A, Bennish M . Mother-to-child transmission of HIV-1 infection during exclusive breastfeeding in the first 6 months of life: an intervention cohort study. Lancet. 2007; 369(9567):1107-16. DOI: 10.1016/S0140-6736(07)60283-9. View

Coutsoudis A, Pillay K, Spooner E, Coovadia H, Pembrey L, Newell M . Morbidity in children born to women infected with human immunodeficiency virus in South Africa: does mode of feeding matter?. Acta Paediatr. 2003; 92(8):890-5. View

10.

De Cock K, Fowler M, Mercier E, de Vincenzi I, Saba J, Hoff E . Prevention of mother-to-child HIV transmission in resource-poor countries: translating research into policy and practice. JAMA. 2000; 283(9):1175-82. DOI: 10.1001/jama.283.9.1175. View

11.

Thea D, Aldrovandi G, Kankasa C, Kasonde P, Decker W, Semrau K . Post-weaning breast milk HIV-1 viral load, blood prolactin levels and breast milk volume. AIDS. 2006; 20(11):1539-47. PMC: 1773053. DOI: 10.1097/01.aids.0000237370.49241.dc. View

12.

Kilewo C, Karlsson K, Massawe A, Lyamuya E, Swai A, Mhalu F . Prevention of mother-to-child transmission of HIV-1 through breast-feeding by treating infants prophylactically with lamivudine in Dar es Salaam, Tanzania: the Mitra Study. J Acquir Immune Defic Syndr. 2008; 48(3):315-23. DOI: 10.1097/QAI.0b013e31816e395c. View

13.

Ruff A, Coberly J, Halsey N, Boulos R, Desormeaux J, Burnley A . Prevalence of HIV-1 DNA and p24 antigen in breast milk and correlation with maternal factors. J Acquir Immune Defic Syndr (1988). 1994; 7(1):68-73. View

14.

Kafulafula G, Hoover D, Taha T, Thigpen M, Li Q, Fowler M . Frequency of gastroenteritis and gastroenteritis-associated mortality with early weaning in HIV-1-uninfected children born to HIV-infected women in Malawi. J Acquir Immune Defic Syndr. 2009; 53(1):6-13. DOI: 10.1097/QAI.0b013e3181bd5a47. View

15.

Gerstein H . Cow's milk exposure and type I diabetes mellitus. A critical overview of the clinical literature. Diabetes Care. 1994; 17(1):13-9. DOI: 10.2337/diacare.17.1.13. View

16.

Chasela C, Hudgens M, Jamieson D, Kayira D, Hosseinipour M, Kourtis A . Maternal or infant antiretroviral drugs to reduce HIV-1 transmission. N Engl J Med. 2010; 362(24):2271-81. PMC: 3440865. DOI: 10.1056/NEJMoa0911486. View

17.

Heinig M . Host defense benefits of breastfeeding for the infant. Effect of breastfeeding duration and exclusivity. Pediatr Clin North Am. 2001; 48(1):105-23, ix. DOI: 10.1016/s0031-3955(05)70288-1. View

18.

. Children born to women with HIV-1 infection: natural history and risk of transmission. European Collaborative Study. Lancet. 1991; 337(8736):253-60. View

19.

Gabiano C, Tovo P, De Martino M, Galli L, Giaquinto C, Loy A . Mother-to-child transmission of human immunodeficiency virus type 1: risk of infection and correlates of transmission. Pediatrics. 1992; 90(3):369-74. View

20.

van de Perre P, Simonon A, Msellati P, Hitimana D, Vaira D, Bazubagira A . Postnatal transmission of human immunodeficiency virus type 1 from mother to infant. A prospective cohort study in Kigali, Rwanda. N Engl J Med. 1991; 325(9):593-8. DOI: 10.1056/NEJM199108293250901. View