Document Detail


Feasibility of using flash-heated breastmilk as an infant feeding option for HIV-exposed, uninfected infants after 6 months of age in urban Tanzania.
MedLine Citation:
PMID:  22362154     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Heat-treating expressed breastmilk is recommended as an interim feeding strategy for HIV-exposed infants in resource-poor countries, but data on its feasibility are minimal. Flash-heating (FH) is a simple in-home technique for heating breastmilk that inactivates HIV although preserving its nutritional and anti-infective properties. Our primary objective was to determine, among HIV-infected mothers, the feasibility and protocol adherence of FH expressed breastmilk after 6 months of exclusive breastfeeding.
DESIGN: Prospective longitudinal.
PARTICIPANTS: One hundred one HIV-infected breastfeeding mothers.
SETTING: Dar es Salaam, Tanzania.
INTERVENTION: Peer counselors provided in-home counseling and support on infant feeding from 2 to 9 months postpartum. Mothers were encouraged to exclusively breastfeed for 6 months followed by FH expressed breastmilk if her infant was HIV negative. Clinic-based staff measured infant growth and morbidity monthly, and mothers kept daily logs of infant morbidity. FH behavior was tracked until 9 months postpartum using daily logs, in-home observations, and clinic-based and home-based surveys. Bacterial cultures of unheated and heated milk samples were performed.
RESULTS: Thirty-seven of 72 eligible mothers (51.4%) chose to flash-heat. Median (range) frequency of milk expression was 3 (1-6) times daily and duration of method use on-study was 9.7 (0.1-15.6) weeks. Mean (SD) daily milk volume was 322 (201) mL (range 25-1120). No heated and 32 (30.5%) unheated samples contained bacterial pathogens.
CONCLUSIONS: FH is a simple technology that many HIV-positive women can successfully use after exclusive breastfeeding to continue to provide the benefits of breastmilk while avoiding maternal-to-child transmission associated with nonexclusive breastfeeding. Based on these feasibility data, a clinical trial of the effects of FH breastmilk on infant health outcomes is warranted.
Authors:
Caroline J Chantry; Sera L Young; Waverly Rennie; Monica Ngonyani; Clara Mashio; Kiersten Israel-Ballard; Janet Peerson; Margaret Nyambo; Mecky Matee; Deborah Ash; Kathryn Dewey; Peggy Koniz-Booher
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  60     ISSN:  1944-7884     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-20     Completed Date:  2012-06-12     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  43-50     Citation Subset:  IM; X    
Affiliation:
Department of Pediatrics, University California Davis Medical Center, Sacramento, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anthropometry
Bacteria / isolation & purification
Diet / methods*
Female
HIV Infections / prevention & control*
Humans
Infant
Infant Mortality
Infectious Disease Transmission, Vertical / prevention & control*
Longitudinal Studies
Milk, Human / microbiology,  radiation effects*
Pasteurization / methods*
Prospective Studies
Tanzania
Young Adult
Grant Support
ID/Acronym/Agency:
R01 HD057602/HD/NICHD NIH HHS; R01 HD057602-01/HD/NICHD NIH HHS; R01HD057602/HD/NICHD NIH HHS
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