Document Detail


Use of lipid-based nutrient supplements by HIV-infected Malawian women during lactation has no effect on infant growth from 0 to 24 weeks.
MedLine Citation:
PMID:  22649265     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The Breastfeeding, Antiretrovirals, and Nutrition Study evaluated the effect of daily consumption of lipid-based nutrient supplements (LNS) by 2121 lactating, HIV-infected mothers on the growth of their exclusively breast-fed, HIV-uninfected infants from 0 to 24 wk. The study had a 2 × 3 factorial design. Malawian mothers with CD4(+) ≥250 cells/mm(3), hemoglobin ≥70 g/L, and BMI ≥17 kg/m(2) were randomized within 36 h of delivery to receive either no LNS or 140 g/d of LNS to meet lactation energy and protein needs, and mother-infant pairs were assigned to maternal antiretroviral drugs (ARV), infant ARV, or no ARV. Sex-stratified, longitudinal, random effects models were used to estimate the effect of the 6 study arms on infant weight, length, and BMI. Logistic regression models were used to calculate the odds of growth faltering [decline in weight-for-age Z-score (WAZ) or length-for-age Z-score (LAZ) >0.67] using the control arm as the reference. Although some differences between study arms emerged with increasing infant age in boys, there were no consistent effects of the maternal supplement across the 3 growth outcomes in longitudinal models. At the ages where differences were observed, the effects on weight and BMI were quite small (≤200 g and ≤0.4 kg/m(2)) and unlikely to be of clinical importance. Overall, 21 and 34% of infants faltered in WAZ and LAZ, respectively. Maternal supplementation did not reduce the odds of infant weight or length faltering from 0 to 24 wk in any arm. These results indicate that blanket supplementation of HIV-infected lactating women may have little impact on infant growth.
Authors:
Valerie L Flax; Margaret E Bentley; Charles S Chasela; Dumbani Kayira; Michael G Hudgens; Rodney J Knight; Alice Soko; Denise J Jamieson; Charles M van der Horst; Linda S Adair
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-05-30
Journal Detail:
Title:  The Journal of nutrition     Volume:  142     ISSN:  1541-6100     ISO Abbreviation:  J. Nutr.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-21     Completed Date:  2012-08-30     Revised Date:  2013-07-02    
Medline Journal Info:
Nlm Unique ID:  0404243     Medline TA:  J Nutr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1350-6     Citation Subset:  IM    
Affiliation:
Carolina Population Center, School of Medicine, University of North Carolina, Chapel Hill, NC, USA. flax@unc.edu
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00164736
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-HIV Agents / therapeutic use
Antigens, CD4
Body Height / drug effects
Body Mass Index
Body Weight / drug effects
Breast Feeding*
Diet*
Dietary Fats / pharmacology,  therapeutic use
Dietary Supplements*
Female
Growth / drug effects*
Growth Disorders / epidemiology,  etiology*,  prevention & control
HIV Infections / complications*
Hemoglobins / metabolism
Humans
Infant
Infant Nutritional Physiological Phenomena / drug effects*
Infant, Newborn
Lactation
Lipids / pharmacology
Logistic Models
Longitudinal Studies
Malawi / epidemiology
Male
Nutritional Requirements
Prevalence
Protein-Energy Malnutrition / prevention & control
Sex Factors
Young Adult
Grant Support
ID/Acronym/Agency:
2-D43 TW01039-06/TW/FIC NIH HHS; 5 R24 HD050924/HD/NICHD NIH HHS; P30-AI50410/AI/NIAID NIH HHS; R24 HD050924/HD/NICHD NIH HHS; R24TW007988/TW/FIC NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/Antigens, CD4; 0/Dietary Fats; 0/Hemoglobins; 0/Lipids
Comments/Corrections

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