Re: [pronut-hiv] South Africa: HIV Positive Moms Can Breastfeed Too, Says Health Department (5)

["Rachel Stern" <sternworks@verizon.net>]

Hi, Anne.  I did not read the article, only the abstract.  I also wondered 
about the HIV status of the newborns and the ARV of the mothers. Basically, my thought was that perhaps we shouldn't reassure mothers that breastfeeding is totally safe.


----- <annem@webmail.co.za> wrote: 

Do you know whether the babies in the study cited below were tested for
HIV before being enrolled into the study?
If not, several of them could have already been infected in utero or
during birth.
Given that 3.4% of the EFF babies were positive at 6 weeks, this suggests
that they were already infected when they were enrolled in the study.
This figure should have remained the same if they were exclusive breastfed
instead of rising to 3.7% - admittedly a small rise, but it suggests that
the exclusive formula feederws may not have adhered to EFF.

It is not clear to me whether the short course of ARVs was provided to all
the breastfeeding mothers, nor does it indicate whether all the mothers
made use of this offer.
 Do you have more details about thi study?

Anne Moys


-- Rachel Stern wrote:

> Is this right? - to assure these mothers that breastfeeding is "safe?"
>
> Mr. Seloba promises to inform women of their choices. Let us hope so, and
> that he provides them with accurate information to make that choice.
>
> Below is another study. At the very best, you could say that breastfeeding
> carries a substantial risk of HIV transmission, although it could be
> reduced somewhat by taking certain precautions (besides exclusive
> breastfeeding, I'm not sure what they are).
>
> Rachel Stern
>
>
> AIDS. 2005 Mar 4;19(4):433-7.  Links
>
> Mode of infant feeding and HIV infection in children in a program for
> prevention of mother-to-child transmission in Uganda.
>   a.. Magoni M,
>   b.. Bassani L,
>   c.. Okong P,
>   d.. Kituuka P,
>   e.. Germinario EP,
>   f.. Giuliano M,
>   g.. Vella S.
> Istituto Superiore di Sanita, Rome, Italy.
>
> OBJECTIVE: To evaluate the impact of different modalities of infant
> feeding
> on HIV transmission in children in a prevention of mother-to-child
> transmission (PMTCT) program in an urban hospital in Uganda. METHODS:
> HIV-infected pregnant women in the PMTCT program at St Francis Hospital
> Nsambya, Kampala were offered the chance to participate in the study.
> Short-course antiretroviral regimens were provided and formula feeding
> offered free of charge for women choosing not to breastfeed. Mother-infant
> pairs were followed until 6 months postpartum. HIV status in children was
> assessed at week 6 and month 6. For the analyses, mother-infant pairs were
> classified into three groups according to the mode of infant feeding:
> exclusive formula feeding (EFF), exclusive breastfeeding (EBF) and mixed
> feeding (MF). RESULTS: A total of 306 children were enrolled. Transmission
> rates were 8.9% at week 6 (3.4% in the EFF group, 11.2% in the EBF group,
> 17.1% in the MF group) and 12.0% at month 6 (3.7% in the EFF group, 16.0%
> in
> the EBF group, and 20.4% in the MF group). The EBF and MF groups were
> associated with a significantly higher risk of HIV transmission than the
> EFF
> group. No significant risk difference was observed between the EBF and the
> MF groups. CONCLUSIONS: HIV transmission rates were significantly lower in
> formula-fed infants in comparison with both exclusively breastfed and
> mixed-fed infants. Transmission through breastfeeding seems to occur
> mainly
> in the first weeks after delivery.
>
>
> ----- "ProNut-HIV" wrote:
>
>
>> South Africa: HIV Positive Moms Can Breastfeed Too, Says Health
>> Department
>>
>> BuaNews (Tshwane)
>> August 3, 2006
>> Sharon Hammond And Simphiwe Mkhabela
>> Nelspruit
>>
>> Mothers with living with HIV can safely breastfeed their babies for the
>> first six months of infancy, says Limpopo health and Social services
>> spokesperson Phuti Seloba.
>>
>> He said breastfeeding remained best for the healthy growth and
>> development of all babies.
>>
>> "We need to protect women from malicious advertising that says infant
>> formula is the only option for HIV positive mothers.
>>
>> "The fact is that it's safe for women living with HIV to breastfeed for
>> up to six months. Thereafter, they can switch to formula."
>>
>> He said mothers who did not have HIV were advised to breastfeed their
>> babies until they were two years of age.
>>
>> Mr Seloba said departmental MEC Seaparo Sekoati would inform women of
>> their choices at an event in Lepelle Nkumpi near Polokwane on Friday as
>> part of World Breastfeeding Week.
>>
>> World Breastfeeding Week runs from August 1 to 7.
>>
>> According to a study done by University of KwaZulu-Natal paediatrics
>> professor, Anna Coutsoudis, it is safe for HIV positive mothers to
>> breastfeed their children for up to six months, as long as they don't
>> combine this with infant formula.
>>
>> Mixed feeding introduces allergens and contaminants into the baby's gut,
>> which could cause inflammation and thus make it easier for the HI virus
>> to pass from mother to child, she explains.
>>
>> Ms Coutsoudis said the risk of HIV transmission was even less if babies
>> were fed exclusively on breast milk until three months.
>>
>> Meanwhile, Mr Sekoati, raised awareness in Botlokwa about oral hygiene
>> on Thursday as part of Oral Health Awareness Month.
>>
>> "Oral diseases appear to be increasing in many sectors of the South
>> African population, especially in disadvantaged and urbanising
>> communities," said Mr Seloba.
>>
>>