Re: [pronut-hiv] Potential impact of infant feeding recommendations on mortality (2)

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

The authors' conclusions, posted below, differ somewhat from those in the 
abstract.

They suggest reducing HIV mortality by treating HIV-infected babies with 
HAART, which is obviously a good idea, but it's also important to 
acknowledge that managing pediatric HIV is not easy; and it is lifelong.


"Conclusions

In conclusion, this analysis presents a framework to assist decision-makers 
in resource limited settings in the choice of which infant-feeding method to recommend for infants born to HIV-infected mothers. Recommending exclusive breast-feeding in infants born to HIV-infected women in these settings, instead of replacement-feeding, may potentially result in very little gains in mortality. Furthermore, although recommending shorter durations of breast-feeding may substantially reduce infant HIV infection, it might slightly increase mortality. When exclusive breast-feeding for shorter durations is recommended, lower mortality could be achieved by a 
simultaneous reduction in of the rate of progression from HIV to AIDS and or HIV/AIDS mortality, reductions that are obtainable by the use of HAART in infants. Making HAART and better care available to infected-infants should thus be an imperative whenever a community and/or policy-maker prefer exclusive breast-feeding over replacement-feeding."

Rachel Stern