Feasibility of Using Flash-heated Breastmilk as an Infant Feeding Option for HIV-exposed, Uninfected Infants after 6 Months of Age in Urban Tanzania
Identifieur interne : 001895 ( Pmc/Corpus ); précédent : 001894; suivant : 001896Feasibility of Using Flash-heated Breastmilk as an Infant Feeding Option for HIV-exposed, Uninfected Infants after 6 Months of Age in Urban Tanzania
Auteurs : 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-BooherSource :
- Journal of Acquired Immune Deficiency Syndromes (1999) [ 1525-4135 ] ; 2012.
Abstract
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 while 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.
Prospective longitudinal
101 HIV-infected breastfeeding mothers
Dar es Salaam, Tanzania
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-and home-based surveys. Bacterial cultures of unheated and heated milk samples were performed.
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.
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 non-exclusive breastfeeding. Based on these feasibility data, a clinical trial of the effects of FH breastmilk on infant health outcomes is warranted.
Url:
DOI: 10.1097/QAI.0b013e31824fc06e
PubMed: 22362154
PubMed Central: 3380080
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PMC:3380080Le document en format XML
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Young</name><affiliation><nlm:aff id="A1">Department of Pediatrics, University California Davis Medical Center, Sacramento, CA, USA</nlm:aff></affiliation></author><author><name sortKey="Rennie, Waverly" sort="Rennie, Waverly" uniqKey="Rennie W" first="Waverly" last="Rennie">Waverly Rennie</name><affiliation><nlm:aff id="A2">University Research Company, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Ngonyani, Monica" sort="Ngonyani, Monica" uniqKey="Ngonyani M" first="Monica" last="Ngonyani">Monica Ngonyani</name><affiliation><nlm:aff id="A2">University Research Company, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Mashio, Clara" sort="Mashio, Clara" uniqKey="Mashio C" first="Clara" last="Mashio">Clara Mashio</name><affiliation><nlm:aff id="A2">University Research Company, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Israel Ballard, Kiersten" sort="Israel Ballard, Kiersten" uniqKey="Israel Ballard K" first="Kiersten" last="Israel-Ballard">Kiersten Israel-Ballard</name><affiliation><nlm:aff id="A3">PATH, Seattle, WA, USA</nlm:aff></affiliation></author><author><name sortKey="Peerson, Janet" sort="Peerson, Janet" uniqKey="Peerson J" first="Janet" last="Peerson">Janet Peerson</name><affiliation><nlm:aff id="A4">Department of Nutrition, University of California Davis, Davis, CA, USA</nlm:aff></affiliation></author><author><name sortKey="Nyambo, Margaret" sort="Nyambo, Margaret" uniqKey="Nyambo M" first="Margaret" last="Nyambo">Margaret Nyambo</name><affiliation><nlm:aff id="A2">University Research Company, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Matee, Mecky" sort="Matee, Mecky" uniqKey="Matee M" first="Mecky" last="Matee">Mecky Matee</name><affiliation><nlm:aff id="A5">Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Ash, Deborah" sort="Ash, Deborah" uniqKey="Ash D" first="Deborah" last="Ash">Deborah Ash</name><affiliation><nlm:aff id="A6">Academy for Educational Development, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Dewey, Kathryn" sort="Dewey, Kathryn" uniqKey="Dewey K" first="Kathryn" last="Dewey">Kathryn Dewey</name><affiliation><nlm:aff id="A4">Department of Nutrition, University of California Davis, Davis, CA, USA</nlm:aff></affiliation></author><author><name sortKey="Koniz Booher, Peggy" sort="Koniz Booher, Peggy" uniqKey="Koniz Booher P" first="Peggy" last="Koniz-Booher">Peggy Koniz-Booher</name><affiliation><nlm:aff id="A3">PATH, Seattle, WA, USA</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">22362154</idno><idno type="pmc">3380080</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3380080</idno><idno type="RBID">PMC:3380080</idno><idno type="doi">10.1097/QAI.0b013e31824fc06e</idno><date when="2012">2012</date><idno type="wicri:Area/Pmc/Corpus">001895</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001895</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Feasibility of Using Flash-heated Breastmilk as an Infant Feeding Option for HIV-exposed, Uninfected Infants after 6 Months of Age in Urban Tanzania</title><author><name sortKey="Chantry, Caroline J" sort="Chantry, Caroline J" uniqKey="Chantry C" first="Caroline J." last="Chantry">Caroline J. Chantry</name><affiliation><nlm:aff id="A1">Department of Pediatrics, University California Davis Medical Center, Sacramento, CA, USA</nlm:aff></affiliation></author><author><name sortKey="Young, Sera L" sort="Young, Sera L" uniqKey="Young S" first="Sera L." last="Young">Sera L. Young</name><affiliation><nlm:aff id="A1">Department of Pediatrics, University California Davis Medical Center, Sacramento, CA, USA</nlm:aff></affiliation></author><author><name sortKey="Rennie, Waverly" sort="Rennie, Waverly" uniqKey="Rennie W" first="Waverly" last="Rennie">Waverly Rennie</name><affiliation><nlm:aff id="A2">University Research Company, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Ngonyani, Monica" sort="Ngonyani, Monica" uniqKey="Ngonyani M" first="Monica" last="Ngonyani">Monica Ngonyani</name><affiliation><nlm:aff id="A2">University Research Company, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Mashio, Clara" sort="Mashio, Clara" uniqKey="Mashio C" first="Clara" last="Mashio">Clara Mashio</name><affiliation><nlm:aff id="A2">University Research Company, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Israel Ballard, Kiersten" sort="Israel Ballard, Kiersten" uniqKey="Israel Ballard K" first="Kiersten" last="Israel-Ballard">Kiersten Israel-Ballard</name><affiliation><nlm:aff id="A3">PATH, Seattle, WA, USA</nlm:aff></affiliation></author><author><name sortKey="Peerson, Janet" sort="Peerson, Janet" uniqKey="Peerson J" first="Janet" last="Peerson">Janet Peerson</name><affiliation><nlm:aff id="A4">Department of Nutrition, University of California Davis, Davis, CA, USA</nlm:aff></affiliation></author><author><name sortKey="Nyambo, Margaret" sort="Nyambo, Margaret" uniqKey="Nyambo M" first="Margaret" last="Nyambo">Margaret Nyambo</name><affiliation><nlm:aff id="A2">University Research Company, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Matee, Mecky" sort="Matee, Mecky" uniqKey="Matee M" first="Mecky" last="Matee">Mecky Matee</name><affiliation><nlm:aff id="A5">Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Ash, Deborah" sort="Ash, Deborah" uniqKey="Ash D" first="Deborah" last="Ash">Deborah Ash</name><affiliation><nlm:aff id="A6">Academy for Educational Development, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Dewey, Kathryn" sort="Dewey, Kathryn" uniqKey="Dewey K" first="Kathryn" last="Dewey">Kathryn Dewey</name><affiliation><nlm:aff id="A4">Department of Nutrition, University of California Davis, Davis, CA, USA</nlm:aff></affiliation></author><author><name sortKey="Koniz Booher, Peggy" sort="Koniz Booher, Peggy" uniqKey="Koniz Booher P" first="Peggy" last="Koniz-Booher">Peggy Koniz-Booher</name><affiliation><nlm:aff id="A3">PATH, Seattle, WA, USA</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Acquired Immune Deficiency Syndromes (1999)</title><idno type="ISSN">1525-4135</idno><idno type="eISSN">1944-7884</idno><imprint><date when="2012">2012</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">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 while 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.</p></sec><sec id="S2"><title>Design</title><p id="P2">Prospective longitudinal</p></sec><sec id="S3"><title>Participants</title><p id="P3">101 HIV-infected breastfeeding mothers</p></sec><sec id="S4"><title>Setting</title><p id="P4">Dar es Salaam, Tanzania</p></sec><sec id="S5"><title>Intervention</title><p id="P5">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-and home-based surveys. Bacterial cultures of unheated and heated milk samples were performed.</p></sec><sec id="S6"><title>Results</title><p id="P6">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.</p></sec><sec id="S7"><title>Conclusion</title><p id="P7">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 non-exclusive breastfeeding. Based on these feasibility data, a clinical trial of the effects of FH breastmilk on infant health outcomes is warranted.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">100892005</journal-id><journal-id journal-id-type="pubmed-jr-id">21821</journal-id><journal-id journal-id-type="nlm-ta">J Acquir Immune Defic Syndr</journal-id><journal-id journal-id-type="iso-abbrev">J. Acquir. Immune Defic. Syndr.</journal-id><journal-title-group><journal-title>Journal of Acquired Immune Deficiency Syndromes (1999)</journal-title></journal-title-group><issn pub-type="ppub">1525-4135</issn><issn pub-type="epub">1944-7884</issn></journal-meta><article-meta><article-id pub-id-type="pmid">22362154</article-id><article-id pub-id-type="pmc">3380080</article-id><article-id pub-id-type="doi">10.1097/QAI.0b013e31824fc06e</article-id><article-id pub-id-type="manuscript">NIHMS363703</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Feasibility of Using Flash-heated Breastmilk as an Infant Feeding Option for HIV-exposed, Uninfected Infants after 6 Months of Age in Urban Tanzania</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Chantry</surname><given-names>Caroline J.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Young</surname><given-names>Sera L.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Rennie</surname><given-names>Waverly</given-names></name><degrees>MPH</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Ngonyani</surname><given-names>Monica</given-names></name><degrees>RN</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Mashio</surname><given-names>Clara</given-names></name><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Israel-Ballard</surname><given-names>Kiersten</given-names></name><degrees>DrPH</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Peerson</surname><given-names>Janet</given-names></name><degrees>MS</degrees><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Nyambo</surname><given-names>Margaret</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Matee</surname><given-names>Mecky</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Ash</surname><given-names>Deborah</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author"><name><surname>Dewey</surname><given-names>Kathryn</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Koniz-Booher</surname><given-names>Peggy</given-names></name><degrees>DrPH</degrees><xref ref-type="aff" rid="A3">3</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Pediatrics, University California Davis Medical Center, Sacramento, CA, USA</aff><aff id="A2"><label>2</label>University Research Company, Dar es Salaam, Tanzania</aff><aff id="A3"><label>3</label>PATH, Seattle, WA, USA</aff><aff id="A4"><label>4</label>Department of Nutrition, University of California Davis, Davis, CA, USA</aff><aff id="A5"><label>5</label>Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</aff><aff id="A6"><label>6</label>Academy for Educational Development, Dar es Salaam, Tanzania</aff><author-notes><corresp id="FN1">Corresponding Author and Address for Reprints: Caroline J. Chantry, MD, Department of Pediatrics, University of California Davis Medical Center, 2516 Stockton Blvd., Sacramento, CA 95817, Telephone: 916-734-4455, Fax: 916-456-2236, <email>caroline.chantry@ucdmc.ucdavis.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>27</day><month>3</month><year>2012</year></pub-date><pub-date pub-type="ppub"><day>1</day><month>5</month><year>2012</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>5</month><year>2013</year></pub-date><volume>60</volume><issue>1</issue><fpage>43</fpage><lpage>50</lpage><abstract><sec id="S1"><title>Objective</title><p id="P1">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 while 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.</p></sec><sec id="S2"><title>Design</title><p id="P2">Prospective longitudinal</p></sec><sec id="S3"><title>Participants</title><p id="P3">101 HIV-infected breastfeeding mothers</p></sec><sec id="S4"><title>Setting</title><p id="P4">Dar es Salaam, Tanzania</p></sec><sec id="S5"><title>Intervention</title><p id="P5">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-and home-based surveys. Bacterial cultures of unheated and heated milk samples were performed.</p></sec><sec id="S6"><title>Results</title><p id="P6">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.</p></sec><sec id="S7"><title>Conclusion</title><p id="P7">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 non-exclusive breastfeeding. Based on these feasibility data, a clinical trial of the effects of FH breastmilk on infant health outcomes is warranted.</p></sec></abstract><kwd-group><kwd>HIV</kwd><kwd>infant feeding</kwd><kwd>breastmilk</kwd><kwd>pasteurization</kwd><kwd>feasibility</kwd><kwd>heat-treatment</kwd><kwd>Flash-heat</kwd><kwd>maternal-to-child transmission</kwd></kwd-group><funding-group><award-group><funding-source country="United States">National Institute of Child Health & Human Development : NICHD</funding-source><award-id>R01 HD057602-01 || HD</award-id></award-group></funding-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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