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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 : 001604 ( Ncbi/Curation ); précédent : 001603; suivant : 001605

Feasibility 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 [États-Unis] ; Sera L. Young [États-Unis] ; Waverly Rennie [Tanzanie] ; Monica Ngonyani [Tanzanie] ; Clara Mashio [Tanzanie] ; Kiersten Israel-Ballard [États-Unis] ; Janet Peerson [États-Unis] ; Margaret Nyambo [Tanzanie] ; Mecky Matee [Tanzanie] ; Deborah Ash [Tanzanie] ; Kathryn Dewey [États-Unis] ; Peggy Koniz-Booher [États-Unis]

Source :

Journal of Acquired Immune Deficiency Syndromes (1999) [ 1525-4135 ] ; 2012.

RBID : PMC:3380080

Abstract

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 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.

Design

Prospective longitudinal

Participants

101 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-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.

Conclusion

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:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3380080

DOI: 10.1097/QAI.0b013e31824fc06e
PubMed: 22362154
PubMed Central: 3380080

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<author><name sortKey="Israel Ballard, Kiersten" sort="Israel Ballard, Kiersten" uniqKey="Israel Ballard K" first="Kiersten" last="Israel-Ballard">Kiersten Israel-Ballard</name>
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<author><name sortKey="Matee, Mecky" sort="Matee, Mecky" uniqKey="Matee M" first="Mecky" last="Matee">Mecky Matee</name>
<affiliation wicri:level="1"><nlm:aff id="A5">Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff>
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<author><name sortKey="Ash, Deborah" sort="Ash, Deborah" uniqKey="Ash D" first="Deborah" last="Ash">Deborah Ash</name>
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<author><name sortKey="Dewey, Kathryn" sort="Dewey, Kathryn" uniqKey="Dewey K" first="Kathryn" last="Dewey">Kathryn Dewey</name>
<affiliation wicri:level="2"><nlm:aff id="A4">Department of Nutrition, University of California Davis, Davis, CA, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="Koniz Booher, Peggy" sort="Koniz Booher, Peggy" uniqKey="Koniz Booher P" first="Peggy" last="Koniz-Booher">Peggy Koniz-Booher</name>
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</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>
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<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>
</record>

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	Le SIDA en Afrique subsaharienne (serveur d'exploration)
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Le SIDA en Afrique subsaharienne (serveur d'exploration)

Feasibility of Using Flash-heated Breastmilk as an Infant Feeding Option for HIV-exposed, Uninfected Infants after 6 Months of Age in Urban Tanzania

Feasibility of Using Flash-heated Breastmilk as an Infant Feeding Option for HIV-exposed, Uninfected Infants after 6 Months of Age in Urban Tanzania

Source :

Abstract

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