Evidence from Zaire that breast-feeding by HIV-1-seropositive mothers is not a major route for perinatal HIV-1 transmission but does decrease morbidity.
Breast-feeding as a route of HIV-1 transmission during infancy but also as a protective measure against early childhood morbidity has been investigated prospectively in children born to HIV-1-seropositive mothers and control children born to age- and parity-matched HIV-1-seronegative women. The mothers of all study children had been enrolled antenatally at a maternity hospital in Kinshasa, Zaire, which served a relatively affluent group of women who sometimes chose not to breast-feed their infants. In 106 children born to HIV-1-seropositive women, the rate of HIV-1 transmission was 21% in 28 infants exclusively breast-fed, 19% in 68 infants both breast- and bottle-fed and 0% in 10 infants who were bottle-fed only (P = 0.35). In contrast, non-HIV-1-infected children of both HIV-1-seropositive and HIV-1-seronegative mothers who were exclusively breast-fed compared with uninfected children who were not exclusively breast-fed had significantly lower incidence rates of acute diarrhea, fever and lower respiratory tract infection. The lack of a dose-response effect between breast-feeding and perinatal HIV-1 transmission and the presence of a protective effect of breast-feeding against common causes of early childhood morbidity and mortality support the current World Health Organization recommendation that breast-feeding should continue to be promoted in all developing countries, including those with high HIV-1 prevalence rates in women of childbearing age.
Ryder
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Project SIDA, Department of Public Health, Kinshasa, Zaire.
Manzila
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T
Baende
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E
Kabagabo
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U
Behets
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F
Batter
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V
Paquot
E
E
Binyingo
E
E
Heyward
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WL
D001942:Breast Feeding; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000401:mortality / Q000635:transmission*; D006679:HIV Seropositivity / Q000382:microbiology; D015497:HIV-1; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009017:Morbidity; D011446:Prospective Studies; D012307:Risk Factors