HIV and infant feeding practices: epidemiological implications for sub-Saharan African countries.
In industrialized countries HIV-1-seropositive mothers who are nursing infants are advised to use artificial feeds, whilst HIV-infected women in the developing world are recommended to breast-feed. Current evidence is insufficient even to estimate the attributable risk associated with breast-feeding. There is a possibility that the policy promoted in industrialized societies will eventually become established in urban and peri-urban areas of sub-Saharan Africa. This may be defensible for some elite urban mothers providing safe artificial feeding. However, calculations of the consequence of any population-level change to bottle-feeding indicate that it would result in more deaths from infectious causes, substantially adding to the child deaths directly attributable to HIV-1 infection. These data demonstrate that there is a clear need for policy-makers and health care workers to undertake further promotion of breast-feeding despite the AIDS epidemic.
African Medical and Research Foundation, Tanzania, Mwanza.
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Nicoll
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Killewo
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Mgone
D000349:Africa / Q000453:epidemiology; D001942:Breast Feeding; D003906:Developing Countries; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D015497:HIV-1 / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007225:Infant Food; D007231:Infant, Newborn; D008895:Milk, Human / Q000382:microbiology; D011446:Prospective Studies; D012424:Rural Population; D014505:Urban Population