title: Replacement-fed infants born to HIV-infected mothers in India have a high early postpartum rate of hospitalization.
abstract: Access to safe breast-feeding alternatives for HIV-infected mothers and their infants in many settings is limited. We compared the rates of early postpartum hospitalization of infants born to HIV-infected mothers using different infant-feeding practices in a large government hospital in Pune, India. From March 1, 2000 to November 30, 2001, infants born to HIV-infected mothers were followed in a postpartum clinic. All mothers had received a standard short course of antenatal zidovudine. Infant-feeding practices were assessed within 3 d of delivery, prior to postpartum hospital discharge. Sixty-two of 148 mothers (42%) were breast-feeding their infants. Eighty-six of the mothers (58%) were providing replacement feeding, primarily diluted cow, goat or buffalo milk (top feeding). Twenty-one of the 148 participating infants (14.2%) born during the study period required hospitalization within the 1st 6 mo of life and 6 infants required repeat hospitalization. All hospitalized infants were receiving replacement feeding with a rate of 0.093 hospitalizations per 100 person-days (95% CI, 0.062 to 0.136). The reasons for hospitalization included acute gastroenteritis (48.1%), pneumonia (18.5%), septicemia (11.1%) and jaundice (11.1%). A high risk for early postpartum hospitalization was seen in replacement-fed infants born to HIV-infected mothers in Pune, India. In settings such as India, where access to safe replacement feeding is limited, interventions making exclusive breast-feeding safer for HIV-infected mothers and infants are needed. Such interventions would be valuable additions to the very effective national prevention programs that currently rely on the provision of short-course zidovudine and nevirapine.
authors.affiliation: Department of Medical Education and Research, Government of Maharashtra, Mumbai, India.
authors.forename: Mridula A
authors.initials: MA
authors.lastname: Phadke
authors.forename: Bhaghyashree
authors.initials: B
authors.lastname: Gadgil
authors.forename: Kapila E
authors.initials: KE
authors.lastname: Bharucha
authors.forename: Aparna N
authors.initials: AN
authors.lastname: Shrotri
authors.forename: Jayagowri
authors.initials: J
authors.lastname: Sastry
authors.forename: Nikhil A
authors.initials: NA
authors.lastname: Gupte
authors.forename: Ronald
authors.initials: R
authors.lastname: Brookmeyer
authors.forename: Ramesh S
authors.initials: RS
authors.lastname: Paranjape
authors.forename: Pandurang M
authors.initials: PM
authors.lastname: Bulakh
authors.forename: Hemalata
authors.initials: H
authors.lastname: Pisal
authors.forename: Nishi
authors.initials: N
authors.lastname: Suryavanshi
authors.forename: Anita V
authors.initials: AV
authors.lastname: Shankar
authors.forename: Lidia
authors.initials: L
authors.lastname: Propper
authors.forename: P L
authors.initials: PL
authors.lastname: Joshi
authors.forename: Robert C
authors.initials: RC
authors.lastname: Bollinger
mesh_terms: D000818:Animals; D001942:Breast Feeding; D005260:Female; D005759:Gastroenteritis / Q000453:epidemiology / Q000628:therapy; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000635:transmission; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007194:India / Q000453:epidemiology; D007225:Infant Food; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D007567:Jaundice, Neonatal / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008892:Milk; D011014:Pneumonia / Q000453:epidemiology / Q000628:therapy; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000821:virology*; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology / Q000628:therapy; D015215:Zidovudine / Q000008:administration & dosage
chemical_list: D015215:Zidovudine