title: The health of HIV-exposed children after early weaning.
abstract: There are potential health risks associated with the use of early weaning to prevent mother-to-child transmission of human immunodeficiency virus (HIV) in resource-poor settings. Our objective was to examine growth and nutrient inadequacies among a cohort of children weaned early. Children participating in the Breastfeeding Antiretrovirals and Nutrition (BAN) Study in Lilongwe, Malawi, had HIV-infected mothers, were weaned at 6 months and fed LNS until 12 months. 40 HIV-negative, BAN-exited children were compared with 40 HIV-negative, community children matched on age, gender and local health clinic. Nutrient intake was calculated from 24-h dietary recalls collected from BAN-exited children. Anthropometric measurements were collected from BAN-exited and matched community children at 15-16 months, and 2 months later. Longitudinal random effects sex-stratified models were used to evaluate anthropometric differences between the two groups. BAN-exited children consumed adequate energy, protein and carbohydrates but inadequate amounts of fat. The prevalence of inadequate micronutrient intakes were: 46% for vitamin A; 20% for vitamin B6; 69% for folate; 13% for vitamin C; 19% for iron; 23% for zinc. Regarding growth, BAN-exited girls gained weight at a significantly lower rate {0.02 g kg(-1) per day [95% confidence interval (CI): 0.01, 0.03]} than their matched comparison [0.05 g kg(-1) per day (95% CI: 0.03, 0.07)]; BAN girls grew significantly slower [0.73 cm month(-1) (95% CI: 0.40,1.06)] than their matched comparison (1.55 cm month(-1) [95% CI: 0.98, 2.12]). Among this sample of BAN-exited children, early weaning was associated with dietary deficiencies and girls experienced reduced growth velocity. In resource-poor settings, HIV prevention programmes must ensure that breastfeeding stop only once a nutritionally adequate and safe diet without breast milk can be provided.
authors.affiliation: International Food Policy Research Institute, Washington D.C., USA. M.Parker@cgiar.org
authors.forename: Megan E
authors.initials: ME
authors.lastname: Parker
authors.forename: Martin
authors.initials: M
authors.lastname: Tembo
authors.forename: Linda
authors.initials: L
authors.lastname: Adair
authors.forename: Charles
authors.initials: C
authors.lastname: Chasela
authors.forename: Ellen G
authors.initials: EG
authors.lastname: Piwoz
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
authors.forename: Sascha
authors.initials: S
authors.lastname: Ellington
authors.forename: Dumbani
authors.initials: D
authors.lastname: Kayira
authors.forename: Alice
authors.initials: A
authors.lastname: Soko
authors.forename: Chimwemwe
authors.initials: C
authors.lastname: Mkhomawanthu
authors.forename: Francis
authors.initials: F
authors.lastname: Martinson
authors.forename: Charles M
authors.initials: CM
authors.lastname: van der Horst
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Bentley
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage; D001205:Ascorbic Acid / Q000008:administration & dosage; D001835:Body Weight; D001942:Breast Feeding / Q000379:methods; D004032:Diet; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology*; D018023:HIV Seronegativity; D006801:Humans; D007223:Infant; D019266:Iron, Dietary / Q000008:administration & dosage; D008137:Longitudinal Studies; D008295:Malawi; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000517:prevention & control; D018977:Micronutrients / Q000008:administration & dosage; D009752:Nutritional Status; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012621:Seasons; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014801:Vitamin A / Q000008:administration & dosage; D025101:Vitamin B 6 / Q000008:administration & dosage; D014815:Vitamins / Q000008:administration & dosage; D014886:Weaning; D055815:Young Adult; D015032:Zinc / Q000008:administration & dosage
chemical_list: D044966:Anti-Retroviral Agents; D004041:Dietary Fats; D004044:Dietary Proteins; D019266:Iron, Dietary; D018977:Micronutrients; D014815:Vitamins; D014801:Vitamin A; D025101:Vitamin B 6; D005492:Folic Acid; D015032:Zinc; D001205:Ascorbic Acid
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