HIV status, breastfeeding modality at 5 months and postpartum maternal weight changes over 24 months in rural South Africa.
OBJECTIVE
To determine the effect of infant feeding practices on postpartum weight change among HIV-infected and -uninfected women in South Africa.


METHODS
In a non-randomised intervention cohort study of antiretroviral therapy-naïve women in South Africa, infants were classified as exclusive (EBF), mixed (MF) or non-breastfed (NBF) at each visit. We analysed infant feeding cumulatively from birth to 5 months using 24-hour feeding history (collected weekly for each of the preceding 7 days). Using generalised estimating equation mixed models, allowing for repeated measures, we compared postpartum weight change (kg) from the first maternal postpartum weight within the first 6 weeks (baseline weight) to each subsequent visit through 24 months among 2340 HIV-infected and -uninfected women with live births and at least two postpartum weight measurements.


RESULTS
HIV-infected (-0.2 kg CI: -1.7 to 1.3 kg; P = 0.81) and -uninfected women (-0.5 kg; 95% CI: -2.1 to 1.2 kg; P = 0.58) had marginal non-significant weight loss from baseline to 24 months postpartum. Adjusting for HIV status, socio-demographic, pregnancy-related and infant factors, 5-month feeding modality was not significantly associated with postpartum weight change: weight change by 24 months postpartum, compared to the change in the reference EBF group, was 0.03 kg in NBF (95% CI: -2.5 to +2.5 kg; P = 0.90) and 0.1 kg in MF (95% CI: -3.0 to +3.2 kg; P = 0.78).


CONCLUSIONS
HIV-infected and -uninfected women experienced similar weight loss over 24 months. Weight change postpartum was not associated with 5-month breastfeeding modality among HIV-infected and -uninfected women.
Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele, South Africa.
Terusha
T
Chetty
Rosalind J
RJ
Carter
Ruth M
RM
Bland
Marie-Louise
ML
Newell
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001942:Breast Feeding / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control; D006801:Humans; D007223:Infant; D041943:Infant Formula; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D007774:Lactation / Q000502:physiology*; D015233:Models, Statistical; D019829:Nevirapine / Q000627:therapeutic use; D010298:Parity; D049590:Postpartum Period / Q000502:physiology*; D011247:Pregnancy; D012959:Socioeconomic Factors; D013019:South Africa / Q000453:epidemiology; D013997:Time Factors; D019562:Viral Load; D015430:Weight Gain / Q000502:physiology; D015431:Weight Loss / Q000502:physiology*; D055815:Young Adult
D019380:Anti-HIV Agents; D019829:Nevirapine
HIV infection; allaitement; amamantamiento; body weight change; breastfeeding; cambio de peso corporal; infección por VIH; infection par le VIH; postparto; postpartum; variation du poids corporel