title: Breastmilk Output in a Disadvantaged Community with High HIV Prevalence as Determined by the Deuterium Oxide Dose-to-Mother Technique.
abstract: BACKGROUND
  World Health Organization breastfeeding guidelines for HIV-infected mothers are exclusive breastfeeding for 6 months and then continued breastfeeding for 12 months, provided the mother is receiving antiretroviral prophylaxis. Many African women perceive that breastmilk alone is not sufficient for their infant's nutritional requirements for the first 6 months of life, and mixed feeding is a common practice.
  
  
  METHODS
  A stable isotope technique was used to determine breastmilk output volumes and maternal body composition objectively at five different time points in the first year of the infant's life.
  
  
  RESULTS
  Breastmilk output volumes were high for HIV-infected mothers: 831 ± 185 g/day at 6 weeks; 899 ± 188 g/day at 3 months; 871 ± 293 g/day at 6 months; 679 ± 281 g/day at 9 months; and 755 ± 287 g/day at 12 months. These high output volumes had no negative impact on the mother's fat-free mass. The breastmilk output volumes for HIV-uninfected mothers were not significantly different to the outputs for HIV-infected mothers at any of the time points (p > 0.05): 948 ± 223 g/day at 6 weeks; 925 ± 227 g/day at 3 months; 902 ± 286 g/day at 6 months; 746 ± 263 g/day at 9 months; and 713 ± 264 g/day at 12 months.
  
  
  CONCLUSIONS
  This study using objective methodology shows that breastmilk outputs of HIV-infected mothers were relatively high (and within published reference ranges), and mothers are able to provide sufficient breastmilk for their infants without compromising their own fat-free mass.
authors: Department of Pediatrics and Child Health, University of KwaZulu-Natal , Durban, South Africa .
authors: Helen
authors: H
authors: Mulol
authors: Department of Pediatrics and Child Health, University of KwaZulu-Natal , Durban, South Africa .
authors: Anna
authors: A
authors: Coutsoudis
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001942:Breast Feeding / Q000379:methods*; D017666:Deuterium Oxide / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008895:Milk, Human / Q000187:drug effects*; D009035:Mothers / Q000193:education / Q000523:psychology; D011204:Poverty Areas; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D015995:Prevalence; D013019:South Africa / Q000453:epidemiology; D013997:Time Factors
chemical_list: D019380:Anti-HIV Agents; D017666:Deuterium Oxide