Longer breast-feeding may be optimal for mothers with HIV

A reduction in the normal duration of breast-feeding by mothers with HIV to uninfected children may be associated with increased child mortality extending into the second year of life, according to new results from a study conducted in Zambia.

The study results demonstrated that halting breast-feeding before the child was aged at least 18 months was associated with a significant increase in child mortality, with increases remaining even after mothers underwent intensive nutritional and counseling interventions.

The researchers recommended continuing breastfeeding for at least 18 months and added that the findings contradict some previous research that indicated that earlier weaning of breast-feeding may help to reduce the risk of mother-to-child transmission of HIV. The researchers said breast-feeding may help to stave off potentially fatal infectious diseases among the infants. But they warned that mothers with HIV should be treated with antiretroviral therapy to prevent mother-to-child transmission of HIV.

The researchers studied 958 mothers with HIV and their infant children in Lusaka, Zambia. Study participants were followed from the child’s birth to 24 months postpartum and were randomly assigned to two groups. The first group was told to wean infants at four months and the second group was told to continue breastfeeding.

Among children who did not stop breast-feeding before 18 months, the mortality rate was 9.7%. Among those who stopped breastfeeding at five months, the mortality rate was 17.4%.

Kuhn L, et al. Clin Infect Dis. 2010;50:437-444.