Breastfeeding poses a danger for HIV+ mothers

HIV positive mothers who breastfed their babies were three times more likely to die than those who used formula milk, according to a Kenyan study published in The Lancet recently.

And the babies of the women who had died were eight times more likely to die than those whose mothers survived, highlighting the impact of maternal health on babies in developing countries.

The researchers, headed by Dr Ruth Nduati, followed up a group of 425 HIV positive women for two years after they had given birth. Of the group, 212 women breastfed their babies and 213 used formula.

Twenty four women died during this period, 18 of whom were from the breastfeeding group. This is three times higher than the mortality rate in the formula feeding group.

Nduati poses two possible reasons for their deaths. The first is that “the combined metabolic burdens of HIV-1 infection and breastfeeding in a population that has inadequate nutritional intake could result in substantial nutritional impairment”.

Without proper nutrition, breastmilk is manufactured from the breakdown of body fat and muscle “which might lead to maternal weight loss and maternal depletion syndrome”, said Nduati.

“We noted that women in the breastfeeding group had greater weight loss postpartum than women in the formula feeding group. Additionally, weight loss was associated with maternal death.”

Secondly, argued Nduati, breastfeeding “might affect HIV-1 replication. Lactation is associated with raised prolactin, an immuno-modulating hormone that might be immuno-suppressive at high concentrations”.

Half the mothers who had died also lost their babies. Significantly, six of these babies died after their mothers. Thus, said Nduati, “promotion of the survival of the mothers is important [in ensuring the survival of their babies]”.

Commenting on the research, Dr Marie-Louise Newell of the Institute of Child Health in London said it was possible that “nutritional and treatment support” for the mothers could cancel out “any supposed harmful effects of breastfeeding”.


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