Heat treatment of expressed breast milk is a feasible option for feeding HIV-exposed, uninfected children after 6 months of age in rural Zimbabwe

Mduduzi N.N. Mbuya, Jean H. Humphrey, Florence Majo, Bernard Chasekwa, Alison Jenkins, Kiersten Israel-Ballard, Monica Muti, Keriann H. Paul, Rufaro C. Madzima, Lawrence H. Moulton, Rebecca J. Stoltzfus

Research output: Contribution to journalArticlepeer-review

Abstract

In the context of a prevention of mother to child transmission of HIV program promoting exclusive breast-feeding (EBF) to 6 mo and offering HIV-PCR testing at ∼6 mo, we ascertained the feasibility of expressing and heat-treating (EHT) all breast milk fed to HIV-exposed, uninfected infants following 6 mo of EBF. Twenty mother-baby pairs were enrolled from a hospital in rural Zimbabwe. Research nurses provided lactation, EHT, and complementary feeding counseling through 21 home visits conducted over an 8-wk period and collected quantitative and qualitative data on the mothers' EHT experiences, children's diets, and anthropometric measurements. Mothers kept daily logs of EHT volumes and direct breast-feeding episodes. Mothers successfully initiated and sustained EHT for 4.5 mo (range, 1-11 mo), feeding 426 ± 227 mL/d (mean ± SD). By wk 2 of follow-up, children were receiving EHT and Nutributter-enriched complementary foods that satisfied 100% of their energy requirements. During the 8-wk follow-up period, no growth faltering was experienced [changes in weight-for-age, weight-for-length, and length-for-age Z scores = +0.03 ± 0.50; +0.77 ± 1.59; and +0.02 ± 0.85 (mean ± SD), respectively]. Stigma was not a major deterrent, likely due to a social marketing campaign for EBF that promoted EHT as a practice to sustain breast-feeding for all women. This study provides evidence that resource-poor rural women can initiate and sustain EHT given family and health systems support. EHT provides a strategy for improving the diets of HIV-exposed but uninfected children after direct breast-feeding has ceased.

Original languageEnglish (US)
Pages (from-to)1481-1488
Number of pages8
JournalJournal of Nutrition
Volume140
Issue number8
DOIs
StatePublished - Aug 2010

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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