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Longer Breastfeeding Best for HIV-Positive Mothers, Children ARLINGTON, Va -- January 14, 2010 -- A new study from Zambia suggests that halting breastfeeding early causes more harm than good for children not infected with HIV who are born to HIV-positive mothers. Stopping breastfeeding before 18 months was associated with significant increases in mortality among these children, according to the study’s findings, published in the February 1, 2010 issue of the journal Clinical Infectious Diseases. The researchers’ initial hypothesis, which proved to be incorrect, suggested that by 4 months of age, children would have passed the critical developmental point when breastfeeding is essential to their survival. However, stopping breastfeeding at 4 months, compared with usual breastfeeding as the child reaches 6 months to 24 months or older, did not decrease mortality or play a significant role in protecting the child from HIV transmission. These findings were consistent with those for mothers not infected with HIV; longer breastfeeding is necessary to protect children against potentially fatal infectious diseases, especially those prevalent in low-resource settings. To prevent postnatal HIV transmission, however, mothers with HIV should be on antiretroviral drugs. “Our results help support the recent change in the World Health Organization (WHO) guidelines for prevention of mother-to-child HIV transmission,” said study author Louise Kuhn, PhD, Columbia University, New York, New York. “The new guidelines encourage postnatal use of antiretrovirals through the duration of breastfeeding to prevent vertical [mother-to-child] transmission.” For the study, 958 HIV-positive mothers and their infants were recruited and followed-up from birth to 24 months postpartum in Lusaka, Zambia. Half were randomised to wean abruptly at 4 months, and the other half continued to breastfeed. The mortality rate among 749 uninfected children was 9.4% by 12 months of age and 13.6% by 24 months of age. Weaning during the interval encouraged by the protocol (4-5 months of age) was associated with a 2.03-fold increased risk of mortality, weaning at 6 to 11 months was associated with a 3.54-fold increase, and weaning at 12 to 18 was associated with a 4.22-fold increase. SOURCE: Infectious Diseases Society of America E-mail this page to a friend or colleague! To print, use this version