Feasibility of Using Flash-Heated Breastmilk as an Infant Feeding Option for HIV-Exposed, Uninfected Infants after 6 Months of Age in Urban Tanzania
OBJECTIVE:Heat-treating expressed breastmilk is recommended as an interim feeding strategy for HIV-exposed infants in resource-poor countries, but data on its feasibility are minimal. Flash-heating (FH) is a simple in-home technique for heating breastmilk that inactivates HIV although preserving its...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2012-05, Vol.60 (1), p.43-50 |
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| creator | Chantry, Caroline J Young, Sera L Rennie, Waverly Ngonyani, Monica Mashio, Clara Israel-Ballard, Kiersten Peerson, Janet Nyambo, Margaret Matee, Mecky Ash, Deborah Dewey, Kathryn Koniz-Booher, Peggy |
| description | OBJECTIVE:Heat-treating expressed breastmilk is recommended as an interim feeding strategy for HIV-exposed infants in resource-poor countries, but data on its feasibility are minimal. Flash-heating (FH) is a simple in-home technique for heating breastmilk that inactivates HIV although preserving its nutritional and anti-infective properties. Our primary objective was to determine, among HIV-infected mothers, the feasibility and protocol adherence of FH expressed breastmilk after 6 months of exclusive breastfeeding.
DESIGN:Prospective longitudinal.
PARTICIPANTS:One hundred one HIV-infected breastfeeding mothers
SETTING:Dar es Salaam, Tanzania
INTERVENTION:Peer counselors provided in-home counseling and support on infant feeding from 2 to 9 months postpartum. Mothers were encouraged to exclusively breastfeed for 6 months followed by FH expressed breastmilk if her infant was HIV negative. Clinic-based staff measured infant growth and morbidity monthly, and mothers kept daily logs of infant morbidity. FH behavior was tracked until 9 months postpartum using daily logs, in-home observations, and clinic-based and home-based surveys. Bacterial cultures of unheated and heated milk samples were performed.
RESULTS:Thirty-seven of 72 eligible mothers (51.4%) chose to flash-heat. Median (range) frequency of milk expression was 3 (1–6) times daily and duration of method use on-study was 9.7 (0.1–15.6) weeks. Mean (SD) daily milk volume was 322 (201) mL (range 25–1120). No heated and 32 (30.5%) unheated samples contained bacterial pathogens.
CONCLUSIONS:FH is a simple technology that many HIV-positive women can successfully use after exclusive breastfeeding to continue to provide the benefits of breastmilk while avoiding maternal-to-child transmission associated with nonexclusive breastfeeding. Based on these feasibility data, a clinical trial of the effects of FH breastmilk on infant health outcomes is warranted. |
| doi_str_mv | 10.1097/QAI.0b013e31824fc06e |
| format | Article |
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DESIGN:Prospective longitudinal.
PARTICIPANTS:One hundred one HIV-infected breastfeeding mothers
SETTING:Dar es Salaam, Tanzania
INTERVENTION:Peer counselors provided in-home counseling and support on infant feeding from 2 to 9 months postpartum. Mothers were encouraged to exclusively breastfeed for 6 months followed by FH expressed breastmilk if her infant was HIV negative. Clinic-based staff measured infant growth and morbidity monthly, and mothers kept daily logs of infant morbidity. FH behavior was tracked until 9 months postpartum using daily logs, in-home observations, and clinic-based and home-based surveys. Bacterial cultures of unheated and heated milk samples were performed.
RESULTS:Thirty-seven of 72 eligible mothers (51.4%) chose to flash-heat. Median (range) frequency of milk expression was 3 (1–6) times daily and duration of method use on-study was 9.7 (0.1–15.6) weeks. Mean (SD) daily milk volume was 322 (201) mL (range 25–1120). No heated and 32 (30.5%) unheated samples contained bacterial pathogens.
CONCLUSIONS:FH is a simple technology that many HIV-positive women can successfully use after exclusive breastfeeding to continue to provide the benefits of breastmilk while avoiding maternal-to-child transmission associated with nonexclusive breastfeeding. Based on these feasibility data, a clinical trial of the effects of FH breastmilk on infant health outcomes is warranted.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0b013e31824fc06e</identifier><identifier>PMID: 22362154</identifier><identifier>CODEN: JDSRET</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Adolescent ; Adult ; Anthropometry ; Bacteria - isolation & purification ; Biological and medical sciences ; Breastfeeding & lactation ; Childrens health ; Diet - methods ; Disease transmission ; Female ; Fundamental and applied biological sciences. Psychology ; Heating ; HIV ; HIV Infections - prevention & control ; Human immunodeficiency virus ; Human viral diseases ; Humans ; Indexing in process ; Infant ; Infant Mortality ; Infectious Disease Transmission, Vertical - prevention & control ; Infectious diseases ; Longitudinal Studies ; Medical sciences ; Microbiology ; Milk, Human - microbiology ; Milk, Human - radiation effects ; Miscellaneous ; Pasteurization - methods ; Prospective Studies ; Tanzania ; Viral diseases ; Virology ; Young Adult</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2012-05, Vol.60 (1), p.43-50</ispartof><rights>2012 Lippincott Williams & Wilkins, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright Lippincott Williams & Wilkins May 1, 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c548e-5c1911735ac129d59f7a5a950f064321fabdf0178c439e90bd1bdf0af531878e3</citedby><cites>FETCH-LOGICAL-c548e-5c1911735ac129d59f7a5a950f064321fabdf0178c439e90bd1bdf0af531878e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25835325$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22362154$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chantry, Caroline J</creatorcontrib><creatorcontrib>Young, Sera L</creatorcontrib><creatorcontrib>Rennie, Waverly</creatorcontrib><creatorcontrib>Ngonyani, Monica</creatorcontrib><creatorcontrib>Mashio, Clara</creatorcontrib><creatorcontrib>Israel-Ballard, Kiersten</creatorcontrib><creatorcontrib>Peerson, Janet</creatorcontrib><creatorcontrib>Nyambo, Margaret</creatorcontrib><creatorcontrib>Matee, Mecky</creatorcontrib><creatorcontrib>Ash, Deborah</creatorcontrib><creatorcontrib>Dewey, Kathryn</creatorcontrib><creatorcontrib>Koniz-Booher, Peggy</creatorcontrib><title>Feasibility of Using Flash-Heated Breastmilk as an Infant Feeding Option for HIV-Exposed, Uninfected Infants after 6 Months of Age in Urban Tanzania</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>OBJECTIVE:Heat-treating expressed breastmilk is recommended as an interim feeding strategy for HIV-exposed infants in resource-poor countries, but data on its feasibility are minimal. Flash-heating (FH) is a simple in-home technique for heating breastmilk that inactivates HIV although preserving its nutritional and anti-infective properties. Our primary objective was to determine, among HIV-infected mothers, the feasibility and protocol adherence of FH expressed breastmilk after 6 months of exclusive breastfeeding.
DESIGN:Prospective longitudinal.
PARTICIPANTS:One hundred one HIV-infected breastfeeding mothers
SETTING:Dar es Salaam, Tanzania
INTERVENTION:Peer counselors provided in-home counseling and support on infant feeding from 2 to 9 months postpartum. Mothers were encouraged to exclusively breastfeed for 6 months followed by FH expressed breastmilk if her infant was HIV negative. Clinic-based staff measured infant growth and morbidity monthly, and mothers kept daily logs of infant morbidity. FH behavior was tracked until 9 months postpartum using daily logs, in-home observations, and clinic-based and home-based surveys. Bacterial cultures of unheated and heated milk samples were performed.
RESULTS:Thirty-seven of 72 eligible mothers (51.4%) chose to flash-heat. Median (range) frequency of milk expression was 3 (1–6) times daily and duration of method use on-study was 9.7 (0.1–15.6) weeks. Mean (SD) daily milk volume was 322 (201) mL (range 25–1120). No heated and 32 (30.5%) unheated samples contained bacterial pathogens.
CONCLUSIONS:FH is a simple technology that many HIV-positive women can successfully use after exclusive breastfeeding to continue to provide the benefits of breastmilk while avoiding maternal-to-child transmission associated with nonexclusive breastfeeding. Based on these feasibility data, a clinical trial of the effects of FH breastmilk on infant health outcomes is warranted.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anthropometry</subject><subject>Bacteria - isolation & purification</subject><subject>Biological and medical sciences</subject><subject>Breastfeeding & lactation</subject><subject>Childrens health</subject><subject>Diet - methods</subject><subject>Disease transmission</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Heating</subject><subject>HIV</subject><subject>HIV Infections - prevention & control</subject><subject>Human immunodeficiency virus</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Indexing in process</subject><subject>Infant</subject><subject>Infant Mortality</subject><subject>Infectious Disease Transmission, Vertical - prevention & control</subject><subject>Infectious diseases</subject><subject>Longitudinal Studies</subject><subject>Medical sciences</subject><subject>Microbiology</subject><subject>Milk, Human - microbiology</subject><subject>Milk, Human - radiation effects</subject><subject>Miscellaneous</subject><subject>Pasteurization - methods</subject><subject>Prospective Studies</subject><subject>Tanzania</subject><subject>Viral diseases</subject><subject>Virology</subject><subject>Young Adult</subject><issn>1525-4135</issn><issn>1944-7884</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkt9u0zAUxiMEYn_gDRCyhJC4IMOO7cS5QSrTSisNTUgrt9FJctx6c-1ip2zjOXhgHLUM2AVc2bJ_33eOj78se8HoCaN19e7zZH5CW8o4cqYKoTta4qPskNVC5JVS4nHay0LmgnF5kB3FeEUpK4Won2YHRcHLgklxmP2YIkTTGmuGO-I1WUTjlmRqIa7yGcKAPfkQEjKsjb0mEAk4Mnca3ECmiP0IX2wG4x3RPpDZ_Et-drvxEfu3ZOGM09iNFjtFEusBAynJJ--GVRzrTZZIjCOL0CbjS3DfwRl4lj3RYCM-36_H2WJ6dnk6y88vPs5PJ-d5J4XCXHasZqziEjpW1L2sdQUSakk1LQUvmIa215RVqhO8xpq2PRsPQMs0sUohP87e73w323aNfYduCGCbTTBrCHeNB9P8fePMqln6bw3nilJFk8GbvUHwX7cYh2ZtYofWgkO_jQ2jTLAEpnb-j1KlirriVUJfPUCv_Da4NImRqllZVpwnSuyoLvgYA-r7vhltxoQ0KSHNw4Qk2cs_33wv-hWJBLzeAxA7sDqA60z8zUnFJS9k4tSOu_E2_Wq8ttsbDM0KwQ6rf_fwE9Yu1xE</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Chantry, Caroline J</creator><creator>Young, Sera L</creator><creator>Rennie, Waverly</creator><creator>Ngonyani, Monica</creator><creator>Mashio, Clara</creator><creator>Israel-Ballard, Kiersten</creator><creator>Peerson, Janet</creator><creator>Nyambo, Margaret</creator><creator>Matee, Mecky</creator><creator>Ash, Deborah</creator><creator>Dewey, Kathryn</creator><creator>Koniz-Booher, Peggy</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><general>Lippincott Williams & Wilkins Ovid Technologies</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7T5</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20120501</creationdate><title>Feasibility of Using Flash-Heated Breastmilk as an Infant Feeding Option for HIV-Exposed, Uninfected Infants after 6 Months of Age in Urban Tanzania</title><author>Chantry, Caroline J ; Young, Sera L ; Rennie, Waverly ; Ngonyani, Monica ; Mashio, Clara ; Israel-Ballard, Kiersten ; Peerson, Janet ; Nyambo, Margaret ; Matee, Mecky ; Ash, Deborah ; Dewey, Kathryn ; Koniz-Booher, Peggy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c548e-5c1911735ac129d59f7a5a950f064321fabdf0178c439e90bd1bdf0af531878e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Anthropometry</topic><topic>Bacteria - isolation & purification</topic><topic>Biological and medical sciences</topic><topic>Breastfeeding & lactation</topic><topic>Childrens health</topic><topic>Diet - methods</topic><topic>Disease transmission</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Heating</topic><topic>HIV</topic><topic>HIV Infections - prevention & control</topic><topic>Human immunodeficiency virus</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Indexing in process</topic><topic>Infant</topic><topic>Infant Mortality</topic><topic>Infectious Disease Transmission, Vertical - prevention & control</topic><topic>Infectious diseases</topic><topic>Longitudinal Studies</topic><topic>Medical sciences</topic><topic>Microbiology</topic><topic>Milk, Human - microbiology</topic><topic>Milk, Human - radiation effects</topic><topic>Miscellaneous</topic><topic>Pasteurization - methods</topic><topic>Prospective Studies</topic><topic>Tanzania</topic><topic>Viral diseases</topic><topic>Virology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chantry, Caroline J</creatorcontrib><creatorcontrib>Young, Sera L</creatorcontrib><creatorcontrib>Rennie, Waverly</creatorcontrib><creatorcontrib>Ngonyani, Monica</creatorcontrib><creatorcontrib>Mashio, Clara</creatorcontrib><creatorcontrib>Israel-Ballard, Kiersten</creatorcontrib><creatorcontrib>Peerson, Janet</creatorcontrib><creatorcontrib>Nyambo, Margaret</creatorcontrib><creatorcontrib>Matee, Mecky</creatorcontrib><creatorcontrib>Ash, Deborah</creatorcontrib><creatorcontrib>Dewey, Kathryn</creatorcontrib><creatorcontrib>Koniz-Booher, Peggy</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chantry, Caroline J</au><au>Young, Sera L</au><au>Rennie, Waverly</au><au>Ngonyani, Monica</au><au>Mashio, Clara</au><au>Israel-Ballard, Kiersten</au><au>Peerson, Janet</au><au>Nyambo, Margaret</au><au>Matee, Mecky</au><au>Ash, Deborah</au><au>Dewey, Kathryn</au><au>Koniz-Booher, Peggy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Feasibility of Using Flash-Heated Breastmilk as an Infant Feeding Option for HIV-Exposed, Uninfected Infants after 6 Months of Age in Urban Tanzania</atitle><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle><addtitle>J Acquir Immune Defic Syndr</addtitle><date>2012-05-01</date><risdate>2012</risdate><volume>60</volume><issue>1</issue><spage>43</spage><epage>50</epage><pages>43-50</pages><issn>1525-4135</issn><eissn>1944-7884</eissn><coden>JDSRET</coden><abstract>OBJECTIVE:Heat-treating expressed breastmilk is recommended as an interim feeding strategy for HIV-exposed infants in resource-poor countries, but data on its feasibility are minimal. Flash-heating (FH) is a simple in-home technique for heating breastmilk that inactivates HIV although preserving its nutritional and anti-infective properties. Our primary objective was to determine, among HIV-infected mothers, the feasibility and protocol adherence of FH expressed breastmilk after 6 months of exclusive breastfeeding.
DESIGN:Prospective longitudinal.
PARTICIPANTS:One hundred one HIV-infected breastfeeding mothers
SETTING:Dar es Salaam, Tanzania
INTERVENTION:Peer counselors provided in-home counseling and support on infant feeding from 2 to 9 months postpartum. Mothers were encouraged to exclusively breastfeed for 6 months followed by FH expressed breastmilk if her infant was HIV negative. Clinic-based staff measured infant growth and morbidity monthly, and mothers kept daily logs of infant morbidity. FH behavior was tracked until 9 months postpartum using daily logs, in-home observations, and clinic-based and home-based surveys. Bacterial cultures of unheated and heated milk samples were performed.
RESULTS:Thirty-seven of 72 eligible mothers (51.4%) chose to flash-heat. Median (range) frequency of milk expression was 3 (1–6) times daily and duration of method use on-study was 9.7 (0.1–15.6) weeks. Mean (SD) daily milk volume was 322 (201) mL (range 25–1120). No heated and 32 (30.5%) unheated samples contained bacterial pathogens.
CONCLUSIONS:FH is a simple technology that many HIV-positive women can successfully use after exclusive breastfeeding to continue to provide the benefits of breastmilk while avoiding maternal-to-child transmission associated with nonexclusive breastfeeding. Based on these feasibility data, a clinical trial of the effects of FH breastmilk on infant health outcomes is warranted.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>22362154</pmid><doi>10.1097/QAI.0b013e31824fc06e</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of acquired immune deficiency syndromes (1999), 2012-05, Vol.60 (1), p.43-50 |
| issn | 1525-4135 1944-7884 |
| language | eng |
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| source | Journals@Ovid Ovid Autoload; MEDLINE; Journals@Ovid LWW Legacy Archive; Free E- Journals |
| subjects | Adolescent Adult Anthropometry Bacteria - isolation & purification Biological and medical sciences Breastfeeding & lactation Childrens health Diet - methods Disease transmission Female Fundamental and applied biological sciences. Psychology Heating HIV HIV Infections - prevention & control Human immunodeficiency virus Human viral diseases Humans Indexing in process Infant Infant Mortality Infectious Disease Transmission, Vertical - prevention & control Infectious diseases Longitudinal Studies Medical sciences Microbiology Milk, Human - microbiology Milk, Human - radiation effects Miscellaneous Pasteurization - methods Prospective Studies Tanzania Viral diseases Virology Young Adult |
| title | Feasibility of Using Flash-Heated Breastmilk as an Infant Feeding Option for HIV-Exposed, Uninfected Infants after 6 Months of Age in Urban Tanzania |
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