Breast-feeding Practices in Relation to HIV in India

  • A. V. Shankar
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 639)

The benefits of breast-feeding on infant and child health are both well established and substantial. Breast-feeding provides complete nutrition for the newborn for at least 6 months and can provide a significant proportion of nutritional needs up to 1 year of life.1 Breast-feeding also confers significant protection against infectious morbidity and mortality from gastrointestinal infections2,3 lower respiratory infections4, and otitis media5 due to the presence of numerous immunological factors in breast-milk.6 Breast-feeding is especially important in developing countries where use of replacement foods is not advisable due to poor sanitation, unsuitable preparation and prohibitive costs.


Exclusive Breastfeed Replacement Feeding Mixed Feeding National Family Health Survey Postnatal Transmission 
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  1. 1.
    The American Academy of Pediatrics Work Group on Breastfeeding (1997) Breastfeeding and the use of human milk. Pediatrics 100:1035.CrossRefGoogle Scholar
  2. 2.
    Blake PA, Ramos S, MacDonald KL, et al (1993) Pathogen-specific risk factors and protective factors for acute diarrheal disease in urban Brazilian infants. J Infect Dis 167:627–632.PubMedGoogle Scholar
  3. 3.
    Lerman Y, Slepon R, Cohen D (1994) Epidemiology of acute diarrheal diseases in children in a high standard of living settlement in Israel. Pediatr Infect Dis J 13:116–122.PubMedCrossRefGoogle Scholar
  4. 4.
    Holberg CJ (1991) Risk factors for RSV associated lower respiratory illnesses in the first year of life. Am J Epidemiol 133:135–151.Google Scholar
  5. 5.
    Alho O (1990) Risk factors for recurrent acute otitis media and respiratory infection in infancy. Int J Ped Otorhinolaryngology 19:151–161.CrossRefGoogle Scholar
  6. 6.
    Hanson LA (1998) Breastfeeding provides passive and likely long-lasting active immunity. Ann Allergy Asthma Immunol 81:523–533.PubMedCrossRefGoogle Scholar
  7. 7.
    WHO Collaborative Study Team on the Role of Breastfeeding on the Prevention of Infant Mortality (2000) Effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. Lancet 355:451–455.Google Scholar
  8. 8.
    Yoon PW, Black RE, Moulton LH, Becker S (1996) Effect of not breastfeeding on the risk of diarrheal and respiratory mortality in children under 2 years of age in Metro Cebu, The Philippines. Am J Epidemiol 143:1142–1148.PubMedGoogle Scholar
  9. 9.
    Cesar JA, Victora CG, Barros FC, Santos IS, Flores JA (1999) Impact of breast-feeding on admission for pneumonia during postneonatal period in Brazil: nested case-control study. BMJ 318:1316–1320.PubMedGoogle Scholar
  10. 10.
    Administrative Committee on Coordination, Subcommittee on Nutrition (ACC/SCN) (2000) 4th report on the world nutrition situation: nutrition throughout the life cycle. Collaborative Publication. Geneva, Switzerland, Washington, DC: United Nations International Food Policy Research Institute (IFPRI).Google Scholar
  11. 11.
    Thiry L, Sprecher-Goldberger S, Jonckheer T et al (1985) Isolation of AIDS virus from cell-free breast milk of three healthy virus carriers. Lancet 2:891–892.PubMedCrossRefGoogle Scholar
  12. 12.
    Lepage P, Van de Perre P, Carael M et al (1987) Postnatal transmission of HIV from mother to child. Lancet 2:400.PubMedCrossRefGoogle Scholar
  13. 13.
    Ziegler JB, Cooper DA, Johnson RO, Gold J (1985) Postnatal transmission of AIDS-associated retrovirus from mother to infant. Lancet 1:896–898.PubMedCrossRefGoogle Scholar
  14. 14.
    Colebunders R, Kapita B, Nekwei W et al (1988) Breastfeeding and transmission of HIV. Lancet 2:1487.PubMedCrossRefGoogle Scholar
  15. 15.
    World Health Organization/UNICEF (1992) Consensus statement. In: The WHO/UNICEF consultation on HIV transmission and breastfeeding. Geneva: WHO.Google Scholar
  16. 16.
    The Breastfeeding and HIV International Transmission Study Group (2004) The late postnatal transmission of HIV-1 in breast-fed children: An individual patient data meta-analysis. J Infect Dis 189:2154–2166.CrossRefGoogle Scholar
  17. 17.
    Gaillard P, Fowler MG, Dabis F et al (2004) Working Group on HIV in Women and Children. Use of antiretroviral drugs to prevent HIV-1 transmission through breast-feeding: from animal studies to randomized clinical trials. JAIDS 35:178–187.PubMedGoogle Scholar
  18. 18.
    WHO Technical Consultation on behalf of the UNFPA/UMCEF/WHO/UNAIDS Inter-Agency Task Team on Mother-to-Child Transmission of HIV (2001) New data on the prevention of mother-to-child transmission of HIV and their policy implications, conclusions, and implications. Geneva.Google Scholar
  19. 19.
    Rollins N, Meda N, Becquet R et al (2004) Working Group on HIV in Women and Children. Preventing postnatal transmission of HIV-1 through breast-feeding: modifying infant feeding practices JAIDS 35:188–195.PubMedGoogle Scholar
  20. 20.
    Nduati R, John G, Ngacha DA et al (2000) Effect of breastfeeding and formula feeding on transmission of HIV-1 : a randomized clinical trial. JAMA 283:1167–1174.PubMedCrossRefGoogle Scholar
  21. 21.
    Walley J, Witter S, Nicoll A (2001) Simplified antiviral prophylaxis with or without artificial feeding to reduce mother-to-child transmission of HIV in low and middle income countries: modelling positive and negative impact on child survival. Med Sci Monit 7:1043–1051.PubMedGoogle Scholar
  22. 22.
    Papathakis PC, Rollins NC (2004) Are WHO/UNAIDS/UNICEF-recommended replacement milks for infants of HIV-infected mothers appropriate in the South African context? Bull World Health Org 82:164–171.PubMedGoogle Scholar
  23. 23.
    Latham MC, Kisanga P (2001) Current status of protection, support and promotion of breastfeeding in four African countries. pp. 1–90. Monograph prepared for UNICEF;
  24. 24.
    Leroy V, Montcho C, Manigart O et al DITRAME Study Group (2001) Maternal plasma viral load, zidovudine and mother-to-child transmission of HIV-1 in Africa: DITRAME ANRS 049a trial. AIDS 15:517–522.PubMedCrossRefGoogle Scholar
  25. 25.
    Rousseau CM, Nduati RW, Richardson BA et al (2003) Longitudinal analysis of human immunodeficiency virus type 1 RNA in breast milk and of its relationship to infant infection and maternal disease. J Infect Dis 187:741–747.PubMedCrossRefGoogle Scholar
  26. 26.
    Moodley D, Coovadia HM, Bobat RA (1996) beta 2-microglobulin and CD4/CD8 ratio as HIV-1 markers of maternal transmissibility, neonatal infection and disease progression. Ann Trop Paediatr 16:155–160.PubMedGoogle Scholar
  27. 27.
    Semba RD, Kumwenda N, Hoover DR et al (1999) Human immunodeficiency virus load in breast-milk, mastitis, and mother-to-child transmission of human immunodeficiency virus type 1. J Infect Dis 189:93–98.CrossRefGoogle Scholar
  28. 28.
    Semba RD, Kumwenda N, Taaha TE et al (1999) Mastitis and immunological factors in breast-milk of human immunodeficiency virus-infected women. J Hum Lact 15:301–306.PubMedCrossRefGoogle Scholar
  29. 29.
    John GC, Nduati RW, Mbori-Ngacha DA et al 2001, Correlates of mother-to-child human immunodeficiency virus type 1 (HIV-1) transmission: association with maternal plasma HIV-1 RNA load, genital HIV-1 DNA shedding, and breast infections. J Infect Dis 183:206–212.PubMedCrossRefGoogle Scholar
  30. 30.
    Gaitan-Cepeda L, Cashat-Cruz M, Morales-Aguirre JJ et al 2002, Prevalence of oral lesions in Mexican children with perinatally acquired HIV: association with immunologic status, viral load, and gender. AIDS Patient Care STDS 4:151–156.CrossRefGoogle Scholar
  31. 31.
    Coutsoudis A, Pillay K, Kuhn L, Spooner E, Tsai W, Coovadia HM 2001, South African Vitamin A Study Group. Method of feeding and transmission of HIV-1 from mothers to children by 15 months of age: prospective cohort study from Durban, South Africa. AIDS 15:379–387.PubMedCrossRefGoogle Scholar
  32. 32.
    NACO website accessed verified October 10, 2004.
  33. 33.
    International Institute for Population Sciences (IIPS) and ORC macro National Family Health Survey (NFHS-2), 1998–1999: India, Mumbai: IIPS Chapter 7 2000.Google Scholar
  34. 34.
    Shrotri A, Shankar AV, Sutar S et al (2003) Awareness of HIV/AIDS and household environment of pregnant women in Pune, India. Int J STD and AIDS 14:835–839.CrossRefGoogle Scholar
  35. 35.
    Shankar AV, Sastry J, Erande A et al (2005) Making the choice: the translation of global HIV and infant feeding policy to local practice among mothers in Pune, India. J Nutr 135:960–965.PubMedGoogle Scholar
  36. 36.
    Phadke MA, Gadgil B, Bharucha KE et al (2003) Replacement-fed infants born to HIV-infected mothers in India have a high early postpartum rate of hospitalization. J Nutr 133:3153–3157.PubMedGoogle Scholar
  37. 37.
    Sastry J, Bollinger RC, Malwade S et al (2004) HIV-associated postpartum infant morbidity and mortality in Pune, India. XV International AIDS Conference, Bangkok, Thailand. Abstract reference number: ThPeB7210.Google Scholar
  38. 38.
    Gupta A, Sastry J, Suryawanshi N et al (2004) IV transmission from non-breastfeeding mothers to their infants in Pune, India. XV International AIDS Conference, Bangkok, Thailand. Abstract reference number: ThPeB7040Google Scholar
  39. 39.
    Leroy V, Karon JM, Alioum A et al (2003) West Africa PMTCT Study Group. Postnatal transmission of HIV-1 after a maternal short-course zidovudine peripartum regimen in West Africa. AIDS 17:1493–1501.PubMedCrossRefGoogle Scholar
  40. 40.
    Bulakh P, Sastry J, Deshmukh S et al (2004) Prevalence of anemia in HIV-infected mothers in India: Potential impact on selection of drugs for prevention of vertical transmission. XV International AIDS Conference, Bangkok, Thailand. Abstract reference number: ThPeB7046.Google Scholar
  41. 41.
    Suryavanshi N, Jonnalagadda S, Erande A et al (2003) Infant feeding practices of HIV-positive mothers in India. J Nutr 133:1326–1331.PubMedGoogle Scholar
  42. 42.
    United Nations Children’s Fund (UNICEF) / The Panos Institute Stigma, HrV/AIDS and prevention of mother-to-child transmission. A pilot study in Zambia, India, Ukraine and Burkina Faso. 2001. UNICEF. accessed on the webGoogle Scholar
  43. 43.
    Prasada Rao JVR, Ganguly NK, Mehendale SM, Bollinger RC (2004) India’s response to the HIV epidemic. Lancet 364:1296–1297.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media B.V. 2009

Authors and Affiliations

  • A. V. Shankar
    • 1
  1. 1.Bloomberg School of Public HealthJohns Hopkins UniversityBaltimoreUSA

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