Survival of Infants Born to HIV-Positive Mothers, by Feeding Modality, in Rakai, Uganda
2008

Infant Survival of HIV-Positive Mothers by Feeding Method in Uganda

Sample size: 182 publication 10 minutes Evidence: high

Author Information

Author(s): Kagaayi Joseph, Gray Ronald H., Brahmbhatt Heena, Kigozi Godfrey, Nalugoda Fred, Wabwire-Mangen Fred, Serwadda David, Sewankambo Nelson, Ddungu Veronica, Ssebagala Darix, Sekasanvu Joseph, Kigozi Grace, Makumbi Fredrick, Kiwanuka Noah, Lutalo Tom, Reynolds Steven J., Wawer Maria J.

Primary Institution: Rakai Health Sciences Program, Entebbe, Uganda

Hypothesis

How does the feeding modality (breastfeeding vs. formula feeding) affect the survival of infants born to HIV-positive mothers?

Conclusion

Formula-feeding was associated with a higher risk of infant mortality than breastfeeding in this rural population.

Supporting Evidence

  • Infant mortality was 18% among formula-fed infants compared to 3% among breast-fed infants.
  • Exclusive breastfeeding was practiced by only 25% of breastfeeding women at one month postpartum.
  • All infants infected with HIV by one month of age in the formula-feeding group died by twelve months.

Takeaway

This study found that babies fed with formula milk were more likely to die than those who were breastfed, especially in rural areas with limited access to clean water.

Methodology

182 infants born to HIV-positive mothers were followed at one, six, and twelve months postpartum to compare mortality and HIV-free survival between formula-fed and breast-fed infants.

Potential Biases

Mothers who chose formula feeding were generally older and had higher parity, which may indicate health status bias.

Limitations

The study may have residual confounding due to self-selection of feeding method by mothers and limited generalizability to urban settings.

Participant Demographics

Mothers were primarily HIV-positive, with a mean age of 29.3 years for formula feeders and 26.1 years for breast feeders.

Statistical Information

P-Value

<0.01

Confidence Interval

95% CI = 11%–29% for formula-fed infants and 95% CI = 1%–9% for breast-fed infants

Statistical Significance

p<0.01

Digital Object Identifier (DOI)

10.1371/journal.pone.0003877

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