Department of Pediatrics, University California Davis Medical Center, Sacramento, CA, USA.
J Acquir Immune Defic Syndr. 2012 May 1;60(1):43-50. doi: 10.1097/QAI.0b013e31824fc06e.
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.
Prospective longitudinal.
One hundred one HIV-infected breastfeeding mothers.
Dar es Salaam, Tanzania.
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.
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.
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.
在资源匮乏的国家，热处理母乳是一种推荐的 HIV 暴露婴儿的临时喂养策略，但关于其可行性的数据很少。闪蒸加热（FH）是一种在家中加热母乳的简单技术，可使 HIV 失活，同时保留其营养和抗感染特性。我们的主要目的是在纯母乳喂养 6 个月后，确定 HIV 感染的母亲中 FH 母乳的可行性和方案依从性。
前瞻性纵向研究。
101 名 HIV 感染的母乳喂养母亲。
坦桑尼亚达累斯萨拉姆。
同伴顾问在产后 2 至 9 个月期间提供家庭内婴儿喂养咨询和支持。鼓励母亲纯母乳喂养 6 个月，如果婴儿 HIV 阴性，则采用 FH 母乳。诊所工作人员每月测量婴儿的生长和发病率，并让母亲每天记录婴儿的发病率。使用每日记录、家庭观察以及诊所和家庭调查来跟踪 FH 行为，直到产后 9 个月。对未加热和加热的牛奶样本进行细菌培养。
72 名合格母亲中有 37 名（51.4%）选择闪蒸加热。中位数（范围）每日挤奶频率为 3（1-6）次，研究期间使用该方法的持续时间为 9.7（0.1-15.6）周。平均（标准差）每日牛奶量为 322（201）mL（范围 25-1120）。没有加热的样本和 32 个（30.5%）未加热的样本含有细菌病原体。
FH 是一种简单的技术，许多 HIV 阳性妇女可以在纯母乳喂养后成功使用，以继续提供母乳喂养的益处，同时避免与非纯母乳喂养相关的母婴传播。基于这些可行性数据，FH 母乳对婴儿健康结果的影响的临床试验是合理的。
