Institute of Tropical and Infectious Diseases, University of Nairobi School of Medicine, Nairobi, Kenya; Intergovermental Authority on Development - Health and Nutrition Office, Nairobi, Kenya.
Institute of Tropical and Infectious Diseases, University of Nairobi School of Medicine, Nairobi, Kenya.
J Nutr. 2023 Jan;153(1):27-33. doi: 10.1016/j.tjnut.2022.11.018. Epub 2022 Dec 26.
Regardless of their HIV serostatus, mothers are advised to exclusively breastfeed infants ≤6 mo postpartum. How this guidance impacts breast milk intake among HIV-exposed infants in varied contexts needs to be better understood.
The objective of this study was to compare breast milk intake of HIV-exposed and HIV-unexposed infants at 6 wk and 6 mo of age, as well as the associated factors.
In a prospective cohort design, which we followed from a western Kenya postnatal clinic, 68 full-term HIV-uninfected infants born to HIV-1-infected mothers (HIV-exposed) and 65 full-term HIV-uninfected infants born to HIV-uninfected mothers were assessed at 6 wk and 6 mo of age. Breast milk intake of infants (51.9% female) weighing 3.0-6.7 kg (at 6 wk of age) was determined using the deuterium oxide dose-to-mother technique. Student t test for independent samples compared the variations in breast milk intake between the 2 groups. Correlation analysis detected the associations between breast milk intake and maternal and infant factors.
Daily breast milk intakes by HIV-exposed and HIV-unexposed infants were not significantly different at either 6 wk (721 ± 111 g/d and 719 ± 121 g/d, respectively) or 6 mo (960 ± 121 g/d and 963 ± 107 g/d, respectively) of age. Maternal factors that significantly correlated with infant breast milk intake were FFM at both 6 wk (r = 0.23; P < 0.05) and 6 mo (r = 0.36; P < 0.01) of age and weight at 6 mo postpartum (r = 0.28; P < 0.01). Infant factors that significantly correlated at 6 wk were birth weight (r = 0.27; P < 0.01), present weight (r = 0.47; P < 0.01), length-for-age z-score (r = 0.33; P < 0.01), and weight-for-age (r = 0.42; P > 0.01). At 6 mo, they were infant length-for-age (r = 0.38; P < 0.01), weight-for-length (r = 0.41; P > 0.01), and weight-for-age (r = 0.60; P > 0.01).
Full-term breastfeeding infants born to HIV-1-infected and HIV-1-uninfected women attending standard Kenyan postnatal care clinics ≤6 mo of age in this resource-poor setting consume comparable amounts of breast milk. This trial was registered at clinicaltrials.gov as PACTR201807163544658.
无论其艾滋病毒血清状况如何，均建议母亲在产后 6 个月内纯母乳喂养婴儿。在不同的情况下，这一指导意见对艾滋病毒暴露婴儿的母乳摄入量有何影响，需要有更深入的了解。
本研究旨在比较艾滋病毒暴露和未暴露婴儿在 6 周和 6 个月龄时的母乳摄入量，并探讨相关因素。
采用前瞻性队列设计，我们对肯尼亚西部一家产后诊所的 68 名足月、无艾滋病毒感染的 HIV-1 感染母亲所生婴儿（HIV 暴露组）和 65 名足月、无艾滋病毒感染的母亲所生婴儿（HIV 未暴露组）进行了评估。在婴儿出生后 3.0-6.7kg（6 周龄）时，采用氘水剂量-母亲技术来确定婴儿的母乳摄入量。采用独立样本 t 检验比较两组间的母乳摄入量差异。相关性分析检测了母乳摄入量与母婴因素之间的关系。
在 6 周龄（分别为 721 ± 111g/d 和 719 ± 121g/d）和 6 月龄（分别为 960 ± 121g/d 和 963 ± 107g/d）时，HIV 暴露组和未暴露组婴儿的每日母乳摄入量无显著差异。与婴儿母乳摄入量显著相关的母体因素有：6 周龄时的去脂体重（r = 0.23；P < 0.05）和 6 月龄时的去脂体重（r = 0.36；P < 0.01）以及产后 6 个月时的体重（r = 0.28；P < 0.01）。与婴儿 6 周龄时的母乳摄入量显著相关的因素还有：出生体重（r = 0.27；P < 0.01）、当前体重（r = 0.47；P < 0.01）、年龄别身长 Z 评分（r = 0.33；P < 0.01）和年龄别体重（r = 0.42；P < 0.01）。6 月龄时，相关因素为婴儿的身长别体重（r = 0.38；P < 0.01）、体重身长指数（r = 0.41；P > 0.01）和体重年龄指数（r = 0.60；P > 0.01）。
在资源匮乏的环境下，在肯尼亚标准产后护理诊所中，6 个月龄以下、由感染艾滋病毒和未感染艾滋病毒的妇女母乳喂养的足月婴儿，摄入的母乳量相当。本研究在临床试验注册中心注册，编号为 PACTR201807163544658。
