Feasibility of using flash-heated breastmilk as an infant feeding option for HIV-exposed, uninfected infants after 6 months of age in urban Tanzania

Caroline J Chantry, Sera L. Young, Waverly Rennie, Monica Ngonyani, Clara Mashio, Kiersten Israel-Ballard, Janet Peerson, Margaret Nyambo, Mecky Matee, Deborah Ash, Kathryn Dewey, Peggy Koniz-Booher

Research output: Contribution to journalArticle

10 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)43-50
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume60
Issue number1
DOIs
StatePublished - May 1 2012

Keywords

  • Breastmilk
  • Feasibility
  • Flash-heat
  • Heat-treatment
  • HIV
  • Infant feeding
  • Maternal-to-child transmission
  • Pasteurization

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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    Chantry, C. J., Young, S. L., Rennie, W., Ngonyani, M., Mashio, C., Israel-Ballard, K., Peerson, J., Nyambo, M., Matee, M., Ash, D., Dewey, K., & Koniz-Booher, P. (2012). Feasibility of using flash-heated breastmilk as an infant feeding option for HIV-exposed, uninfected infants after 6 months of age in urban Tanzania. Journal of Acquired Immune Deficiency Syndromes, 60(1), 43-50. https://doi.org/10.1097/QAI.0b013e31824fc06e