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- Title
The health of HIV-exposed children after early weaning.
- Authors
Parker, Megan E.; Tembo, Martin; Adair, Linda; Chasela, Charles; Piwoz, Ellen G.; Jamieson, Denise J.; Ellington, Sascha; Kayira, Dumbani; Soko, Alice; Mkhomawanthu, Chimwemwe; Martinson, Francis; van der Horst, Charles M.; Bentley, Margaret E.
- Abstract
There are potential health risks associated with the use of early weaning to prevent mother-to-child transmission of human immunodeficiency virus (HIV) in resource-poor settings. Our objective was to examine growth and nutrient inadequacies among a cohort of children weaned early. Children participating in the Breastfeeding Antiretrovirals and Nutrition (BAN) Study in Lilongwe, Malawi, had HIV-infected mothers, were weaned at 6 months and fed LNS until 12 months. 40 HIV-negative, BAN-exited children were compared with 40 HIV-negative, community children matched on age, gender and local health clinic. Nutrient intake was calculated from 24-h dietary recalls collected from BAN-exited children. Anthropometric measurements were collected from BAN-exited and matched community children at 15-16 months, and 2 months later. Longitudinal random effects sex-stratified models were used to evaluate anthropometric differences between the two groups. BAN-exited children consumed adequate energy, protein and carbohydrates but inadequate amounts of fat. The prevalence of inadequate micronutrient intakes were: 46% for vitamin A; 20% for vitamin B6; 69% for folate; 13% for vitamin C; 19% for iron; 23% for zinc. Regarding growth, BAN-exited girls gained weight at a significantly lower rate {0.02 g kg−1 per day [95% confidence interval (CI): 0.01, 0.03]} than their matched comparison [0.05 g kg−1 per day (95% CI: 0.03, 0.07)]; BAN girls grew significantly slower [0.73 cm month−1 (95% CI: 0.40,1.06)] than their matched comparison (1.55 cm month−1[95% CI: 0.98, 2.12]). Among this sample of BAN-exited children, early weaning was associated with dietary deficiencies and girls experienced reduced growth velocity. In resource-poor settings, HIV prevention programmes must ensure that breastfeeding stop only once a nutritionally adequate and safe diet without breast milk can be provided.
- Subjects
MALAWI; HIV infection transmission; MALNUTRITION; ANALYSIS of variance; ANTHROPOMETRY; BREASTFEEDING; CHI-squared test; COMPARATIVE studies; CONFIDENCE intervals; FOLIC acid; HUMAN growth; INFANT weaning; LONGITUDINAL method; MOTHERS; QUESTIONNAIRES; RESEARCH funding; SEASONS; SEX distribution; MICRONUTRIENTS; VITAMIN A; SAMPLE size (Statistics); SOCIOECONOMIC factors; DISEASE prevalence; DATA analysis software; CHILDREN
- Publication
Maternal & Child Nutrition, 2013, Vol 9, Issue 2, p217
- ISSN
1740-8695
- Publication type
Article
- DOI
10.1111/j.1740-8709.2011.00369.x