@article{fdi:010062722,
  title = {{M}orbidity in relation to feeding mode in {A}frican {HIV}-exposed, uninfected infants during the first 6 mo of life : the {K}esho {B}ora study},
  author = {{B}ork, {K}irsten and {C}ournil, {A}mandine and {R}ead, {J}. {S}. and {N}ewell, {M}. {L}. and {C}ames, {C}{\'e}cile and {M}eda, {N}. and {L}uchters, {S}. and {M}batia, {G}. and {N}aidu, {K}. and {G}aillard, {P}. and de {V}incenzi, {I}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {R}efraining from breastfeeding to prevent {HIV} transmission has been associated with increased morbidity and mortality in {HIV}-exposed {A}frican infants. {O}bjective: {T}he objective was to assess risks of common and serious infectious morbidity by feeding mode in {HIV}-exposed, uninfected infants <= 6 mo of age with special attention to the issue of reverse causality. {D}esign: {HIV}-infected pregnant women from 5 sites in {B}urkina {F}aso, {K}enya, and {S}outh {A}frica were enrolled in the prevention of mother-to-child transmission {K}esho {B}ora trial and counseled to either breastfeed exclusively and cease by 6 mo postpartum or formula feed exclusively. {M}aternal-reported morbidity (fever, diarrhea, and vomiting) and serious infectious events ({SIE}s) (gastroenteritis and lower respiratory tract infections) were investigated for 751 infants for 2 age periods (0-2.9 and 3-6 mo) by using generalized linear mixed models with breastfeeding as a time-dependent variable and adjustment for study site, maternal education, economic level, and cotrimoxazole prophylaxis. {R}esults: {R}eported morbidity was not significantly higher in non-breastfed compared with breastfed infants [{OR}: 1.31 (95% {CI}: 0.97, 1.75) and 1.21 (0.90, 1.62) at 0-2.9 and 3-6 mo of age, respectively]. {B}etween 0 and 2.9 mo of age, never-breastfed infants had increased risks of morbidity compared with those of infants who were exclusively breastfed ({OR}: 1.49; 95% {CI}: 1.01, 2.2; {P} = 0.042). {T}he adjusted excess risk of {SIE}s in nonbreastfed infants was large between 0 and 2.9 mo ({OR}: 6.0; 95% {CI}: 2.2, 16.4; {P} = 0.001). {B}etween 3 and 6 mo, the {OR} for {SIE}s was sensitive to the timing of breastfeeding status, i.e., 4.3 (95% {CI}: 1.2, 15.3; {P} = 0.02) when defined at end of monthly intervals and 2.0 (95% {CI}: 0.8, 5.0; {P} = 0.13) when defined at the beginning of intervals. {O}f 52 {SIE}s, 3 mothers reported changes in feeding mode during the {SW} although none of the mothers ceased breastfeeding completely. {C}onclusions: {N}ot breastfeeding was associated with increased risk of serious infections especially between 0 and 2.9 mo of age.},
  keywords = {{A}frica ; {HIV}/{AIDS} ; diarrhea ; infant feeding ; infections ; {BURKINA} {FASO} ; {KENYA} ; {AFRIQUE} {DU} {SUD}},
  booktitle = {},
  journal = {{A}merican {J}ournal of {C}linical {N}utrition},
  volume = {100},
  numero = {6},
  pages = {1559--1568},
  ISSN = {0002-9165},
  year = {2014},
  DOI = {10.3945/ajcn.113.082149},
  URL = {https://www.documentation.ird.fr/hor/fdi:010062722},
}