%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Bork, Kirsten
%A Cournil, Amandine
%A Read, J. S.
%A Newell, M. L.
%A Cames, Cécile
%A Meda, N.
%A Luchters, S.
%A Mbatia, G.
%A Naidu, K.
%A Gaillard, P.
%A de Vincenzi, I.
%T Morbidity in relation to feeding mode in African HIV-exposed, uninfected infants during the first 6 mo of life : the Kesho Bora study
%D 2014
%L fdi:010062722
%G ENG
%J American Journal of Clinical Nutrition
%@ 0002-9165
%K Africa ; HIV/AIDS ; diarrhea ; infant feeding ; infections
%K BURKINA FASO ; KENYA ; AFRIQUE DU SUD
%M ISI:000345267600019
%N 6
%P 1559-1568
%R 10.3945/ajcn.113.082149
%U https://www.documentation.ird.fr/hor/fdi:010062722
%> https://www.documentation.ird.fr/intranet/publi/2014/12/010062722.pdf
%V 100
%W Horizon (IRD)
%X Background: Refraining from breastfeeding to prevent HIV transmission has been associated with increased morbidity and mortality in HIV-exposed African infants. Objective: The 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. Design: HIV-infected pregnant women from 5 sites in Burkina Faso, Kenya, and South Africa were enrolled in the prevention of mother-to-child transmission Kesho Bora trial and counseled to either breastfeed exclusively and cease by 6 mo postpartum or formula feed exclusively. Maternal-reported morbidity (fever, diarrhea, and vomiting) and serious infectious events (SIEs) (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. Results: Reported 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]. Between 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). The adjusted excess risk of SIEs in nonbreastfed infants was large between 0 and 2.9 mo (OR: 6.0; 95% CI: 2.2, 16.4; P = 0.001). Between 3 and 6 mo, the OR for SIEs 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. Of 52 SIEs, 3 mothers reported changes in feeding mode during the SW although none of the mothers ceased breastfeeding completely. Conclusions: Not breastfeeding was associated with increased risk of serious infections especially between 0 and 2.9 mo of age.
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