| Popis: |
Background: Early feeding patternsmay affect the growth of HIV-exposed children and thus their subsequent health and cognition. Objective: We assessed the association of infant feeding (IF) mode with length-for-age z score (LAZ) and stunting fromage 2 d to 18 mo in HIV-exposed African childrenwithin a controlled randomized trial, which evaluated triple antiretrovirals initiated during pregnancy and continued for 6 mo postpartum to prevent HIV transmission. Methods: HIV-infected pregnant women with CD4 + counts of 200-500 cells/mm(3) from Burkina Faso, Kenya, and South Africa were advised to exclusively breastfeed for up to 6 mo or to formula-feed from birth. Factors associated with LAZ were investigated in all uninfected children by using mixed-effects linear models; those associated with stunting (LAZ < 22) at 6 or 12 mo were assessed in multiple logistic regression after exclusion of children stunted at age 2 d. Independent variables were IF mode: formula feeding (FF), exclusive breastfeeding (EBF) < 3 mo, or EBF $ 3 mo (reference); sex; trial arm; maternal characteristics; and site. Results: Among 728 children, FF was associated with a greater increase in LAZ from 2 d to 6 mo (+ 0.07 z score/mo, P < 0.001). Between 6 and 18 mo, FF and EBF < 3mowere both associated with greatermean LAZ than was EBF$ 3mo (+ 0.52z scores and + 0.43 z scores, respectively, P < 0.001). Among children not stunted at 2 d, FF was independently associatedwith a reduced risk of stunting at 6mo (OR: 0.24; 95% CI: 0.07, 0.81; P = 0.021), whereas EBF < 3 mo was not (OR: 0.49; 95% CI: 0.22, 1.10; P= 0.09). Conclusions: In this observational study of HIV-exposed uninfected infants, growth in length in the first 6mo of lifewas faster in formula-fed infants than in exclusively breastfed infants. The plausibility of |
