Feasibility of using flash-heated breastmilk as an infant feeding option for HIV-exposed, uninfected infants after 6 months of age in urban Tanzania.
Feasibility of using flash-heated breastmilk as an infant feeding option for HIV-exposed, uninfected infants after 6 months of age in urban Tanzania.
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在坦桑尼亚城市，使用快速加热母乳作为 6 个月大后暴露于 HIV 的未感染婴儿的婴儿喂养选择的可行性。
DOI：
10.1097/qai.0b013e31824fc06e
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发表时间：
2012
期刊：
影响因子：
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通讯作者：
Koniz-Booher,Peggy
中科院分区：
文献类型：
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作者：
Chantry,CarolineJ;Young,SeraL;Rennie,Waverly;Ngonyani,Monica;Mashio,Clara;Israel-Ballard,Kiersten;Peerson,Janet;Nyambo,Margaret;Matee,Mecky;Ash,Deborah;Dewey,Kathryn;Koniz-Booher,Peggy
目的：在资源贫乏的国家，对母乳进行热处理被推荐为艾滋病毒暴露婴儿的临时喂养策略，但其可行性的数据很少。快速加热（FH）是一种简单的家庭加热母乳技术，在保留其营养和抗感染特性的同时使艾滋病毒失活。我们的主要目的是确定感染艾滋病毒的母亲在纯母乳喂养6个月后使用FH表达的母乳的可行性和方案依从性。设计:前瞻性纵向。活动地点：坦桑尼亚达累斯萨拉姆干预措施：同伴辅导员提供产后2至9个月婴儿喂养方面的家庭咨询和支持。如果婴儿的艾滋病毒呈阴性，则鼓励母亲纯母乳喂养6个月，然后再用FH表达的母乳喂养。诊所工作人员每月测量婴儿生长和发病率，母亲每天记录婴儿发病率。通过每日记录、在家观察以及基于诊所和家庭的调查，追踪FH行为直到产后9个月。对未加热和加热的牛奶样品进行细菌培养。结果：72名符合条件的母亲中有37名（51.4%）选择了闪热。乳汁表达的中位数（范围）频率为每天3（1-6）次，研究中使用方法的时间为9.7（0.1-15.6）周。平均（SD）日产奶量为322 (201)mL（范围25-1120）。没有加热样品和32个（30.5%）未加热样品含有细菌病原体。结论：FH是一种简单的技术，许多艾滋病毒阳性妇女在纯母乳喂养后可以成功使用，继续提供母乳的益处，同时避免与非纯母乳喂养相关的母婴传播。基于这些可行性数据，有必要对FH母乳对婴儿健康结果的影响进行临床试验。
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 mothersSetting:Dar es Salaam, TanzaniaIntervention: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.