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Risk for mother to child HIV-1 infection was increased by breast feeding

Design
Randomised (allocation concealed^*), blinded (investigators to interim results),^* controlled trial with 2 year follow up.

Setting
4 antenatal clinics in Nairobi.

Patients
425 HIV-1 infected pregnant women (mean age 23 y) who resided in Nairobi and had access to municipally treated water. 401 mother-infant pairs (94%) were included in the analysis.

Intervention
Women were allocated to breast feed (n=212) or formula feed (n=213) their infants. Women in the formula feed group were told to feed their infant with a cup and had to demonstrate proper formula preparation and cup feeding to a visiting nurse.

Main outcome measures
Infant HIV-1 infection and mortality within the first 2 years. Mortality rates were compared using Kaplan-Meier survival analysis.

Main results
Analysis was by intention to treat. At 24 months, the cumulative probability of HIV-1 infection was higher in breastfed infants than in formula fed infants (p=0.001) (table). A significant difference existed between breastfed and formula fed infants at all . . . [Full text of this article]

Susan King, MD

Hospital for Sick Children Toronto, Ontario, Canada