Journal article
Lipid-Based Nutrient Supplements Are Feasible As a Breastmilk Replacement for HIV-Exposed Infants from 24 to 48 Weeks of Age
The Journal of nutrition, Vol.143(5), pp.701-707
05/01/2013
DOI: 10.3945/jn.112.168245
PMCID: 3738238
PMID: 23468553
Abstract
The Breastfeeding, Antiretrovirals, and Nutrition (BAN) Study randomized HIV-infected mothers and their infants to receive either maternal lipid-based nutrient supplements (LNS) during lactation or no LNS and then to 1 of 3 antiretroviral drug (ARV) arms (maternal, infant, or no drugs). Assigned interventions were provided from 0 to 28 wk and all infants (n = 1619) were given LNS during (24–28 wk) and following (28–48 wk) weaning. This paper assesses the feasibility of infant LNS as a breastmilk replacement and uses longitudinal random effects models to examine associations of interventions, morbidity, and season with weight-for-age (WAZ), length-for-age (LAZ), and BMI-for-age (BMIZ) Z-scores from 24 to 48 wk. Infant LNS adherence was high (94.1% ate it daily). From 24 to 48 wk, mean WAZ (−0.42 to −0.76 SD; P < 0.001) and LAZ (−0.93 to −1.56 SD; P < 0.001) steadily declined, whereas BMIZ remained >0 throughout. A higher LAZ was associated with assignment to the maternal LNS arm (β=0.19; P < 0.05). Lower WAZ and BMIZ were associated with seasonal food insecurity (β=−0.08 and −0.09, respectively; both P < 0.001), fever (β=−0.07 and −0.13; both P < 0.001), diarrhea (β=−0.19 and −0.23; both P < 0.001), and assignment to the infant ARV arm (β=−0.17 and −0.17; both P < 0.05). The magnitude of the season and morbidity effects was small and BAN infants had higher weights and lengths than their counterparts in the general population. High LNS adherence and the modest impact of morbidity on growth indicate that LNS is a feasible breastmilk replacement for HIV-exposed infants weaned early, but controlled trials are needed to quantify the effects of LNS on growth in this population.
Details
- Title: Subtitle
- Lipid-Based Nutrient Supplements Are Feasible As a Breastmilk Replacement for HIV-Exposed Infants from 24 to 48 Weeks of Age
- Creators
- Valerie L. Flax - University of North Carolina at Chapel HillMargaret E. Bentley - University of North Carolina at Chapel HillCharles S. Chasela - University of the WitwatersrandDumbani Kayira - UNC Project, Lilongwe, MalawiMichael G. Hudgens - University of North Carolina at Chapel HillKopekani Z. Kacheche - UNC Project, Lilongwe, MalawiCharity Chavula - UNC Project, Lilongwe, MalawiAthena P. Kourtis - Centers for Disease Control and PreventionDenise J. Jamieson - Centers for Disease Control and PreventionCharles M. van der Horst - University of North Carolina at Chapel HillLinda S. Adair - University of North Carolina at Chapel Hill
- Resource Type
- Journal article
- Publication Details
- The Journal of nutrition, Vol.143(5), pp.701-707
- Publisher
- Elsevier Inc
- DOI
- 10.3945/jn.112.168245
- PMID
- 23468553
- PMCID
- 3738238
- ISSN
- 0022-3166
- eISSN
- 1541-6100
- Language
- English
- Date published
- 05/01/2013
- Academic Unit
- Obstetrics and Gynecology; VPMA - Administration
- Record Identifier
- 9984446527402771
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