Important note: Information in this article was accurate in 2001. The state of the art may have changed since the publication date.

Reuters NewMedia - Tuesday November 20, 2001

While previous research has verified that the AIDS virus can be transmitted to babies via breast milk, the new research was aimed at finding whether there were any differences in overall death rates or other illnesses such as pneumonia and diarrhea between breast-fed and formula-fed infants.

The report from the University of Nairobi and the University of Washington in Seattle found there was no significant difference in death rates or the incidence of various illnesses among infants who were breast-fed and those who received formula.

The study, reported in this week's Journal of the American Medical Association, was conducted between 1992 and 1998 at four clinics in Nairobi and involved 186 HIV-positive mothers who were told to use formula and 185 who were assigned to breast-feed their babies.

A previous report from the same study concluded that formula use could prevent 44 percent of HIV infections in infants of HIV-positive mothers. But the authors said little had been known about whether there are severe health risks associated with formula feeding in such in poor areas, compared to breast feeding which carries natural protections with it.

"Two-year estimated mortality rates among infants were similar in the formula-feeding and breast-feeding groups," the study concluded.

The incidence of diarrhea during the two years was similar in both groups of babies and the incidence of pneumonia was identical. However infants who were breast-fed tended to have better nutritional status, especially during the first six months of life, the study said.

"Our current analyzes show that the use of formula to prevent HIV-1 transmission can be a safe and viable option even in resource poor settings, if maternal education, clean water, a supply of formula, and access to health care are available," the study concluded.

However, in an editorial published in the same issue, researchers at Johns Hopkins University of School of Medicine warned against generalizing the study's results.

Withholding breast milk is not likely to become standard practice among the majority of HIV-positive mothers in sub-Saharan Africa, the editorial said.

It suggested that until that situation changes health experts should seek means of making breast-feeding safer for HIV-infected women and their babies.

"That breast-feeding with all its benefits should also pose a significant risk of HIV transmission is one of the ultimate public health paradoxes and will likely continue to be a major challenge for the prevention of HIV infections in infants living in resource-poor settings," the editorial concluded.

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