Frank - thank you for kindly sending in the report from the Pharmacy Times, 
July 2005 on the ZVITAMBO study in Zimbabwe. Was the report by any chance 
referring to the journal article, Iliff et al, Early exclusive 
breastfeeding reduces the risk of postnatal HIV-1 transmission and 
increases HIV-free survival, AIDS 2005, 19:699708  ??  Or was it reporting 
on another, newer sub-study by the ZVITAMBO group in Harare (of which there 
are likely to be many - this group tested everything!) and which I'm 
*really* eager to see in print???

That exclusive breastfeeding has been shown to have such a protective 
effect against both transmission of HIV and against mortality for 
HIV-exposed babies is particularly good news in view of the current 
situation in Zimbabwe. In fact, the words attributed to Professor Jean 
Humphrey -  that "many African mothers are not able to find a safe, 
reliable milk substitute for their babies"  - if she indeed did say them, 
are an astonishing understatement of what is actually happening right 
now.  As long ago as November 2002 milk of all kinds - pasteurized, 
powdered, skim, tinned and infant formula - was virtually unobtainable - a 
very grave situation when HIV-infected mothers might be counselled not to 
breastfeed their babies.  The researchers cannot have ever dreamed how 
important their study might be when it was started in 1997, at a time when 
one US$ was worth about Z$15.  As we speak, one US$ is now worth Z$45 000 
and rising, with inflation of 163% compared to even this time last year. 
There is 70% unemployment, nearly half the population face critical food 
shortages, and 2.4 million people have been internally displaced by 
government action in the last 3 months.  I've written to UNICEF in Harare 
to ask if they are able to document what has happened to the babies in the 
PMTCT of HIV sites, many of which would have been affected, as would many 
of the babies/young children who formed part of the 14 000 mother-baby 
pairs recruited into the ZVITAMBO study.  But so far UNICEF don't appear to 
have the mechanisms in place to especially record what has happened to 
these mothers and babies.   In situations like this babies who are not 
breastfed will not survive.

The ZVITAMBO study results serve to provide the "evidence" that 
healthworkers will need in order to endorse exclusive breastfeeding for ALL 
babies, including those exposed to HIV, especially in Africa. Publication 
of these life-saving results are welcome.  Thanks for letting us know, Frank.

Pamela Morrison IBCLC
 From Harare, Zimbabwe, now living in Rustington, England
[log in to unmask]


At 01:01 08/08/2005, Frank Nice wrote:


A study tracking 2000 infants in Zimbabwe showed that mothers who are 
HIV-positive are less likely to transmit AIDS to their babies if they 
breastfeed exclusively rather than combining breastfeeding with a diet of 
animal milk and solids.  researchers gathered data on the babies' diets and 
the rate of AIDS infection from birth until age 2.  They found that those 
babies who were fed only breast milk were 3 times less likely to die.  They 
also found that not introducing solids until around 3 months would 
contribute to a lower incidence of AIDS infection.  Johns Hopkins 
University Associate Professor Jean Humphrey said that these findings were 
significant because many African mothers are not able to find a safe, 
reliable milk substitute for their babies.
Pharmacy Times, July 2005,  p. 68

Frank J. Nice, DPA, CPHP


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