They are probably referring to the article in JAMA, Mar 1, 2000, " Effect of
Breastfeeding and Formula Feeding on Transmission of HIV-1: A randomized
trial" by Ndauti et al.  page 1167.

They found that the overall mortality rates in each group at 2 years was
similar but that the HIV-1 survival rate  at 2 years was significantly lower
in the breastfeeding arm than in the formula feeding arm .

BF transmission rate =36.7% and formula feeding rate-20%
Under complicance with the Intervention: they state that 95% wer e BF at 3
months, 90% at 6 months and 80% at 12, 47% at 18 and 23% at 24 months.
MEDIAN TIME TO INTRO OF WEANING FOODS WAS 3.8 MONTHS.   17% AT 6 WEEKS, 38%
AT  3 MONTHS,   9% AT 6 MONTHS WERE GIVING OTHER SUBSTANCES.
(caps for emphasis only)
96% of those in the breastfeeding group complied and 70% of the formula group
complied.


They  found that transmission was more likely to occur early on and they give
some possible reasons for this.  They include, variation in milk infectivity
over time, exposure DIMINISHING AS WEANING FOODS ARE INTRODUCED and milk
intake declines and infant susuceptibility may vary over time and may be
affected by the developing immune system or GI tract etc.
No mention about formula causing the disruption of the intestine and
increasing susceptability.  No mention of the importance of EXCLUSIVELY BF.
But it seems the information is available to measure the difference between
those exclusively breastfed and those exclusively formula fed but I cannot
see that they report it in the article

However they do say that weaning foods were usually introduced due to low
milk supply  which many times was caused by maternal illness or poor infant
feeding all of which may be linked to infection from HIV-1.

SIGHHHhh.  But the good news is that there is an article following it that
recommends early weaning following EXCLUSIVE BREASTFEEDING!!!
.    Christine Betzold MSN NP CLE

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