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Question: Is breastfeeding useful in the management of neonatal abstinence syndrome?
Case scenario A 23-year-old woman is admitted to the postnatal ward after she gave birth to a term infant of 3 kg. During pregnancy, she is known to have used methadone. There is no known use of other illicit drugs or prescription medication. The midwife who is taking care of this woman and her baby asks if she can encourage the mother to breastfeed her child. Structured clinical question Can a mother who used methadone during pregnancy (patient) breastfeed her newborn (intervention) to help the management of neonatal abstinence syndrome (NAS) (outcome)? Search Search strategy: terms used: Breastfeeding AND neonatal a...
Source: Archives of Disease in Childhood - March 17, 2015 Category: Pediatrics Authors: Lefevere, J., Allegaert, K. Tags: ADC Archimedes, Liver disease, Immunology (including allergy), Hepatitis and other GI infections, HIV/AIDS, Childhood nutrition, Pregnancy, Reproductive medicine, Child health, Infant health, Infant nutrition (including breastfeeding), Neonatal health, Un Source Type: research

Financial and Food Insecurity are Primary Challenges to Breastfeeding for Women Living with HIV in Western Kenya: A Longitudinal Qualitative Investigation
AbstractExclusive breastfeeding for the first 6 months and continued breastfeeding for 24 months or longer is recommended for all mothers world-wide, including women living with HIV (WLWH). Given evidence of suboptimal infant feeding and the need to understand context specific barriers, we explored experiences of perinatal WLWH in Kisumu, Kenya. We applied a longitudinal qualitative approach (4 in-depth interviews) with 30 women from pregnancy to 14 –18 months postpartum. Cross-sectional profiling led to a narrative description of infant feeding across time. The majority of women breastfed exclusively for 6 months and we...
Source: AIDS and Behavior - April 12, 2023 Category: Infectious Diseases Source Type: research

Maternal and health care workers' perceptions of the effects of exclusive breastfeeding by HIV positive mothers on maternal and infant health in Blantyre, Malawi
Conclusion: While most participants considered exclusive breastfeeding as an important component of the wellbeing of their infants' health, they did not share the worldwide acknowledged benefits of exclusive breastfeeding in the prevention of mother-to-child transmission (PMTCT) of HIV. These results suggest a need for more breastfeeding education for all mothers, communities and nurse-midwives involved in breastfeeding counseling in the context of HIV infection. Maternal wellbeing promotion activities such as nutrition supplementation need to be included in all PMTCT of HIV programs.
Source: BMC Pregnancy and Childbirth - Latest articles - July 25, 2014 Category: OBGYN Authors: Ursula KafulafulaMary HutchinsonSusan GennaroSally Guttmacher Source Type: research

Maternal and health care workers¿ perceptions of the effects of exclusive breastfeeding by HIV positive mothers on maternal and infant health in Blantyre, Malawi
Conclusion: While most participants considered exclusive breastfeeding as an important component of the wellbeing of their infants’ health, they did not share the worldwide acknowledged benefits of exclusive breastfeeding in the prevention of mother-to-child transmission (PMTCT) of HIV. These results suggest a need for more breastfeeding education for all mothers, communities and nurse-midwives involved in breastfeeding counseling in the context of HIV infection. Maternal wellbeing promotion activities such as nutrition supplementation need to be included in all PMTCT of HIV programs.
Source: BMC Pregnancy and Childbirth - Latest articles - July 25, 2014 Category: OBGYN Authors: Ursula KafulafulaMary HutchinsonSusan GennaroSally Guttmacher Source Type: research

Changes in body mass index and hemoglobin concentration in breastfeeding women living with HIV with a CD4 count over 350: Results from 4 African countries (The ANRS 12174 trial)
ConclusionBreastfeeding was not negatively correlated with the BMI of HIV-1 infected Sub-Saharan African mothers. However, a higher baseline BMI and a CD4 count>500 cells/ μl were associated with maternal BMI during the exclusive/ predominant breastfeeding period. Considering the benefits of breast milk for the infants and the recurrent results from different studies that breastfeeding is not harmful to the HIV-1-infected mothers, this study also supports the WHO 201 6 guidelines on infant feeding that mothers living with HIV should breastfeed where formula is not safe for at least 12 months and up to 24 months, given tha...
Source: PLoS One - May 9, 2017 Category: Biomedical Science Authors: Eric Nagaonl é Somé Source Type: research

Optimal breastfeeding durations for HIV-exposed infants: the impact of maternal ART use, infant mortality and replacement feeding risk.
CONCLUSIONS: In settings with high RRRF and long maternal ART durations, HFS is maximized when mothers breastfeed longer than the previously-recommended 12 months. In settings with low RRRF or short maternal ART durations, shorter breastfeeding durations optimize HFS. If mothers are supported to use ART for longer periods of time, it is possible to reduce transmission risks and gain the benefits of longer breastfeeding durations. PMID: 29667336 [PubMed - in process]
Source: Journal of the International AIDS Society - April 19, 2018 Category: Infectious Diseases Tags: J Int AIDS Soc Source Type: research

Timing of HIV testing among pregnant and breastfeeding women and risk of mother-to-child HIV transmission in Malawi: a sampling-based cohort study
CONCLUSIONS: MTCT in Malawi occurred disproportionately among women with a last positive HIV test during breastfeeding. Testing delayed until the postpartum period may lead to higher MTCT. To optimize maternal and child health outcomes, PMTCT programmes should focus on early ART initiation and providing targeted testing, prevention, treatment and support to breastfeeding women.PMID:33749155 | DOI:10.1002/jia2.25687
Source: Journal of the International AIDS Society - March 22, 2021 Category: Infectious Diseases Authors: Maganizo B Chagomerana Jessie K Edwards Lauren C Zalla Nicole B Carbone Godfrey T Banda Innocent A Mofolo Mina C Hosseinipour Michael E Herce Source Type: research

Exclusive breastfeeding practice among HIV infected mothers in the southern highlands of Tanzania; assessing the prevalence and factors associated with the practice, an analytical cross-sectional survey
CONCLUSION: More than half of interviewed mothers with HIV practiced EBF. The EBF practice among HIV lactating mothers was significantly influenced by adequate knowledge of EBF, positive perception toward EBF, adequate ANC visits, and having never experienced breast problems. Strengthening adherence to ANC routine visits, counseling on breastfeeding, and improving mothers' knowledge about exclusive breastfeeding would contribute to the enhancement of EBF practice in this region. An innovative interventional study is recommended to develop more effective strategies to improve EBF knowledge and practice among HIV-infected mo...
Source: AIDS Research and Therapy - June 27, 2022 Category: Infectious Diseases Authors: Rose Faustine Fabiola Vincent Moshi Source Type: research

Efficacy of WHO recommendation for continued breastfeeding and maternal cART for prevention of perinatal and postnatal HIV transmission in Zambia.
CONCLUSIONS: Maternal cART may limit MTCT of HIV to the UNAIDS target of <5% for eradication of paediatric HIV within the context of a clinical study, but poor adherence to cART and follow-up can limit the benefit. Continued breastfeeding can prevent the rise in infant mortality after six months seen in previous studies, which encouraged early COB. PMID: 26140453 [PubMed - as supplied by publisher]
Source: Journal of the International AIDS Society - July 4, 2015 Category: Infectious Diseases Tags: J Int AIDS Soc Source Type: research

Breastfeeding mitigates the effects of maternal HIV on infant infectious morbidity in the Option B+ era
Conclusion: In settings with universal antiretroviral coverage and high breastfeeding rates, breastfeeding mitigates the effects of in-utero HIV exposure among infants during the first year of life. These findings support previous recommendations for exclusive breastfeeding among HIV-infected women and highlight the role that breastfeeding plays on the health of infants in settings where exclusive breastfeeding is not always feasible or where replacement feeding is recommended.
Source: AIDS - October 5, 2018 Category: Infectious Diseases Tags: Epidemiology and Social Source Type: research

The prevalence, incidence, and recurrence of intimate partner violence and its association with adverse childhood experiences among pregnant and breastfeeding women living with HIV in Malawi
CONCLUSIONS: IPV is highly prevalent among pregnant women living with HIV and continues to occur throughout the pregnancy and postpartum period; its graded relationship with ACEs is a concern in resource-limited settings where HIV/AIDS remains a public health concern. Strategies aimed to address the needs of pregnant/breastfeeding women living with HIV may benefit from the regular screening of this population for IPV and ACE, including in antenatal care clinics.PMID:36654873 | PMC:PMC9841851 | DOI:10.1177/20499361221148875
Source: Adv Data - January 19, 2023 Category: Epidemiology Authors: Steven P Masiano Tapiwa A Tembo Xiaoying Yu Elizabeth Wetzel Mtisunge Mphande Mike Chitani Angella Mkandawire Innocent Khama Alick Mazenga Elaine Abrams Saeed Ahmed Maria H Kim Source Type: research

Effect of cytomegalovirus infection on breastfeeding transmission of HIV and on the health of infants born to HIV-infected mothers
Conclusion: Most breastfed infants of HIV-infected mothers in this resource-limited setting are infected with CMV by 24 weeks of age. Early CMV infection may be a risk factor for subsequent infant HIV infection through breastfeeding, pointing to the need for comprehensive approaches in order to achieve elimination of breastfeeding transmission of HIV.
Source: AIDS - March 28, 2015 Category: Infectious Diseases Tags: Epidemiology and Social Source Type: research

Delayed HIV detection among infants exposed to postnatal antiretroviral prophylaxis during breastfeeding
Conclusion: The prolonged inability to detect HIV with standard assays in the context of postnatal antiretroviral prophylaxis suggests that early antiretrovirals may restrict HIV replication sufficiently to lead to missed diagnosis among infected infants. Therefore, repeat virologic testing is warranted beyond the WHO-recommended point of testing at 6 weeks after breastfeeding cessation.
Source: AIDS - September 11, 2015 Category: Infectious Diseases Tags: Clinical Science Source Type: research

Extended pre-exposure prophylaxis with lopinavir–ritonavir versus lamivudine to prevent HIV-1 transmission through breastfeeding up to 50 weeks in infants in Africa (ANRS 12174): a randomised controlled trial
Publication date: Available online 19 November 2015 Source:The Lancet Author(s): Nicolas Nagot, Chipepo Kankasa, James K Tumwine, Nicolas Meda, G Justus Hofmeyr, Roselyne Vallo, Mwiya Mwiya, Mary Kwagala, Hugues Traore, Amwe Sunday, Mandisa Singata, Chafye Siuluta, Eric Some, David Rutagwera, Desire Neboua, Grace Ndeezi, Debra Jackson, Valérie Maréchal, Dorine Neveu, Ingunn M S Engebretsen, Carl Lombard, Stéphane Blanche, Halvor Sommerfelt, Claire Rekacewicz, Thorkild Tylleskär, Philippe Van de Perre Background Strategies to prevent postnatal mother-to-child transmission of HIV-1 in Africa, ...
Source: The Lancet - November 21, 2015 Category: Journals (General) Source Type: research