Evidence map›Paper›PMID 19553300›Full record

Trial reportThe American journal of clinical nutrition2009

Growth faltering due to breastfeeding cessation in uninfected children born to HIV-infected mothers in Zambia.

Stephen Arpadi, Ashraf Fawzy, Grace M Aldrovandi, Chipepo Kankasa, Moses Sinkala, Mwiya Mwiya, Donald M Thea, Louise Kuhn

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The American journal of clinical nutrition, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00310726 (Short Duration Exclusive Breastfeeding With Abrupt Weaning to Reduce the Risk of Mother-to-Child HIV Transmission), which is not on this map. Cited by 59 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00310726 nacompletednot on this map

Short Duration Exclusive Breastfeeding With Abrupt Weaning to Reduce the Risk of Mother-to-Child HIV Transmission

TypeinterventionalSponsorBoston Medical CenterRan2001 to 2006Enrolled1,435ConditionsHIV InfectionArmsabrupt weaning at 4 months, Continued exclusive breastfeeding
3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  14. The acceptance and feasibility of replacement feeding at 6 months as an HIV prevention method in Lilongwe, Malawi: results from the BAN study.AIDS education and prevention : official publication of the International Society for AIDS Education · 2011
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Stephen ArpadiColumbia University Gertrude H Sergievsky Center, College of Physicians and Surgeons and Mailman School of Public Health, New York, NY 10030, USA. sma2@columbia.edu
Ashraf Fawzy
Grace M Aldrovandi
Chipepo Kankasa
Moses Sinkala
Mwiya Mwiya
Donald M Thea
Louise Kuhn

Funding

Short Exclusive Breastfeeding to Reduce Postnatal Transmission of HIVR01HD039611 · NICHD · BOSTON UNIVERSITY MEDICAL CAMPUS · PI THEA, DONALD M · 2000 to 2006
$8.0M
Pathogenesis of Mother to Child Transmission of HIVR01HD040777 · NICHD · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI ALDROVANDI, GRACE M · 2002 to 2011
$4.4M
NICHD NIH HHS HD 39611NICHD NIH HHS HD 40777NICHD NIH HHS HD 57161NICHD NIH HHS R01 HD039611
6 · The paper itself

Abstract

backgroundThe effect of breastfeeding on growth in HIV-exposed infants is not well described.

objectiveThe objective was to evaluate the effect of early breastfeeding cessation on growth.

designIn a trial conducted in Lusaka, Zambia, HIV-infected mothers were randomly assigned to exclusive breastfeeding for 4 mo followed by rapid weaning to replacement foods or exclusive breastfeeding for 6 mo followed by introduction of complementary foods and continued breastfeeding for a duration of the mother's choice. Weight-for-age z score (WAZ), length-for-age z score (LAZ), and weight-for-length z score (WLZ) and the self-reported breastfeeding practices of 593 HIV-uninfected singletons were analyzed. Generalized estimating equations were used to adjust for confounders.

resultsWAZ scores declined precipitously between 4.5 and 15 mo. The decline was slower in the breastfed infants. At 9, 12, and 15 mo, mean WAZs were, respectively, -0.74, -0.92, and -1.06 in infants who were reportedly breastfed and were -1.07, -1.20, and -1.31 in the weaned infants (P = 0.003, 0.007, and 0.02, respectively). No differences were observed past 15 mo. Breastfeeding practice was not associated with LAZ, which declined from -0.98 to -2.24 from 1 to 24 mo. After adjustment for birth weight, maternal viral load, body mass index, education, season, and marital and socioeconomic status, not breastfeeding was associated with a 0.28 decline in WAZ between 4.5 and 15 mo (P < 0.0001). During the rainy season, not breastfeeding was associated with a larger WAZ decline (0.33) than during the dry season (0.22; P for interaction = 0.02).

conclusionsEarly growth is compromised in uninfected children born to HIV-infected Zambian mothers. Continued breastfeeding partially mitigates this effect through 15 mo. Nutritional interventions to complement breastfeeding after 6 mo are urgently needed. This trial was registered at clinicaltrials.gov as NCT00310726.

Indexed as

Breast FeedingWeaningAdultAnthropometryBody HeightBody WeightCohort StudiesFailure to ThriveFemaleGrowthHIV InfectionsHumansInfantInfant FoodInfant, NewbornInfant Nutritional Physiological Phenomena

Identifiers

PMID19553300
PMCPMC2709311

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.