Does early breastfeeding cessation for mothers with low CD4 counts increase infant mortality?

April 2009

Evidence shows that HIV-exposed, uninfected infants are at greater risk of illness and death than unexposed infants, and that low maternal CD4 count is associated with even greater risk of infant death. However, the cause of this association is not fully understood. In a recent study published by the International Journal of Epidemiology, investigators in Zambia tested the hypothesis that earlier breastfeeding cessation among women with low CD4 counts is responsible for some of the increased infant mortality risk. This study confirmed that both CD4 count and early breastfeeding cessation were associated with increased infant mortality, but that only a small percentage of the association between low CD4 count and high mortality could be attributed to early breastfeeding cessation. Other potential factors requiring investigation include exposure to infectious diseases, low birth weight, poor growth, and poor caring practices. Nonetheless, the authors concluded that some portion of infant deaths could be averted by increased breastfeeding duration among mothers with low CD4 counts.

Role of breastfeeding cessation in mediating the relationship between maternal HIV disease stage and increased child mortality among HIV-exposed uninfected children