Nutrition Supplementation Of Hiv-Infected Women During Lactation Does Not Consistently Influence Infant Growth From 0-24 Weeks

This study evaluated the effect of daily consumption of lipid-based nutrient supplements (LNS) by 2112 lactating HIV-infected mothers on the growth of their exclusively breastfed HIV-uninfected infants from 0–24 wks. Malawian mothers participating in the Breastfeeding, Antiretroviral, and Nutrition (BAN) study were randomized to receive either no LNS or 140g/d of LNS, to meet lactation energy and protein needs. Within these groups, there was further randomization to maternal antiretroviral drugs, daily infant nevirapine, or no postnatal antiretroviral regimen. Outcomes included infant weight-for-age (WAZ), length-for-age (LAZ), and body-mass index (BMIZ) z-scores estimated in longitudinal random effects models, and the likelihood of growth faltering (change in WAZ or LAZ>−0.67) estimated using logistic regression. Maternal supplementation was associated with a higher WAZ (p<0.01) and BMIZ (p<0.01) only in boys receiving the infant drug. Supplement did not reduce the odds of faltering in weight or length from 0–24 wks in any group. These results agree with other studies showing minimal or delayed effects of maternal supplementation during lactation on infant growth. Generalizability may be limited because BAN mothers were healthy (CD4≥200, Hb≥7 and BMI≥17) and infants were full term and weighed≥2 kg at birth. Supported by CDC (U48-DP000059-01) and Bill & Melinda Gates Foundation (OPP53107).