The Experts below are selected from a list of 243 Experts worldwide ranked by ideXlab platform
Anna Coutsoudis - One of the best experts on this subject based on the ideXlab platform.
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Breast-Feeding and HIV transmission.
Nutrition research reviews, 2001Co-Authors: Anna CoutsoudisAbstract:HIV-1 (subsequently referred to as HIV) infection may be transmitted to the infant during Breast-Feeding. The risk of transmission varies with stage of maternal infection, duration of Breast-Feeding, type of Breast-Feeding (i.e. exclusive or mixed Breast-Feeding), and Breast pathology. Recent studies support the findings of a meta-analysis (Dunn et al. 1992) and indicate that when Breast-Feeding is practised for over 2 years, the risk of infection is about 14%. Shorter durations of Breast-Feeding may therefore minimize the risk of transmission. Although the risk of infection appears to be greatest in the first 6 months this risk needs to be weighed against the excess risk of morbidity and mortality if children are not Breast-fed in the first 6 months. In resource-poor settings any policy decision to replace Breast-Feeding with formula Feeding in order to prevent postnatal HIV transmission needs to be balanced against the risks to the infant of malnutrition, morbidity and death if not Breast-fed. New information suggests that exclusive Breast-Feeding, instead of the norm of mixed Breast-Feeding, may not increase risk of HIV transmission at 6 months and suggests that exclusive Breast-Feeding with early cessation may be a viable option for some women. The present review suggests options for reducing risk of HIV transmission through Breast-Feeding. Finally, current knowledge points to the dangers of large-scale replacement Feeding programmes in contexts where women will have low education, poor access to water and health services, and strong cultural pressures to Breast-feed. Emphasising replacement Feeding in these contexts may fuel the mixed Breast-Feeding practice for mothers who will have no other choice than Breast-Feeding, yet will try to follow the recommendations applied to replacement feed.
Marielouise Newell - One of the best experts on this subject based on the ideXlab platform.
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Breast Feeding and transmission of hiv 1
Journal of Acquired Immune Deficiency Syndromes, 2004Co-Authors: Grace Johnstewart, Dorothy Mboringacha, Rene Ekpini, Edward N Janoff, John Nkengasong, Jennifer S Read, Phillippe Van De Perre, Marielouise NewellAbstract:Breast-Feeding substantially increases the risk of HIV-1 transmission from mother to child, and although peripartum antiretroviral therapy prophylaxis significantly decreases the risk of mother-to-child transmission around the time of delivery, this approach does not affect Breast-Feeding transmission. Increased maternal RNA viral load in plasma and Breast milk is strongly associated with increased risk of transmission through Breast-Feeding, as is Breast health, and it has been suggested that exclusive Breast-Feeding could be associated with lower rates of Breast-Feeding transmission than mixed Feeding of both Breast- and other milk or feeds. Transmission through Breast-Feeding can take place at any point during lactation, and the cumulative probability of acquisition of infection increases with duration of Breast-Feeding. HIV-1 has been detected in Breast milk in cell-free and cellular compartments; infant gut mucosal surfaces are the most likely site at which transmission occurs. Innate and acquired immune factors may act most effectively in combination to prevent primary HIV-1 infection by Breast milk.
James Stewart Forsyth - One of the best experts on this subject based on the ideXlab platform.
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Policy and pragmatism in Breast Feeding
Archives of disease in childhood, 2011Co-Authors: James Stewart ForsythAbstract:The optimal duration of exclusive Breast Feeding is a subject of continuing debate. Most recently Fewtrell and colleagues1 have challenged the evidence underpinning the 2002 World Health Assembly endorsement of the recommendation that in both developing and developed countries exclusive Breast Feeding should be for a minimum of 6 months.2 They questioned whether there was sufficient evidence to support the change from 4 to 6 months in developed countries and they also suggested that the 6-month policy could be disadvantageous to some infants. Questioning the validity of any aspect of Breast Feeding policy generates widespread media, professional and public interest and with the possibility of misinterpretation there is a potential risk that the key health message of Breast milk being the nutrition of choice for newborn babies may be undermined. It is therefore important that the specific issue that has been raised is set within the wider context of Breast Feeding and health benefits. In relation to duration of exclusive Breast Feeding, there appears to be scientific and clinical consensus that in developing countries the optimal duration of exclusive Breast Feeding is 6 months. For developed countries there is a strong consensus of opinion, based on evidence from the UK and other developed countries, that there are important health benefits from exclusive Breast Feeding for a minimum of 4 months.3 However, there continues to be a division of opinion on the strength of evidence to support the World Health Organization (WHO) recommendation that in developed countries the minimum duration of exclusive Breast Feeding should be extended from 4 to 6 months.1 The WHO media response to the Fewtrell paper contained a reaffirmation of their recommendation that mothers worldwide should exclusively Breast feed their infants for the first 6 months of life.4 Their evidence is underpinned …
Shinya Ito - One of the best experts on this subject based on the ideXlab platform.
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drug therapy for Breast Feeding women
The New England Journal of Medicine, 2000Co-Authors: Shinya ItoAbstract:Breast-Feeding is the best method of Feeding neonates and young infants.1 Its popularity has increased in recent years,2 although in 1995 only about 60 percent of new mothers in the United States were Breast-Feeding their infants at the time of hospital discharge.3 Current recommendations suggest that in the absence of contraindications, women should Breast-feed their infants for at least the first 12 months of life. However, many mothers are likely to need to take medications at some point during this time.4,5 The possible effects of these medications on Breast-fed infants are therefore of great concern. Benefits of Breast-Feeding Breast-Feeding . . .
H Kilburn - One of the best experts on this subject based on the ideXlab platform.
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unintended pregnancy and Breast Feeding behavior
American Journal of Public Health, 1997Co-Authors: Timothy D Dye, Martha A Wojtowycz, Richard H Aubry, J Quade, H KilburnAbstract:OBJECTIVES: This study assessed the effect of unintended pregnancy on Breast-Feeding behavior. METHODS: All women delivering a live birth between January 1, 1995, and July 31, 1996 (n = 33,735), in the 15-county central New York region were asked whether they had intended to become pregnant and their Breast-Feeding plans. RESULTS: Women with mistimed pregnancies, and pregnancies that were not wanted were significantly less likely to Breast-feed than were women whose pregnancies were planned. After adjustment for confounding variables and contraindications for Breast-Feeding, the odds ratios of not Breast-Feeding remained significant. CONCLUSIONS: Promoting Breast-Feeding among women with unintended pregnancies is important to improve health status.
