This study examines, in the context of the human immunodeficiency virus (HIV) epi-demic, the effects of optimal breast-feeding, complete avoidance of breast-feeding, and early cessation of breast-feeding.
The three categories of breast-feeding were weighed in terms of HIV transmission and infant mortality, Estimates of the frequency of adverse outcomes were obtained by simulation, Results.
Avoidance of all breast-feeding by the whole population always - produces the worst outcome.
The lowest frequency of adverse outcomes occurs if no HIV-seroposi-negative women breast-feed optimally, given infant mortality rates below 100 per 1000 and relative risks of dying set at 2.5 for non-breast-fed compared with optimally breast-fed infants.
For known HIV-seropositive mothers, fewer adverse outcomes result from early cessation than from prolonged breast-feeding if the hazard of HIV transmission through breast-feeding after 3 months is 7% or more, even at high mortality rates, given relative risks of dying set at 1.5 for early cessation compared with optimal duration of breast-feeding.
The risk of HIV transmission through breast-feeding at various ages needs to be more precisely quantified.
The grave issues that may accompany a possible decline in breast-feeding in the less developed world demand evaluation.
Mots-clés Pascal : Allaitement, Durée, Alimentation, SIDA, Virose, Infection, Nourrisson, Homme, Mortalité, Epidémiologie, Transmission mère enfant, Pays en développement, Modèle simulation, Estimation statistique, Immunopathologie, Immunodéficit
Mots-clés Pascal anglais : Breast feeding, Duration, Feeding, AIDS, Viral disease, Infection, Infant, Human, Mortality, Epidemiology, Mother to child transmission, Developing countries, Simulation model, Statistical estimation, Immunopathology, Immune deficiency
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0413219
Code Inist : 002B30A01A1. Création : 19/12/1997.