Breastfeeding outcomes and associated risks in HIV-infected and HIV-exposed infants : a systematic review
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Date
Authors
Eccles, Renata
Du Toit, Maria
De Jongh, Grethe
Kruger, Esedra
Journal Title
Journal ISSN
Volume Title
Publisher
Mary Ann Liebert
Abstract
PURPOSE : To critically appraise recent literature regarding breastfeeding outcomes and associated risks in HIV-infected (HI) and HIV-exposed (HE) infants, using the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) statement guidelines.
MATERIALS AND METHODS : Five electronic databases were systematically searched to obtain English publications from the last 10 years (2010–2020), pertaining to breastfeeding outcomes and associated risks of HI and HE infants and children. Gray literature sources were also included. Data were extracted according to various data items and were synthesized using thematic synthesis.
RESULTS : Of the initial 7,151 sources identified, 42 articles were eligible for final inclusion. The final selection included 19 cohort studies and 2 expert committee reports, classified as gray literature. The remaining 21 studies comprised case–control, cross-sectional, and randomized controlled trial studies. The following themes were identified: breastfeeding outcomes in HI and HE infants, risks for suboptimal breastfeeding, HI and HE infant growth and developmental outcomes, and barriers and facilitators to feeding decisions. Most studies highlighted HE infants' growth and developmental outcomes and did not directly interrogate breastfeeding outcomes. The most prevalent risks for suboptimal breastfeeding were maternal factors affecting decision making for breastfeeding.
CONCLUSIONS : This systematic review adds to the evidence of breastfeeding in HIV-affected mother-infant dyads. Findings reiterated that exclusive breastfeeding has a positive outcome on growth and development of all infants irrespective of HIV status. The review highlighted a dearth of research on breastfeeding outcomes of HI and HE infants. Large-scale prospective comparative studies should profile breastfeeding and developmental outcomes of infants with HIV infection or exposure and antiretroviral treatment exposure to enable early identification and intervention for this vulnerable population in low-income settings.
Description
Keywords
Preferred reporting items for systematic review and meta-analyses protocols (PRISMA-P), Human immunodeficiency virus (HIV), HIV-infected infants, HIV-exposed infants, Breastfeeding outcomes
Sustainable Development Goals
Citation
Eccles, R., Du Toit, M., De Jongh, G. & Kruger, E. 2022, 'Breastfeeding outcomes and associated risks in HIV-infected and HIV-exposed infants : a systematic review', Breastfeeding Medicine, vol. 17, no. 2: pp. 112-130. doi: 10.1089/bfm.2021.0107.