Heat treatment of expressed breast milk is a feasible option for feeding HIV-exposed, uninfected children after 6 months of age in rural Zimbabwe

J Nutr. 2010 Aug;140(8):1481-8. doi: 10.3945/jn.110.122457. Epub 2010 Jun 23.


In the context of a prevention of mother to child transmission of HIV program promoting exclusive breast-feeding (EBF) to 6 mo and offering HIV-PCR testing at approximately 6 mo, we ascertained the feasibility of expressing and heat-treating (EHT) all breast milk fed to HIV-exposed, uninfected infants following 6 mo of EBF. Twenty mother-baby pairs were enrolled from a hospital in rural Zimbabwe. Research nurses provided lactation, EHT, and complementary feeding counseling through 21 home visits conducted over an 8-wk period and collected quantitative and qualitative data on the mothers' EHT experiences, children's diets, and anthropometric measurements. Mothers kept daily logs of EHT volumes and direct breast-feeding episodes. Mothers successfully initiated and sustained EHT for 4.5 mo (range, 1-11 mo), feeding 426 +/- 227 mL/d (mean +/- SD). By wk 2 of follow-up, children were receiving EHT and Nutributter-enriched complementary foods that satisfied 100% of their energy requirements. During the 8-wk follow-up period, no growth faltering was experienced [changes in weight-for-age, weight-for-length, and length-for-age Z scores = +0.03 +/- 0.50; +0.77 +/- 1.59; and +0.02 +/- 0.85 (mean +/- SD), respectively]. Stigma was not a major deterrent, likely due to a social marketing campaign for EBF that promoted EHT as a practice to sustain breast-feeding for all women. This study provides evidence that resource-poor rural women can initiate and sustain EHT given family and health systems support. EHT provides a strategy for improving the diets of HIV-exposed but uninfected children after direct breast-feeding has ceased.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Height
  • DNA, Viral / analysis
  • Energy Intake
  • Female
  • HIV Infections / diagnosis
  • HIV Infections / prevention & control*
  • HIV Infections / transmission*
  • Health Education
  • Hot Temperature*
  • Humans
  • Infant
  • Infant Food
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Lactation
  • Male
  • Milk, Human / virology*
  • Nutritive Value
  • Polymerase Chain Reaction
  • Rural Population
  • Weight Gain
  • Zimbabwe


  • DNA, Viral