Modeling the Effects of Different Infant Feeding Strategies on Infant Survival and Mother-to-Child Transmission of HIV
Jay S. Ross, PhD and
Miriam H. Labbok, MD, MPH
Jay S. Ross is with the Academy for Educational Development, Washington, DC. Miriam H. Labbok was with the Nutrition and Maternal Health Division, Global Bureau, US Agency for International Development (USAID) during preparation of the article. She is currently with the Nutrition Section, UNICEF, New York, NY.
FIGURE 1——Decision tree with 3 mutually exclusive categories of postnatal infections and deaths: HIV infections, non-AIDS deaths among uninfected breastfed infants, and non-AIDS deaths among uninfected nonbreastfed infants.
Note. The formula for infections or mortality in any category is obtained by multiplying the cells in that path of the tree (1. HIV infections = N x B x T; 2. Non-AIDS deaths among uninfected breastfed infants = N x B x (1 – T) x M; 3. Non-AIDS deaths among uninfected nonbreastfed infants = N x (1 – B) x M x R). The first interval (shown) begins with n = 880 (1000 live births – 120 infants infected during pregnancy and delivery). For each subsequent interval, N is the number of infants surviving HIV-free at the end of the preceding interval.
FIGURE 2——Simulated risk of infection or death from other causes in interval for each of 3 infant feeding strategies: replacement feeding (RF), breastfeeding (BF), and safer breastfeeding (SBF), calculated per 1000 infants entering the period HIV-free.
FIGURE 3——Cumulative total of deaths and HIV infections per 1000 live births to HIV-infected mothers who used perinatal antiretroviral therapy and different infant feeding strategies: no breastfeeding (B0), breastfeeding to 6 months (B6), breastfeeding to 24 months (B24), safer breastfeeding to 6 months (SB6), and safer breastfeeding to 24 months (SB24).
