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A randomized trial of infant-feeding strategies among HIV-infected women in Kenya suggested that mortality rates were three times higher among women who breast-fed than among women who did not (Lancet 2001; 357:1651). Subsequent studies, however, have not supported this observation.
In this prospective cohort study, investigators in Kenya followed 296 HIV-infected pregnant women from 32 weeks’ gestation through 24 months’ postpartum. All women were counseled on infant-feeding strategies and received standard antenatal care and short-course AZT; formula was provided free of charge to those who chose it. A total of 98 mothers elected to formula-feed exclusively, and 198 opted to breast-feed (with or without supplemental formula). Women who for…