Effect of nutritional supplementation of breastfeeding HIV positive mothers on maternal and child health: findings from a randomized controlled clinical trial

BACKGROUND: It has been well established that breastfeeding is beneficial for child health, however there has been debate regarding the effect of lactation on maternal health in the presence of HIV infection and the need for nutritional supplementation in HIV positive lactating mothers. AIMS: To assess the effect of nutritional supplementation to HIV infected lactating mothers on nutritional and health status of mothers and their infants. METHODS: A randomized controlled clinical trial to study the impact of nutritional supplementation on breastfeeding mothers. Measurements included anthropometry; body composition indicators; CD4 count, haemoglobin and albumin; as well as incidence rates of opportunistic infections; depression and quality of life scores. Infant measurements included anthropometry, development and rates of infections. RESULTS: The supplement made no significant impact on any maternal or infant outcomes. However in the small group of mothers with low BMI, the intake of supplement was significantly associated with preventing loss of lean body mass (1.32 kg vs. 3.17 kg; p = 0.026). There was no significant impact of supplementation on the infants. CONCLUSIONS: A 50 g daily nutritional supplement to breastfeeding mothers had no or limited effect on mother and child health outcomes. CLINICAL TRIAL REGISTRATION: ISRCTN68128332 (http://www.controlled-trials.com/ISRCTN68128332)