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August 23/30, 2000

Breastfeeding in Women With HIV

Author Affiliations

Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(8):956-957. doi:10.1001/jama.284.8.956

To the Editor: The study by Dr Nduati and colleagues1 confirms observations from nonrandomized studies that breastfeeding (irrespective of duration or exclusivity) increases the risk of HIV-1 transmission. The study is uninformative about other dimensions of breastfeeding transmission such as weaning practices and the duration of breastfeeding. Since the authors did not collect detailed information on breastfeeding practices (eg, whether the infant received water), the appropriate definition of exclusive breastfeeding cannot be applied to these data. Exclusive breastfeeding in Kenya is rare: surveys estimate rates from 0% to 17%.2