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March 6, 2002

Breastfeeding vs Formula-Feeding Among HIV-Infected Women in Resource-Poor Areas—Reply

Author Affiliations

Copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2002

JAMA. 2002;287(9):1110-1113. doi:10.1001/jama.287.9.1109

In Reply: As Dr Nogueira states, the study by Mbori-Ngacha et al1 was well designed and carefully implemented and analyzed. Our comments about the trial's results reinforced some of the conclusions made by the authors themselves. The authors indicated that their results were not necessarily generalizable to all women and represented a best-case scenario. All women had access to clean water, extensive health education, and medical care and close follow-up of their infants. For women in countries such as Brazil, Thailand, South Africa, and the subset of women in all resource-poor settings who have similar access, the findings of Mbori-Ngacha et al are reassuring. Formula feeding can decrease the rate of HIV transmission and can likely be done with minimal risk to the infant under these circumstances. However, this study does not establish that access to and use of formula is indeed safe and effective nor desired by all women in developing countries.

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