@article{10.1371/journal.pone.0003877, doi = {10.1371/journal.pone.0003877}, author = {Kagaayi, Joseph AND Gray, Ronald H. AND Brahmbhatt, Heena AND Kigozi, Godfrey AND Nalugoda, Fred AND Wabwire-Mangen, Fred AND Serwadda, David AND Sewankambo, Nelson AND Ddungu, Veronica AND Ssebagala, Darix AND Sekasanvu, Joseph AND Kigozi, Grace AND Makumbi, Fredrick AND Kiwanuka, Noah AND Lutalo, Tom AND Reynolds, Steven J. AND Wawer, Maria J.}, journal = {PLOS ONE}, publisher = {Public Library of Science}, title = {Survival of Infants Born to HIV-Positive Mothers, by Feeding Modality, in Rakai, Uganda}, year = {2008}, month = {12}, volume = {3}, url = {https://doi.org/10.1371/journal.pone.0003877}, pages = {1-7}, abstract = {Background Data comparing survival of formula-fed to breast-fed infants in programmatic settings are limited. We compared mortality and HIV-free of breast and formula-fed infants born to HIV-positive mothers in a program in rural, Rakai District Uganda. Methodology/Principal Findings One hundred eighty two infants born to HIV-positive mothers were followed at one, six and twelve months postpartum. Mothers were given infant-feeding counseling and allowed to make informed choices as to whether to formula-feed or breast-feed. Eligible mothers and infants received antiretroviral therapy (ART) if indicated. Mothers and their newborns received prophylaxis for prevention of mother-to-child HIV transmission (pMTCT) if they were not receiving ART. Infant HIV infection was detected by PCR (Roche Amplicor 1.5) during the follow-up visits. Kaplan Meier time-to-event methods were used to compare mortality and HIV-free survival. The adjusted hazard ratio (Adjusted HR) of infant HIV-free survival was estimated by Cox regression. Seventy-five infants (41%) were formula-fed while 107 (59%) were breast-fed. Exclusive breast-feeding was practiced by only 25% of breast-feeding women at one month postpartum. The cumulative 12-month probability of infant mortality was 18% (95% CI = 11%–29%) among the formula-fed compared to 3% (95% CI = 1%–9%) among the breast-fed infants (unadjusted hazard ratio (HR) = 6.1(95% CI = 1.7–21.4, P-value<0.01). There were no statistically significant differentials in HIV-free survival by feeding choice (86% in the formula-fed compared to 96% in breast-fed group (Adjusted RH = 2.8[95%CI = 0.67–11.7, P-value = 0.16] Conclusions/Significance Formula-feeding was associated with a higher risk of infant mortality than breastfeeding in this rural population. Our findings suggest that formula-feeding should be discouraged in similar African settings.}, number = {12}, }