HIV-positive South African mothers losing weight when breastfeeding

A study of South African breastfeeding mothers has found that HIV-positive mothers lost weight and fat between eight and 24 weeks after giving birth, while HIV-negative mothers gained weight. The study is published in the December 1^st edition of the Journal of Acquired Immune Deficiency Syndromes.

Many African mothers continue to breastfeed. While the risk of HIV transmission to the nursing baby is well understood, the health and nutritional effects of breastfeeding on the mother have not been as thoroughly researched. This group of researchers at the Africa Center for Health and Population Studies in northern KwaZulu-Natal province, South Africa, chose to look at the health effects of breastfeeding on HIV-positive and HIV-negative mothers. (An associated study also looked at the HIV transmission risks.)

HIV is extremely prevalent in this area: in 2002, 36.5% of women at childbirth clinics were HIV-positive. Most people are unemployed, poor, and have little or no access to clean water.

The study ran between May 2002 and February 2004. A total of 142 mothers (92 HIV-positive, 50 HIV-negative) were enrolled, beginning six weeks after birth, with further visits 14 and 24 weeks after birth. One hundred and eighteen completed the study. The women were between 14 and 50 years old and generally fairly healthy; their average CD4 cell counts were over 590 cells/mm³ and illnesses were uncommon.

At eight weeks after birth, the HIV-negative and HIV-positive mothers were similar in terms of weight, height, and middle upper arm circumference, which was used to gauge the amount of fat under the skin (subcutaneous). After the eight-week mark, 70% of the HIV-positive mothers lost weight, compared to 47% of the HIV-negative mothers. As a group, the HIV-positive mothers lost an average of 1.4kg, while the HIV-negative mothers gained an average of 0.4kg.

The weight loss seen in the HIV-positive mothers was mostly fat mass, not lean body mass, and it did not depend on CD4 cell count or viral load.

Other studies have also found weight loss in lactating HIV-positive African mothers; however, the researchers point out that “there is no consistent pattern of weight change during lactation in developing countries.” They believe that “further study is needed to determine whether weight and fat loss in … breast-feeding [HIV-positive] mothers is associated with long-term consequences for their health.”