We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Letters |

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

Dorothy Mbori-Ngacha, MBChB, MPH; Ruth Nduati, MBChB, MPH; Grace John-Stewart, MD, PhD; Barbra Richardson, PhD; Joan Kreiss, MD, MSPH
JAMA. 2002;287(9):1110-1113. doi:10.1001/jama.287.9.1109.
Text Size: A A A
Published online


In Reply: Dr Kent and Ms Brussel and colleagues question our conclusion that formula feeding resulted in better health outcome among participants in our randomized clinical trial than breastfeeding. We respond by summarizing our key findings.

  • Breastmilk transmission of HIV-1 accounted for 44% of all infant infections in a breastfeeding population.

  • Formula feeding was not associated with increased mortality risk overall, or after controlling for or stratifying by infant HIV-1–infection status.

  • Formula feeding was not associated with increased 2-year incidence of diarrhea, pneumonia, malnutrition, or any other measured morbidity.

  • Breastfeeding conferred better nutritional status, particularly during the first 6 months of life.

  • Formula feeding was associated with significantly better HIV-1–free survival at 2 years; ie, children in the formula group were more likely to be alive and HIV-1 uninfected than those in the breastfeeding group. To us, this composite study outcome measure is the critical one.

  • Mothers in the breastfeeding group had a 3-fold higher mortality risk.


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.