Growth of infants born to HIV-infected women, when fed a biologically acidified starter formula with and without probiotics

Abstract

Objectives: To compare the growth of HIV-exposed uninfected infants fed a biologically acidified milk formula with or without probiotics (Bifidobacterium lactis) during the first six months of life, with control infants fed a standard starter formula. Design: Multi-centre, double-blinded randomised controlled trial. Setting: Infants born to HIV-infected women delivering at one of three academic hospitals in Johannesburg, South Africa. Subjects: Consenting HIV-positive women, who had previously decided not to breast-feed, were randomised to receive one of three milk formulas for their newborn infants. Outcome measures: Comparisons of growth parameters through the first four months of life were made between infants fed the acidified formula without probiotics and those fed the control formula (“acidification effect), and between infants fed the acidified formulas with and without added probiotics (“probiotic effect). Results: Of 131 randomised infants, 33 (25%) did not complete the study and 13 (10%) were HIV infected, leaving 85 infants available for analysis. Infants receiving the acidified formula with probiotics had more rapid head growth (p=0.04) and showed a trend towards more rapid weight gain (p=0.06) over the first four months of life than the infants receiving the acidified formula without probiotics. No other significant differences between the feeding groups were demonstrated. Conclusions: Infants in all study groups grew well, with increased head growth and a trend towards increased weight gain for those receiving probiotics. There were no differences in morbidity between the three study groups and no evidence of adverse effects of the study formulas.