Putting the heat on HIV in breast milk

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In the Kibera slum outside Nairobi, Kenya, an unidentified community health worker demonstrates the flash-heating process -- using a glass jar of cow'
In the Kibera slum outside Nairobi, Kenya, an unidentified community health worker demonstrates the flash-heating process -- using a glass jar of cow's milk on a charcoal stove. The demonstration included the use of temperature probes, but the method can

A UC Davis Children's Hospital physician and researcher, Caroline Chantry, is taking the lead on field trials following up on the successful use of simple flash-heating to deactivate human immunodeficiency virus in breast milk.

Notably, the technique -- heating a glass jar of breast milk in a pan of water over a flame or single burner -- can be easily applied in the homes of mothers in developing nations. The discovery, therefore, provides hope that mothers with the AIDS-causing virus will soon be able to more safely feed their babies.

With live virus, mothers risk passing it on to their breastfed children. Transmission through prolonged breast-feeding is responsible for an estimated 40 percent of HIV infections among the 700,000 children who are infected with the virus each year.

"Clinical trials are urgently needed to substantiate that mothers can express, flash-heat and store their milk safely, and to test the impact of this method on actual HIV transmission," said Chantry, a pediatrician and infant nutrition researcher. "What is important about this study is that women have the right to an informed choice. It's amazing to me that in our paternalistic society, people so often readily dismiss the possibility that women would be willing to express and heat their milk to prevent their babies from getting infected with HIV."

The initial research is the subject of a paper due to be published in the July 1 issue of the Journal of the Acquired Immune Deficiency Syndromes. The paper is available online now (www.jaids.com/pt/re/jaids/paptoc.htm).

Kiersten Israel-Ballard, a staff research associate with UC Davis pediatrics, was the lead author. Chantry was among several co-authors.

The flash-heating method is similar to the pasteurization already used by human-milk banks -- but pasteurization commonly requires thermometers and timers that may be hard to obtain in resource-poor communities.

Flash-heating brings the milk to a higher temperature for a shorter period of time, a method known to be superior to the pasteurization used in most human milk banks -- because the flash-heating process is better at protecting the milk's anti-infective and nutritional properties.

The researchers noted the high infant mortality in developing countries, from diarrhea and other illnesses, which means that children cannot afford to lose any of the anti-infective agents found in breast milk, or any of the nutrition.

Moreover, the low-tech materials used for this study are readily available in the developing world, and the heating method can be easily incorporated into a mother's daily routine.

"We conducted this research to help HIV-positive mothers and their infants who do not have safe alternatives to breastfeeding," Israel-Ballard said.

In some regions of the world, mothers cannot afford infant formula. Contaminated water and other sociocultural conditions also make replacement feeding difficult.

"The risks and benefits of heating HIV-contaminated breast milk are different for women in developing countries than for women in the United States," Chantry. said "Here we have access to safe water and formula, so it makes less sense for HIV-positive mothers in developed countries to take the risks associated with feeding babies their breast milk."

For the field trials, Chantry will move the flash-heating technique out of the laboratory and into African homes. The researchers are seeking funding to assess the flash-heating method's feasibility in developing countries.

Israel-Ballard said: "Mothers in Africa have told us they will do anything to keep their babies alive, and this work is ultimately about providing them with viable options to do just that."

Karen Finney is a senior public information representative for the UC Davis Health System.

Media Resources

Dave Jones, Dateline, 530-752-6556, dljones@ucdavis.edu

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