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Weight changes during and after 6 months of breastfeeding in HIV-infected mothers receiving antiretroviral therapy in Malawi.

Editor: Weight changes during breastfeeding are very variable in healthy populations with reported changes during 6 months of lactation between a mean loss of 0.9 kg/month and a mean gain of 0.8 kg/month.1 Breastfeeding increases the nutrient needs of women, although metabolic adaptions generally occur to protect energy reserves during lactation. In the presence of HIV infection, which also increases metabolic demands, if dietary intake is inadequate, breastfeeding mothers can become nutritionally depleted. Data previously reported on HIV-infected women concerning the potential effect of breastfeeding on maternal weight are controversial with some studies showing no major impact on body weight and adverse outcomes2,3 and others reporting significant weight loss and possible associated increased disease progression.4–6