Use of the Australian Milk Biscuit to Combat Infant Malnutrition and Mother-To-Child Transmission of HIV Infection

Richard Nasra
Dept. of Zoology, University of Melbourne
nasrar@unimelb.edu.au

Ready-To-Use foods such as the Australian Milk Biscuit have long been used for famine and disaster relief. They were initially designed for emergency feeding and nutritional supplementation, and still represent an effective means of delivering macro- and micro-nutrients to people in resource-poor areas.

Today, as the HIV/AIDS pandemic continues to spread in many parts of the world, especially in Africa and Asia, we have discovered novel uses for these milk biscuits. They could be used for nutritional support of AIDS orphans, and for preventing HIV transmission from mother to baby.

Recent clinical studies in South Africa (Coutsoudis et al, 2001) and Zimbabwe (IIiff et al, 2005) have shown that if an HIV-positive mother exclusively breastfeeds her child, it will not become infected with HIV. But if she gives the child any non-breastmilk supplements, the amount of virus in her breastmilk increases, and the child may become infected. Overall, 10-20% of the children will become infected through breastfeeding from their HIV-positive mothers (De Cock et al, 2000, Coutsoudis et al, 2001).

Thus, the practical recommendation in a developing country setting has to be exclusive breastfeeding for 6 months, followed by abrupt weaning (Latham et al, 2000; Willumsen et al, 2003). But what weaning food could you use? Milk Biscuits! They are highly nutritious, extremely palatable, lactose-free, ready-to-eat, and have a long shelf life.

A three-month acceptability study just completed in an Ethiopian AIDS orphanage demonstrated that the biscuits stimulated growth in 145 young HIV-positive orphans aged between 5-12 years. The children’s diets were supplemented with 5 biscuits per day, providing them with 8g of milk protein and 190kcal of energy. The biscuits were highly palatable and hence, an ideal nutritional supplement.

Recent UNICEF estimates suggest that 600,000 children a year will become infected with HIV; we cannot let them starve to death (WABA Press Release, 2005).

In the future, we hope to use the biscuits as a complete weaning food for HIV-positive mothers, to see if we can prevent the mother-to-child infection that normally occurs once mixed-feeding is introduced. The Australian Dairy Industry could play a vital role in saving children around the world from malnutrition and HIV infection.

References

De Cock et al (2000). Prevention of mother to child transmission in resource-poor countries. J Amer. Med. Assoc. 283, 1175-1182.

Coutsoudis, H.M et al (2001). Method of feeding and transmission of HIV-1 from mothers to children by 15 months of age: a prospective cohort study in Durban South Africa. AIDS 15, 379-387.

IIif, P.J et al (2005). Early exclusive breastfeeding reduces the risk of postnatal HIV-1 transmission and increases HIV-free survival. AIDS 19, 699-708.

Latham, M.C et al (2000). Appropriate feeding methods for infants of HIV infected mothers in Sub-Saharan Africa. Brit. Med. J. 320, 1656-1660.

Willumsen, J.F et al (2003). Breastmilk RNA viral load in HIV-infected South African women: effects of subclinical mastitis and infant feeding. AIDS 17, 407-414.

WABA Press Release December 2005. New studies point to reduced risk of postnatal HIV transmission during breastfeeding.