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Journal of Tropical Pediatrics Advance Access published online on December 6, 2007
Journal of Tropical Pediatrics, doi:10.1093/tropej/fmm059
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© The Author [2007]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Bacterial Contamination and Over-Dilution of Commercial Infant Formula Prepared by HIV-Infected Mothers in a Prevention of Mother-to-Child Transmission (PMTCT) Programme, South Africa

E. Andresena, N. C. Rollinsb, A. W. Sturmc, N. Conanac and T. Greinerd

aDepartment of Women's and Children's Health, Uppsala University, Uppsala, Sweden, Departments of bPaediatrics and Child Health, andcMedical Microbiology, The University of KwaZulu-Natal, Durban, South Africa, and dPATH 1800 K St NW, Suite 800, Washington DC 20006 USA

Correspondence: Ted Greiner, Senior Nutritionist, PATH, 1800 K St NW, Suite 800, Washington DC, USA. Tel.: +1 202 822-0033; Fax: 202 457-1466. E-mail < tgreiner{at}path-dc.org> (to be published).


  Abstract

To examine the safety of formula feeds used by mothers participating in a Prevention of Mother-to-Child Transmission (PMTCT) programme, contents of 94 feeding bottles collected at a PMTCT-clinic were analysed. An additional 17 samples were taken from already prepared feeds during home visits, as well as 21 samples from bottles prepared under observation. Living conditions and educational levels were overall good and mothers had been counselled on safe formula preparation. Samples were analysed for faecal bacteria, using Escherichia coli and Enterococcus sp. as indicators. Protein concentration was used as an indicator of concentration of the formula. Out of 94, 63 (67%) of samples obtained at the clinic and 13/16 (81%) of available home samples were contaminated with faecal bacteria, compared to 8/21 (38%) of those prepared under observation. Out of 94, 58 (62%) of the clinic samples containing E. coli and 23/94 (24%) of those containing Enterococcus sp. were contaminated with more than the US government recommended limit of 10 CFU/ml. Out of 94, 26 (28%) of samples obtained at the clinic, 8/17 (47%) of home samples and 3/21 (14%) of those prepared under observation were over-diluted, compared to standards. Many mothers did not follow recommended practices in preparing and feeding the bottles.


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