Could pre-chewed baby food be a vector for HIV transmission? A report in the August issue of Pediatrics suggests that it may -- but when thinking about this phenomenon, we need to avoid the knee-jerk "Ewwww" (literally) reaction that a ScienceNews reporter had. In reading the ScienceNews piece I was reminded that not everyone has heard of pre-chewing food and a lot of people simply can not suspend their ethnocentric response it, which may explain why this news item was treated more as a curiosity than medical news.
I don't have the disgusted response to the idea of pre-chewed food being fed to babies because my family has long used the practice when weaning a baby. As a matter of fact, my Grandmother swore by it and freely admitted to feeding pre-chewed food to all of her children and grandchildren. And this story is more than a report of odd behavior - as the ScienceNews piece points out, the findings that there is a probable link between pre-chewed food and HIV transmission from adult to child have important implications and may prove false a long held belief in the late transmission of HIV through breastfeeding.
It is important to put the practice of pre-chewing food for babies into context. There are many parts of the world where baby food is not available in charmingly labeled glass jars sold in conveniently located markets. There are still other parts of the world where pre-chewing food for babies is simply cultural accepted as tradition, including parts of America. My grandmother was born and raised in rural Mississippi where both factors applied - people made baby food at home or they pre-chewed and our family valued pre-chewing baby food as a perfectly tradition for grandmothers and mothers to participate in. Since the practice of pre-chewing food for babies is widespread across the world the implications of the probably transmission of HIV through the practice are huge.
That raises the question of how HIV might have been passed from adult to child through pre-chewing. As reported in the August issue of Pediatrics, three cases of HIV infection were diagnosed in children ranging in age from 15 to 39 months after symptoms prompted doctors to perform testing. In two out of those three cases of positive HIV infection, the mothers were known to be infected with HIV and had not breastfed their children. Perinatal transmission of HIV had also been ruled out in those two cases. In the third case, the mother of the child was not HIV positive but a great aunt who helped care for the child was determined to be infected with HIV. All three children had been fed pre-chewed food on multiple occasions by an individual infected with HIV and in two cases concurrent oral bleeding in that individual was also reported. The Pediatrics report concludes that the children were infected through exposure to pre-chewed food from an HIV positive individual in two out of the three cases studied.
The researchers recommend that doctors educate patients about the new findings linking pre-chewed food with HIV transmission when oral bleeding is a factor so that parents can make informed decisions and take appropriate preventive action where warranted. This research also highlights the need for everyone to know their HIV status and for there to be safe, affordable and confidential opportunities for testing. In poor communities and countries, not pre-chewing food is not a viable option but testing and education should be so that parents and caregivers can have all the information needed to make the best choice for their child.
This study may also play a key role in the analysis of cases where breastfeeding was thought to be responsible for late HIV transmission from mother to child. Armed with this new data, researches are reviewing those cases to see if pre-chewing may have played a role. Given the important health benefits of breastfeeding and the debate over whether HIV positive mothers should nurse, the outcome of those case reviews could have global implications.
It sometimes seems that there is a new study debunking a previous study announced everyday and it is easy for a body to become numb to news of yet another one. This story should suffer that fate. Mothers and caregivers deserve to know the facts about the potential of HIV transmission through pre-chewed food and what, if any, new light that shines on the potential of HIV transmission through breastfeeding.
