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1.  Postnatal Depression Symptoms are Associated with Increased Diarrhea among Infants of HIV-Positive Ghanaian Mothers 
AIDS and behavior  2012;16(8):2216-2225.
HIV infection is linked to increased prevalence of depression which may affect maternal caregiving practices and place young infants at increased risk of illness. We examined the incidence and days ill with diarrhea among infants of HIV positive (HIV-P), HIV negative (HIV-N), and unknown HIV status (HIV-U) women, and determined if symptoms of maternal postnatal depression (PND) modulated the risk of diarrhea. Pregnant women (n=492) were recruited from 3 antenatal clinics; mothers and infants were followed for 12 mo postpartum. Diarrheal incidence was 0.6 episodes/100-d at risk. More HIV-P than HIV-N and HIV-U women tended to report PND symptoms (P=0.09). PND symptoms increased the risk of infantile diarrhea only for HIV-P and HIV-U but not HIV-N women (interaction term, P=0.02). Health care providers should be aware of the increased risk of infantile diarrhea when both maternal HIV and PND symptoms are present and take preventive action to reduce morbidity.
PMCID: PMC4175408  PMID: 22331392
infantile diarrhea; HIV; depression; postpartum
2.  Subclinical Mastitis May Not Reduce Breastmilk Intake During Established Lactation 
Breastfeeding Medicine  2009;4(3):161-166.
This study determined the effect of subclinical mastitis (SCM) on infant breastmilk intake.
Participants (60 Ghanaian lactating mothers and their infants) were from periurban communities in the Manya Krobo district of Ghana in 2006–2007. Bilateral breastmilk samples were obtained once between months 3 and 6 postpartum and tested for SCM using the California mastitis test (CMT) and the sodium/potassium (Na/K) ratio. Infants' 12-hour breastmilk intake was assessed by test weighing. CMT scoring for SCM diagnosis was scaled as ≥1 = positive (n = 37) and <1 = negative (n = 23). SCM diagnosis was confirmed as a Na/K ratio of >1.0 (n = 14).
Breastmilk intake was nonsignificantly lower among infants whose mothers had elevated Na/K ratios of >1.0 (−65.1 g; 95% confidence interval −141.3 g, 11.1 g). Infants whose mothers were positive for SCM with both CMT and Na/K ratio criteria had significantly lower breastmilk intake (−88.9 g; 95% confidence interval −171.1 g, −6.9 g) compared to those whose mothers tested either negative with both tests or positive on only one. Infant weight (p < 0.01) and frequency of feeding (p = 0.01) were independently associated with breastmilk intake. However, the effect of SCM on breastmilk intake disappeared when infant weight and feeding frequency were included in a multiple linear regression model.
The results of this study did not show an effect of SCM on breastmilk intake among 3–6-month-old infants. A larger sample size with a longitudinal design will be needed in future studies.
PMCID: PMC2932540  PMID: 19243263

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