Pre-chewed baby food common in HIV-positive households, study suggests

Here’s a particularly disturbing stat: 31 percent of babies in households where the mom is HIV-positive get at least some pre-chewed food. In most cases the surveyed caregivers who reported doing that pre-chewing were the infected moms. Or so reports the Centers for Disease Control and Prevention.

In 2009, I blogged about a paper in Pediatrics that reviewed three instances of HIV transmission to babies through pre-chewed foods. That report had suggested such “premastication” of baby food was not common. The new study challenges that assessment.

CDC’s study was carried out in nine clinics around the country and in Puerto Rico. Each surveyed family had a child who was at least 6 months old and its mother infected with HIV. During a clinic visit, researchers asked the primary caregiver of each child, which 80 percent of the time was the mom, about a host of issues, including whether the child received pre-chewed food.

A 2008 Pediatrics paper had indicated rates of premastication in the United States might be as high as 14 percent. The new study finds the rate at least twice as high among caregivers of at-risk children in the 154 households it surveyed.

Eighty percent of those surveyed had been the child’s biological mothers. But regardless of who the primary caregiver was, younger individuals proved most likely to share food from their mouth. Some 44 percent of caregivers under 20 premasticated a baby’s food compared to just 13 percent of caregivers who were at least twice that age. The frequency of offering kids pre-chewed foods was almost twice as high among black caregivers as among non-blacks (although at 66 percent, blacks were also over-represented among the surveyed caregivers).

“Similar prevalences of premastication were found regardless of the sex of the child and the primary caregiver’s country of origin, education level, and income,” report Natella Y. Rakhmanina of Children’s National Medical Center in Washington D.C. and her colleagues in the March 11 Morbidity and Mortality Weekly Report.

When asked why people shared their food, premasticators said a child had begged for it, that the adult didn’t want a child to choke or that it was just a common family practice. Not all foods were pre-chewed (meat, fish and fruits most commonly were), and most adults that adhered to the practice did it only a few days a week. However, some began sharing food with babies as young as one month old and continued doing so until a child was over a year old (sometimes as old as 3).

An estimated 13 percent of HIV infections among children 12 and under develop after birth, often from unknown sources, CDC notes. Clearly, this is likely to be an underreported source.

As part of the new study, CDC cautioned caregivers after the survey was over about risks of HIV transmission that pre-chewing can pose. But owing to how widespread the practice appears to be — even among adults who knew they were infected — CDC cautions that pediatricians make a point to regularly discuss the topic with parents and caregivers where at least one household member is infected with the virus. The new data also point to a need for targeting prevention messages at moms who are especially young, CDC says.

Of course, fear of HIV shouldn’t be the only reason to steer clear of this practice. Plenty of other germs can also be shed by saliva, including those responsible for cold sores, hepatitis infections, dental cavities and stomach ulcers.