Please select the eligibility criteria that correspond to the clinical trial below.
Title: Short Duration Exclusive Breastfeeding With Abrupt Weaning to Reduce the Risk of Mother-to-Child HIV Transmission
Brief Summary: The study is designed as a randomized, controlled trial with specific observational objectives. All HIV-seropositive pregnant subjects electing to breastfeed their child will be counselled to exclusively breastfeed through 4 months of age. All live-born children will be randomized (1:1) at birth to one of two counseling programs: A) to encourage abrupt weaning at 4 months of age, or B) to encourage exclusive breastfeeding through 6 months of age with the introduction of typical weaning foods ad lib.


Options:
A: Inclusion Criteria:

* full-term infant(\> 37 0/7 weeks gestational age)discharged from hospital without significant morbidity
* singleton infant
* nursery/NICU/maternity stay of 7 days or less
* primiparous mother
* English speaking mother

Exclusion Criteria:

* presence of a congenital anomaly or neonatal condition that significantly affects a newborn's feeding (e.g. cleft lip, cleft palate, metabolic disease
* any major maternal morbidities and/or pre-existing condition that would affect postpartum care such as cancer, multiple sclerosis, lupus, etc.
* maternal age \<=20 years
* prenatal ultrasound presence of intrauterine growth retardation (IUGR)
* infant birth weight \<2500 grams plan for newborn to be adopted
* plan to move from Central Pennsylvania within 3 years
* inability to complete contact form with name, address, phone numbers, etc.
* Practicing pediatrician or pediatric resident
B: Inclusion Criteria:

* HIV-positive pregnant women identified through VCT
* After counseling about the risks and benefits of feeding alternatives report that it is their intended decision to breastfeed
* Live within the catchment area of George or Chawama clinic
* Are between 30 - 34 wks gestation. (To insure that opportunity exists to receive a minimum of 2 lactation counseling sessions prior to delivery)
* Do not have any significant presenting illness that requires hospitalization
* Agree to adhere to the requirements of study participation (including exclusive breastfeeding and randomization into one of two infant feeding groups at four months).
* Willing to inform a household member (preferably husband/father) of HIV-status.

Exclusion Criteria:

* Lives outside of catchment area;
* Have known major illnesses likely to influence pregnancy outcome including diabetes, severe renal or heart disease, or active tuberculosis, prior to randomization;
* Does not intend to breastfeed;
* Prior enrollment in this study or concurrent enrollment in another study
C: Inclusion Criteria:

* \> 34 0/7 weeks gestational age
* Discharged from the newborn nursery or neonatal intensive care unit (NICU) without significant neonatal morbidity
* Singleton infant
* Nursery or NICU stay of 7 days or less
* Primiparous mother
* Maternity stay of 7 days or less
* Pediatric primary care provider from one of 3 University-affiliated pediatric practices or University-affiliated family medicine practices
* Feeding human milk (breast milk) during the maternity/newborn stay with intent to continue to breastfeed after discharge
* English speaking mother.

Exclusion Criteria:

* Newborn nursery, NICU, or maternity stay \> 7 days
* Exclusive formula feeding in the nursery or NICU
* Multiparous mother
* Any metabolic condition that requires feedings at precise intervals
* Gestational age of 33 6/7 weeks or less
* Presence of a congenital anomaly or neonatal condition that significantly affects a newborn's feeding (e.g. cleft lip or cleft palate) or sleeping (hyperexplexia - exaggerated startle reflex)
* Non-singleton newborn
D: Inclusion Criteria:

* pregnant and less than 34 weeks gestation
* planning to deliver at study hospital
* between ages 14 and 21

Exclusion Criteria:

* planning to move out of community after giving birth
* planning to give up custody of infant
* prior c-section delivery

Answer: B