Water Used for Infant Formula Often Contaminated in Developing Countries

J Acquir Immun Defic Syndr 2001;28:393-398. Reprinted in Medscape.

 

NEW YORK (Reuters Health) Dec 28 - Stored drinking water is often contaminated with E. coli in Abidjan, Cote d'Ivoire, and probably other developing countries, with implications for the safety of replacement feeding of infants in such settings.

 

As the authors of a paper in the December 1st Journal of Acquired Immune Deficiency Syndromes explain, HIV-infected women have been instructed in substituting infant formula for breast milk as one strategy for reducing maternal-infant transmission of the infection. However, little is known about the quality of water used to prepare infant formula in developing countries.

Dr. Steve Luby, from Centers for Disease Control and Prevention in Atlanta, and colleagues surveyed water use and infant feeding practices in 120 households in the Koumassi District of Abidjan, Cote d'Ivoire.

Most households (93%) used water from the municipal system, the authors report, with the remaining households using bottled water. Eighty-three percent of the households stored drinking water, the report indicates, either because of the distance from the water supply or because of the unreliability of the supply.

Ninety percent of infants in these households had been given drinking water by 1 month of age, and 90% of these were given stored drinking water, according to the results.

Although coliform bacteria were detected in only 2% of the samples of source water, the researchers note, 74% of stored water samples contained coliform bacteria. Similarly, 41% of stored water samples contained E. coli, compared with only 1% of source water samples.

"Developing countries, especially those implementing formula-feeding programs to prevent mother-to-child HIV transmission, need to evaluate the water used to make infant formula and to make provisions for safe water," the authors conclude.

"In the setting of Koumassi," the investigators add, "safe storage may be all that is required to improve stored drinking water quality."

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