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.