There was an August 2009 article in Pediatrics about three toddlers that acquired HIV from caregivers who gave them pre-chewed table food. Feeding of pre-chewed food happens when a parent or other caregiver chews table food and gives some or all of the pre-chewed food from their mouth to the child. A recent (March 11, 2011) weekly bulletin from the Centers for Disease Control (CDC) discussed a small study from nine different HIV Health Care Centers that 152 HIV infected caregivers engaged in the practice, which was distributed roughly along ethnic lines. About 2/3 of those engaging in the practice were black (CDC's label), 1/4 were Hispanic, and 7% were white (again, CDC's label).
It is known that HIV transmission by saliva is exceedingly rare if it happens at all. However, the practice of feeding children (primarily toddlers) pre-chewed foods warrants attention. It is something that is hardly ever considered in epidemiology (disease transmission), and other health concerns. I have written a column about it for my local paper. This blog is not a duplication of that article.
Feeding pre-chewed food was a primary weaning process (from breast milk) prior to industrialization. It is still practiced around the world in rural areas and many cultures. There are many benefits to the practice, including the fact that infants younger than 9 months do not have saliva that is efficient enough to process complex starches. The adult saliva contributed by pre-chewed food helps. Further, switching to cow's milk can contribute to iron deficiency. Pre-chewed food combats/prevents iron deficiency. There is a good article about pre-chewed food in the journal Maternal and Child Nutrition (2010) by G. Pelto and others at Cornell University.
However, some pretty serious diseases can be transmitted by saliva and pre-chewed food. The CDC cites articles that describe transmission of Hepatitis B, Group A Streptococcus, Herpes, and Epstein-Barr Virus by pre-chewed food. The notion of pre-chewed food requires further consideration by health care advocates.
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The FDA requires that pharmaceutical companies list products that can appear in breast milk and cause a risk to infants. There is no such listing for saliva in pre-chewed food. It is known that amphetamines, barbiturates, and THC (marijuana) can be found in saliva. Does anyone wonder whether this can be transferred in pre-chewed food? Then, there are tobacco products.
It is known that cotinine, a tobacco product, can be found in saliva for one to four days following smoking. Cotinine, a by-product of second-hand smoke, can be found in infants and toddlers living in homes with smoking adults. Can the same be said about pre-chewed food? There is research to show that cotinine is associated with the development of learning problems in children and adolescents.
This is a health issue that is in the shadows. There needs to be wider consideration of the risks and benefits of pre-chewed foods, a practice that continues in America and around the world.