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ContextBreastfeeding among women infected with human immunodeficiency virus type 1 (HIV-1) is associated with substantial risk of HIV-1 transmission, but little is known about the morbidity risks associated with formula feeding in infants of HIV-1–infected women in resource-poor settings.ObjectiveTo compare morbidity, nutritional status, mortality adjusted for HIV-1 status, and cause of death among formula-fed and breastfed infants of HIV-1–infected women.DesignRandomized clinical trial conducted between 1992 and 1998.SettingFour antenatal clinics in Nairobi, Kenya.ParticipantsOf 401 live-born, singleton, or first-born twin infants of randomized HIV-1–seropositive mothers, 371 were included in the analysis of morbidity and mortality.InterventionsMothers were randomly assigned either to use formula (n = 186) or to breastfeed (n = 185) their infants.Main Outcome MeasuresMortality rates, adjusted for HIV-1 …