Dear Kim:  The issue of HIV+ mothers and breastfeeding is truly a
dilemma.  I did a literature search, which showed that the risk of
transmission through breastmilk is small but definite, and apparently
increases with prolonged breastfeeding.  The current estimate about
vertical transmission (i.e. mother to baby), is 25-40%, with
approximately 10% through breast milk, the rest in utero and/or during
labor.  The earlier studies were hard to interpret because they used HIV
antibodies, which could be mother's passively transmitted antibodies.
But more recent studies have used the PCR technique to actually look at
the presence of the virus in the baby.  I don't have my references handy,
but I can post them in a day or two if anyone is interested.  However,
Andrea Ruff spoke on this subject at the Chicago LLL/Physician's Seminar
and she published a paper in the Seminars in Perinatology issue (I
believe it was 12/94, an issue devoted to breastfeeding) about this
topic.  The bottom line is that in countries where the water supply and
hygiene are adequate and therefore mortality from mixing ABM with
contaminated water, etc, is lower, breastfeeding is contraindicated for
an HIV+ mother.  Someone recently mentioned pasteurization of the
mother's own milk as a possible alternative.  Since no studies have been
done, this can't be officially recommended, but I imagine that a mother
who adamantly wants to breastfeed and would do so despite the known small
risk of transmission, might do so more safely by heat treating her milk.
I never saw any further discussion of this, but I imagine that the Human
Milk Banking Association has information.  Does anyone know if they've
ever dealt with such requests?  Alicia.  [log in to unmask]