Thanks to Patricia for making me "go fish" for information I referred to in
my note on transmission of HIV.  Originally the issue I was addressing was re
 whether C-Sections were safer than vag deliveries for HIV+ mothers (no),
then I went on to add the aspect of transmission of the virus through
breastfeeding.  While I have seen and heard this info in several places, the
reference I could lay my hands on comes from  JHL June 1995, pp133-135 which
contain lots of lovely references!  Just to give you a summary of the
article: transmission of HIV through breastmilk is estimated at 25-53%, with
9 cases prior to 1992 that are strongly suggestive of this mode.  "Assuming
that the transmission of HIV via breastmilk is small compared to the risk of
morbidity and mortality attributed to artificial baby milk feeding under poor
hygienic conditions, the WHO carefully recommends continuing the promotion of
bf in areas where safe alternatives do not exist.  However, the CDC (USA) and
the UK Dep't of Health and Social Security recommend that women who are known
to be infected with HIV should be advised against bf if a safe alternative is
available for the infant."  The article does also point out that bf may
prolong the life of an HIV+ infant d/t anti-infective properties.   I agree
that the decision to bf when the mother is HIV+ is hers and hers alone, I
merely echoed what I have been hearing and reading.  Of course, if safe
alternatives do not exist, I would strongly advocate bf!  The references in
the JHL article, I'm sure, shed more light.  This was just a thumbnail of
what I'm hearing in  the literature and at workshops.

Yours for a healthier world,
Marsha Puckett RN IBCLC