Here is a question for all you wizards! :-)

I have a mom who I helped initiate breastfeeding after her baby was born &
her baby is now 4 months old.  The mom is a surgical resident & often
works 24 hour shifts or longer, in a VERY busy county hospital.  When she
first started breastfeeding she was only going to do it for her maternity
leave, then for a few weeks after going back to work, etc. & now she's at
4 months hoping to go till she was 12-15 months.

Unfortunately today at work she accidentally stuck herself with a needle.
The patient has full-blown AIDS & is sick now with very elevated viral
counts, per mom.  Mom started today taking the AZT & another drug to try
to prevent the infection.  She is HEARTBROKEN & is in the process of
weaning today.  She did state that her baby has been getting a little bit
of formula already in the daytime by the nanny as she was getting
exhausted...had a near meltdown at work, trying to keep up with the
pumping, her hectic schedule & getting rest.  She is mourning the fact
right now that she is losing that special nursing/bonding experience with
her child.

I went over with her that she could relactate again when she was cleared
medically if she wanted, but to protect her child I didn't know of any
other options at this time except to stop breastfeeding for now.  I also
mentioned that if she was wanting to share the closeness with her baby
after she had stopped her milk supply for little bit, she might consider
putting her baby to breast again, but using a lactaid device with the feed
in it & maybe a nipple shield stuffed with a cotton ball to try & prevent
any of mom's milk coming through if she produced any by chance (it maybe a
crazy thought, but trying to think of any possible ideas)  I did warn her
that this may cause her milk supply to come back though.

She states that with work & her schedule it would be way toooo much for
her to keep pumping the next several months until she is cleared
medically.  In the Riordan & Auerbach book it states that with
pasteurization of EBM now that it is not really necessary to test the milk
for HIV as that should kill the virus most of the time.  I did not know if
getting her milk pasteurized would be an option that would work even, but
once again no guarantees in life...the closest one would be to stop
breastfeeding.  Mom stated that the cost of the pasteurization (if it was
even possible) was not feasible now & she would prefer formula.  It just
dawned on me now that I forgot to mention the possiblity of getting donor
milk for her baby, so I will mention that for sure to mom next time I talk
with her.

Mom asked if I would post this information & would greatly appreciate any
thoughts.  Since she is a doctor, she had already done an online search
for medical articles on HIV & breastfeeding, but all the articles she
found were pertaining to mothers that have had the virus prior to or found
out during the pregnancy.  She is also interested in reading actual
medical articles or where she could access them online, if at all
possible.  She was wanting to know if anyone has ANY ideas!

In the archives I see someone mentioned getting a PCR (polymerase chain
reaction) blood test done for quicker results and someone else
mentioned "you have to consider new research that shows that HIV infection
may not be much of an issue if the baby is EXCLUSIVELY post-exposure."
Does anyone have any articles to back up this information?

Thank you in advance for your thoughts/ideas!  I am having problems
accessing the internet at my home the last few days, (but I will be
checking the archives whenever my computer allows me to access the
internet) or you may email me personally.

Denise, RN, IBCLC
[log in to unmask]

P.S.  I know that a couple of my ideas (pasteurization & lactaid) may not
even be feasible or workable.  Mom verbalized understanding that these
were just a "thought", she was not going to do them & I wanted more input
from others on Lactnet on my ideas.

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html