It does not seem very odd to me that exclusively breastfeeding for 3-6 months would offer protection from HIV transmission, even if that were followed by a period of mixed feeding.  We already know that the gut is most immature during the first 3-4 months of life and that breastmilk contains many factors which contribute to the healthy maturation of the GI tract.  The older the baby gets, the more likely it is that he will be able to handle foreign substances in the GI tract, including, perhaps, HIV.  If the baby transitions slowly from breastmilk to solids, with the introduction of traditional foods least likely to irritate the intestinal mucosa (in other words, no use of formula or like substances), then I would think that the baby would continue to receive the benefits of the immune substances in the breastmilk which are neutralizing the HIV without having to worry too much about the chance of viral penetration into an inflamed and porous GI mucosa.  Exclusive breastfeeding for 3-6 months followed by gradual weaning would allow HIV positive moms to present a "normal" picture to the community, which seems to be a very important part of the equation.  I would agree that abrupt weaning could very possibly lead to engorgement and mastitis in the mothers who would then possibly put their babies at greater risk should they put them to breast thereafter.  I think that exclusive breastfeeding for one year would be an unrealistic goal at this point in time.  Am looking forward to hearing about follow-up studies which will confirm what the Coutsoudis work is showing - I hope that they are in the works.


Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
mailto:[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(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html