Dear Lactnetters: Just spent several hours catching up on digests.  I
appreciate hearing that other lactnetters have trouble keeping
up...sometimes I feel like I am the only one and wonder why I am so
unorganized with my time. Maybe there is just too much out there!

I received my lateset Journal of the American Dietetic Assoc. yesterday and
there is an interesting research article in there "Transmission of HIV-1 in
the breastfeeding process".  The work was done by Rebecca Black, an R.D. and
an IBCLC. I have only perused the article so far but wanted to mention it to
any of you who might be interested and who have access to this journal.
Here is the abstract:

Current laboratory techniques cannot distinguish the mode of vertical
transmission of HIV type 1 from mother to infant.  The ability to transmit
HIV-1 via breastfeeding has been established in 24 case reports, primarily
involving mothers who seroconvert after delivery.   Whether breastfeeding
adds a notable additional risk of HIV-1 infection to the risk from pregnancy
is controversial. The importance of the duration and intensity of
breastfeeding in modulationg the outcome of HIV transmission via breastmilk
is also unclear. Factors in breastmilk play play important roles in an
infant's susceptibility to infections with HIV and in the expression of the
virus.  Pasteurization and storage enhance the intrinsic, antiviral
properties of human milk.  Banked human milk is pasteurized to destroy the
HIV-1 virus but retains properties that may be helpful to infants of HIV-1
postive mothers in developed countries where breastfeeding is not
recommended.  For infants in populations where the infant mortality rate is
high, the risk of death associated with HIV infection acquired via
breastmilk is lower than the risk associated with not being breastfed.  J AM
Diet Assoc. 1996; 96:267-274.

The article also contains a very good flowchart designed to help clinicians
and others working with this population make infant feeding decisions based
on  HIV status.

-Laura Aldag
[log in to unmask]
Laura Aldag, M.S.,R.D.
Assistant in Extension

"Never doubt that a small group of thoughtful, committed citizens can change
the world; indeed its the only thing that has"   Margaret Mead