> DAVID CROWE
>
> December 14, 2002
>
> AN ANALYSIS OF THE INACURRATE INFORMATION ABOUT HIV-POSITIVE WOMEN AND
> BREASTFEEDING
>
> By David Crowe
>
> Breastfeeding by HIV-positive women has been frowned upon for a long time. In
> fact, in at least one case, it has been declared illegal for an HIV-positive
> woman. This view is based on inaccurate information, and it seems likely that
> breastfeeding is the best thing that HIV-positive mothers could possibly do
> for their babies, just as is the case for all other mothers.
>
> It only took two anecdotal cases for the CDC to warn against HIV-positive
> mothers breastfeeding, but it was a meta-analysis published by Dunn et al in
> Lancet in 1992 that was the beginning of the end for choice in feeding
> practices. This study concluded that breastfeeding posed a 14% excess risk of
> HIV transmission. Since then, breastfeeding has been difficult for women in
> poor countries, and a huge amount of effort by WHO, Unicef and others has gone
> into studying and implementing replacement feeding (i.e. formula) by mothers
> in poor countries.
>
> Dunn believed that the HIV status of breastfed children was a combination of
> HIV transmission in the womb (in utero transmission) and through breastmilk.
> He therefore, searched for data sets that compared the HIV transmission
> frequency of formula fed and breastfed babies. He found six, from Zaire,
> Miami, France, Switzerland, Australia as well as a pan-European study. He
> subtracted the HIV transmission frequency of the formula fed babies (which he
> believed could only be due to in utero transmission) from the frequency in
> breastfed babies for each study. His 14% figure was a weighted average of the
> difference in each study.
>
> This is very clever but, like all meta-analyses (those that use the output of
> other researchers as their raw material) it is subject to the GIGO principle
> (Garbage In ‹ Garbage Out). And, in the case of the studies used by Dunn,
> there are enough holes to drive trucks full of formula through (and many have
> been).
http://www.redflagsweekly.com/crowe/2002_dec14.html
Jodine Chase
http://bfnews.blogspot.com
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