I'd like to thank everyone who was willing to add 
their thoughts to the debate about the baby's 
right to be breastfed - often at great length. 
And for the nice, easy-going way in which you all 
responded.  This is a difficult topic, and I 
appreciated your thoughts - so many of them - and 
responses. I read each one very carefully, and I 
continue to learn from you all.  Thank you!

Julie asks for the link to Ruth Nduati's RCT, 
which Danica has supplied at 
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372408/>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3372408/ 
.  It's also available here 
<http://jama.ama-assn.org/cgi/reprint/283/9/1167>http://jama.ama-assn.org/cgi/reprint/283/9/1167 
Before you quote from it though, it's important 
to note that this study has been roundly 
criticized by other researchers (Anna Coutsoudis 
and Louise Kuhn).  It's value in fact is how 
hadly it was done!  It's unlikely that any of the 
babies were exclusively breastfed, and in fact a 
large percentage from both the breastfeeding and 
formula-feeding arms actually practised mixed 
feeding.  In addition, the researchers had to 
make valiant efforts to keep the formula-fed 
babies healthy in the conditions which pertained 
in the Nairobi suburbs where the study was 
undertaken.  The interesting thing about it is 
what Ruth Nduati herself says about the ethical 
concerns of doing a randomised trial in such 
conditions.  And her remarks can be found in the 
report of a 1998 WHO/UNICEF/UNAIDS meeting at 
<http://www.unaids.org/sites/default/files/media_asset/jc180-hiv-infantfeeding-4_en_0.pdf>http://www.unaids.org/sites/default/files/media_asset/jc180-hiv-infantfeeding-4_en_0.pdf 
You will note that I summarized them but I think 
the intended meaning remains clear.   The other 
interesting thing is that it was Dr Nduati 
herself who drafted the very first WHO HIV and Infant Feeding recommendations.

Pamela Morrison IBCLC
Rustington, England
-----------------------------

"Â But according
to Ruth Nduati, the Nairobi researcher who oversaw the only
randomised controllled trial ever conducted on breastfeeding vs
formula-feeding in the context of HIV, the ethical promotion of
infant feeding choice is only permissible in a balanced state of
ignorance."
Do you have a copy of this study?  Preferably a link to it?
Thank you,Julie Tardos




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