Sam Interesting question. There have been a few reported cases of child-to-mother transmission of HIV through breastfeeding, mostly from Eastern Europe. My concern would be that an HIV+ child would be at risk for oral thrush and that nipple thrush for the mother might result in tissue breakdown, bleeding and contact with the virus. When a mother is at risk of HIV, it would need to be borne in mind that her sexual partner would also be at risk, and if there are any other children in the family, the implications for them if the mother were to become infected. So the HIV+ adoptive baby would not be the sole concern. But there is no doubt that breastmilk would be a huge health advantage to a baby with a compromised immune system. Perhaps the adopting mom would consider inducing lactation and breastmilk-feeding by bottle for the little one? I'm pasting below an abstract from the 2006 IAC conference, which may be relevant. I have a couple more abstracts documenting HIV transmission from an HIV+ baby to an HIV- mother - let me know if you would like them. Pamela Morrison IBCLC Rustington, England ------------------------------------------- From IAC 2006 Toronto Conference Abstract Child-to-mother transmission of HIV by breastfeeding during the epidemic in Benghazi, Libya B Longo1, G Liuzzi2, V Tozzi2, G Anzidei2, M A Budabbus3, O A Eljhawi4, M I Mehabresh4, A Antinori2, E Girardi2, U Visco-Comandini2 1Centro Operativo AIDS, Istituto Superiore di Sanità/National Institute Infectious Diseases "L.Spallanzani", Rome, Italy; 2National Institute Infectious Diseases "L.Spallanzani", rome, Italy; 3Embassy of the Popular Jamajria of Lybia, Rome, Italy; 4"El Fath" Children Hospital, Benghazi, Libyan Arab Jamahiriya Via di Torrevecchia 298, Background: In the HIV-1 epidemic that occurred in the Benghazi Children Hospital in Libya in 1998-99, at least 402 children and 20 mothers were infected by a monophyletic CRF2-AG strain. The children had clearly acquired the infection through nosocomial transmission. The objective of this study was to determine the transmission modality for the mothers. Methods: We considered the child-mother pairs involved in the epidemic as concordant if both the mother and child were HIV-positive and as discordant if only the child was HIV-positive. Epidemiological data on the children, with particular focus on the duration of breastfeeding in relation to hospitalization periods, were retrospectively collected by directly interviewing the mothers at our Institution in Rome, where Libyan HIV-infected patients underwent clinical follow-up in 2001. Results: Of the 104 pairs, 20 were concordant and 84 discordant. In all of the children and in 5 of the 20 infected mothers, an intravenous treatment or a needle-stick injury during the epidemic was documented. Information on breastfeeding was available for 92 pairs. Breastfeeding during or after the child's hospitalisation was reported by 87.5% of the HIV-infected mothers and 30.3% of the HIV-negative mothers (OR 16.13; 95%CI 3.20-152.64). This association remained significant after excluding from the analysis the 5 mothers who reported a possible at-risk parenteral exposure (OR 23.04; 95%CI 2.87-1018.9). All of the 61 fathers tested for HIV were negative. When repeating the analysis only on the pairs with an HIV-negative father (n=56), so as to exclude the possibility of sexually transmitted infection, the association between the mother's serostatus and breastfeeding during hospitalisation remained significant (OR 12.76; 95%CI 1.38-593). Conclusions: These results support the hypotheses that HIV can be acquired by breastfeeding an infected child, which could be of particularly great concern in countries where wet-nursing is common. -------------------------------- Date: Sat, 19 Sep 2009 09:39:45 -0400 From: Sam <[log in to unmask]> Subject: HIV resources Usually it's the HIV+ mom! I am working with an adoptive mom with an HIV+ baby. Does anyone have recommendations on breastfeeding or not (the party line she's gotten is "not") and trusted sources? Looking into anotherlook, but wondered if anyone had any favorites. Thank you! Sam Doak - RN IBCLC J *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome