Beth, 
What you are describing in your post is the "spillover" effect in which 
breastfeeding is sabatoged because the HIV status of the mother is unknown.  Thus 
HIV counseling and testing effects the promotion of breastfeeding and increases 
the use of infant formula.  This has been well described in Africa.  UNAID 
materials for health care providers, state that breastfeeding is recommended for 
women who are HIV negative and of unknown status.  And they specifically 
mention the need to avoid the spillover effect in counseling.  I have never seen a 
discussion on the spillover effect in developed nations like the USA. 

All mothers should have the right to refuse hiv testing (particularly since 
this test generates alot of false positives, pregnancy, by itself, can create a 
false positive).  The CDC's revised recommendations for testing of HIV in 
pregnancy states at the very beginning of the document:

"These guidelines recommend voluntary HIV testing to preserve a woman's right 
to participate in decisions regarding testing to ensure a provider-patient 
relationship conducive to optimal care for mothers and infants and to support a 
woman's right to refuse testing if she does not think it is in her best 
interest."

I believe the revised recommendations by the CDC are still considered 
current.  If you live in New York State or Connecticutt, there is mandatory newborn 
HIV testing and thus legislation has circumvented informed consent of mothers.  
Newborns of mothers that have refused HIV testing during pregnancy and 
delivery have their blood tested for HIV.  Newborn HIV testing only tells you the 
HIV status of the mother not the infant. 

Sorry I can't help you out regarding policy in hospitals, since I am not 
employed by a hospital.  What you are witnessing should be documented.  It shows 
us that the "spillover effect" of HIV testing is not limited to developing 
nations.
Valerie W. MClain, breastfeeding advocate

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [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(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html