Rachel wrote:
"... why should the mother have to wait six months to see whether she
seroconverts to HIV positive status, when the identity of the patient is
known?  It should be simple enough to do the relevant tests on the patient's
blood and unless the patient is HIV positive right now, the risk from
continuing to breastfeed seems infinitesimal."  

I agree completely.  It may be that the patient will need to be redrawn, but
most patients are fine with that in these situations.  If patient is very
low risk and presently tests negative, I would say that the benefits of
breastfeeding would far outweigh the risks.  The cancer society guidelines
are the usual "one size fits all" recommendations that don't look at the
actual circumstances of each situation. And they downplay the importance of
breastfeeding for both mother and baby.

The usual initial testing for HIV is ELISA and Western blot which test for
the presence of antibodies to HIV.  However, there are newer tests, such as
PCR, which actually look for evidence of the virus itself and can detect
very recent infection, before significant antibody production has begun.
Perhaps the mom could request PCR instead of or in addition to the usual
tests.  She might have to pay for it herself, but the peace of mind would
probably make it well worth it. She could dialogue with her doctor and the
testing laboratory about the best choices for her in this situation. The
testing could be requested STAT for as quick a result as possible.  Good
luck to this mom and baby.

Sharon Knorr, BSMT(ASCP),IBCLC
Donning both my med tech and LC hats

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