Carla,  I think breastfeeding advocates would be better off reading the original study rather than the news article from Reuters. I know, time, none of us have any.  But one of the many interesting things that happens when we rely on a news agency to relay information is that it may be slanted or sensationalized depending on the particular new agency.  That particular study actually says at one point, "even in the 2nd year of life not breastfeeding was still associated with a 2-fold increased risk of death from disease."  And this study does mention that breastfeeding was not defined and they did not look at statistics for the first week postpartum.(meaning I think that the risks may actually be higher)  This is certainly less than the 6-fold risk calculated for infants not breastfed in the first month.  But the impression from reading the Reuters article is that breastfeeding may not be so important later on.  To see the original article  http://www.thelancet.com/newlancet/reg/issues/vol355no9209/menu_NOD999.html

I am deeply troubled by the trends I see in regard to studies about hiv transmission through breastfeeding.  It is my wish that more breastfeeding advocates will take a hard look at those studies.  The recent study in the JHL (December 1999) about mastitis as a risk for higher transfer of hiv during breastfeeding is a case in point.  Mastitis was defined as elevated sodium concentrations from breast milk samples that were 2 years old(samples taken in Nov 1995-Dec 1996, study done in January 1998)  These samples had been frozen at -70 degrees C.  Elevated sodium levels can also mean weaning or preterm milk(Riordan & Auerbach,1999).  Since the samples were from 6-week postpartum mothers, we can rule out preterm milk but we can not rule out weaning.  But this study used only a laboratory definition of mastitis, no clincial evaluation tied to the samples or microbacterial studies.  All the women in this study were "educated" about hiv transmission, one can conjecture that possibly some of these women limited feedings at the breast because of fear about that transmission.  Mastitis can certainly be the result of weaning.  My understanding of the storage of breast milk makes me wonder what the researchers saw and how that can relate to what is freshly given?  

This new idea put forth by the UN that hiv-positive women in developing countries should be "educated" about hiv-transmission is known to diminish a mother's desire to breastfeed.  While some may view that positively, especially since programs will be put in place to provide formula, I view this as a disaster.  My hope is that those of you on this list, will read those studies.  I think you will see what I am seeing.  Valerie W. McClain, IBCLC

Riordan, J. & Auerbach, K.  Breastfeeding and Human Lactation, 2nd ed., Toronto, Jones and Bartlett Publishers, 1999, pp.131-132.

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