Just back from an inservice on HIV delivered by Edith White, and I'm SO
DEPRESSED!  It was an excellent presentation if not a sobering one.  She
discussed many current studies that have nothing positive to share about
the transmission through breastmilk. Transmission DOES occur and quite
readily.  It doesn't really matter what stage of the disease you have as
previously thought.   It is a gloomy picture and it's getting gloomer.
In fact the longer one nurses (if HIV+) the higher the risk of
transmission.  In fact it is DOUBLE that of babies that are bottlefed
ABM.  How can we ignore this!
New testing has been able to determine more accurately when babies have
aquired the infection and we can be more certain of transmission that
have been said to occur; in utero, during childbirth and through
breastmilk.
In the US the two most common modes of aquiring HIV are blood
transfusion and right there in the number 2 position is mother to baby!
Within the mother to baby catagory, aquired through breastmilk is in the
number one position of mode of transmission!!!!
         In the African studies she sited where the mothers (HIV +) that
elected to breastfeed were compared to the mothers (HIV+) that elected
to bottlefeed ABM the morbidity/mortality of bottlefed babies was no
worse than those breastfed.  Apparently, this was even in the most
impoverished areas where clean water was not readily available.  POOF,
there goes that advantage.
        It seems inexcusable to shy away from mentioning HIV as a
contradiction
to breastfeeding.  Apparently in NY and NJ it has become a state policy
at WIC to include two statements during prenatal counseling:
1)  All women should know there HIV status, and
2)  Breastfeeding by HIV + women can transmit HIV
        I must repeat to myself over and over this only applies to women
testing HIV + , so I can no longer in good conscience make blanket
statements such as "breastfeeding is the best choice for ALL babies
worldwide".  I will be changing my prenatal infant nutrition groups to
reflect this new found knowledge of the risks involved.
        How will this affect our breastfeeding rates at our WIC office,
I don't
know.  How will this affect my breastfeeding promotion efforts in the
community of high risk clients, I don't know.  I think the answer (or
some of the answer) lies in getting women HIV tested so we can deal with
that population separately.  In MA apparently only 50% of pregant women
know there HIV status and the 50% that don't know are most likely the
ones at highest risk.   I'm sad I can no longer promote breastfeeding
across the board.  I'm left with disturbing feelings and wondering why
it isn't being discussed more frequently online.
--
Warmly, Ilene
Please come to my "mall"
http://www.geocities.com/Heartland/4558
Girl Scout Troop 522 Homepage
http://www.geocities.com/Yosemite/Trails/9268
"Contentment is not the fulfillment of what you want,
but the realization of how much you already have!"