Thanks Kathy D. for your comment on the WHO definition of exclusive
breastfeeding.  The implications of that definition are quite fascinating in
regard to the studies of hiv and breastfeeding.  It seems highly likely that
Nduati et al in her last study on MTCT of hiv used the WHO definition of
exclusive breastfeeding.  This is the study that shows a 40% transmision rate
of hiv and higher maternal mortality rates for the breastfeeding arm.   That
simple change of a definition would impact any studies one looked at, if one
believes the implications of the Coutsaudis et al study.   For whatever
reason, the Nduati studies are the ones that are setting our policies on hiv
and breastfeeding world-wide.  Yet, this simple change of definition means
that the arm designated as "exclusive" breastfeeders (with higher hiv
transmission and maternal mortality) may very well include many or most mixed
feeders.  Yet this very same study is pulled out to make the Coutsaudis study
look questionable.  It is disheartening that most research that is done on
hiv and breastfeeding does not utilize those of us who have clinical
knowledge of breastfeeding.  It is upsetting that the lives of so many women
and children will be impacted by something as simple as a definition.
Valerie W. McClain, IBCLC

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html