It has been very interesting to read in posts to Lactnet the interpretations
of the CDC's policy of universal precautions in regard to the handling of
human milk.  It's fascinating that government agencies can create health care
policies and we, lactation consultants have very different understandings of
the same policy.  Rather scary, don't you think?

Hiv/aids and breastfeeding seems to have created this huge muddle of
bureaucratic policies around the world that make little or no sense to me.
But maybe they make sense to you?

For instance there is an interesting study done by Orloff, Wallingford, and
McDougal called "Inactivation of Human Immunodeficiency Virus Type I in Human
Milk:  Effects of Intrinsic Factors in Human Milk and fo Pasteurization."  in
our very own JHL  in March of 1993.  Orloff an McDougal were part of the
Immunology Division of HIV/AIDS at the CDC and Wallingford was from the FDA.
This study was initiated to document the effectiveness of pasteurization in
regard to hiv and help with the decision making process of our Federal
guidelines for human milk banks.

The researchers spiked/innoculated human milk with hiv-1 and pasteurized it.
No virus was recovered after pasteurization.  But to me the really
interesting part of this research occured to the control human milk that was
spiked with hiv-1 and not heated.  They could not recover the hiv-1 virus.
The virus was inactivated.  They discuss past studies that have shown that
the lipids in milk dissolve or disrupt envelope viruses (hiv is an enveloped
virus).  They state,

"The intrinsic inactivating effect of human milk adds an additonal margin of
safety and may be considered beneficial.  However, it makes it impossible to
separate the effects of heat from intrinsic inactivation in the pasterization
procedure."

Fascinating.  Is it the heat or the intrinsic inactivation of human milk that
kills the hiv virus?  Of course what makes it interesting to me is that there
are patents in regard to milk lipids ability to inactivate the hiv virus.
Charles Isaacs has a patent on this  ability of milk lipids to inactivate
enveloped viruses. He specifically mentions human milk and its ability to
kill these viruses in the human gut and how freezing of these lipids does not
change that ability to inactivate those viruses.

After reading the Orloff study, I start wondering how other studies on hiv
and breastfeeding ever found hiv in their milk samples.  How could they have
found hiv in human milk samples, if the intrinsic factors kills the virus?
This study has been used to show that pasteurization of human milk kills hiv
and therefore human milk banking is safe.  I think this is a curious study
that raises alot of questions and has obviously been long forgotten.
Valerie W. McClain, IBCLC

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

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(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html