This paper is accessible through the web at
http://pediatrics.aappublications.org/cgi/content/full/112/5/1196

I think there are many flaws with this paper--in fact too many to address in
one post to Lactnet.  But let me briefly cover a few.

This paper says there is epidemiologic studies that show evidence of MTCT of
hiv through breastfeeding.  Then they proceed to reference that to Ziegler (a
letter to the Lancet in 1985 on one infant).  They mention reports from all
over the world.  Six of the thirteen references to these reports are letters
written to journals.  Letters are not peer reviewed.  Many of these references
are dated in the 80's and early 90's.  The kind of hiv testing of infants used
back then is no longer considered valid for a true diagnosis.

The Nduati study in Kenya  is used as further proof  of hiv-1 transmission
through breastfeeding.  Yet, we know that the Nduati study has certain flaws
such as the exclusive formula feeding group also breastfed and vice versa.  Oddly
enough, the sicker mothers were in the breastfeeding group.  Nduati et al.
seem to think that meant that breastfeeding was the cause of a higher maternal
mortality rate.  Yet it is quite obvious that when you have sicker people in
one group than another (randomly or not), then it would seem very likely that
mortality rates would be higher.  Yet the Read et al. paper seems unaware of
these kinds of questions that many have asked about the Nduati study.  I believe
that there are many people who feel that the Nduati study was poorly done.

I find it rather interesting that this paper states, "characteristics of
human milk possibly associated with a higher risk of breastfeeding transmission of
HIV-1 include lower concentrations of antiviral substances, such as
lactoferrin, lysozyme, secretory leukocyte  protease inhibitor (SLPI), and epidermal
growth factor....."   All substances that are currently being patented and sold
in products (genetically engineered).  So what they seem to be saying is that
women have a deficiency of these substances in their milk that causes them to
transmit the virus.  They reference that to a study by Donovan SM called,
"Growth factors as mediators of infant development"  in Annu Rev Nutr written in
1994.  I sometimes think it is so easy to say that human milk is deficient in
something.  Yet I don't think the reference is the proof I would need to say
that their is a deficiency in hiv positive mothers.

The paper goes on to discuss the "use of active immunization of infants to
prevent postnatal acquisation of HIV-1 infection through breastfeeding."  Yet I
question this.  Isn't breastfeeding nature's vaccination.  Thus the infant
born of the hiv positive mother will get "nature's"l vaccination not the
synthetic vaccination proposed by the US Government.  Why do babies carry these
antibodies from their mothers?  Is this showing ill infants or the defense system of
the mammary gland to protect the young from any new diseases?  In short isn't
this showing nature's vaccine?

The paper states:  "In settings such as the United States, with virtually
universal access to clean water and with widespread cultural acceptance of
formula feeding as an  alternative to breastfeeding, avoidance of breastfeeding by
HIV-1 infected women is possible."  Is the problem with infant formula access
to clean water?  I would say the babies who died of enterobacter sakazakii had
access to clean water--they were in hospitals but it was their powdered infant
formula that was contaminated during manufacturing.  So is clean water the
only issue in regard to infant formula feeding?  I think not.

Lastly.  Jennifer Read authored this article along with the Committe on
Pediatric AIDS, 2003-2004 with Mark W. Kline, chairperson of that committee.  He
teaches at Baylor College of Medicine.  I call Baylor human milk component
patent land.  Baylor owns the Pharm Woman patent, claiming ownership of real human
lactoferrin as well as many other patents on human lactoferrin.    Kline has
also received funding from Bristol Myers Squibb (Mead Johnson) from the program
Secure the Future (hiv program).  Whether that effects his stance on hiv and
breastfeeding is hard to tell.  But I start to wonder when researchers have
ties to the very companies that stand to gain quite a bit by government policy
that disgards breastfeeding because of hiv.
Valerie W. McClain, IBCLC

for information on funding of Dr. Kline
http://research.bcm.tmc.edu/reports/web_tmg.pdf

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