Sam
Interesting question. There have been a few
reported cases of child-to-mother transmission of
HIV through breastfeeding, mostly from Eastern
Europe. My concern would be that an HIV+ child
would be at risk for oral thrush and that nipple
thrush for the mother might result in tissue
breakdown, bleeding and contact with the
virus. When a mother is at risk of HIV, it would
need to be borne in mind that her sexual partner
would also be at risk, and if there are any other
children in the family, the implications for them
if the mother were to become infected.
So the HIV+ adoptive baby would not be the sole
concern. But there is no doubt that breastmilk
would be a huge health advantage to a baby with a
compromised immune system. Perhaps the adopting
mom would consider inducing lactation and
breastmilk-feeding by bottle for the little one?
I'm pasting below an abstract from the 2006 IAC
conference, which may be relevant. I have a
couple more abstracts documenting HIV
transmission from an HIV+ baby to an HIV- mother
- let me know if you would like them.
Pamela Morrison IBCLC
Rustington, England
-------------------------------------------
From IAC 2006 Toronto Conference Abstract
Child-to-mother transmission of HIV by
breastfeeding during the epidemic in Benghazi, Libya
B Longo1, G Liuzzi2, V Tozzi2, G Anzidei2, M A
Budabbus3, O A Eljhawi4, M I Mehabresh4, A
Antinori2, E Girardi2, U Visco-Comandini2
1Centro Operativo AIDS, Istituto Superiore di
Sanità/National Institute Infectious Diseases
"L.Spallanzani", Rome, Italy; 2National Institute
Infectious Diseases "L.Spallanzani", rome, Italy;
3Embassy of the Popular Jamajria of Lybia, Rome,
Italy; 4"El Fath" Children Hospital, Benghazi, Libyan Arab Jamahiriya
Via di Torrevecchia 298,
Background: In the HIV-1 epidemic that occurred
in the Benghazi Children Hospital in Libya in
1998-99, at least 402 children and 20 mothers
were infected by a monophyletic CRF2-AG strain.
The children had clearly acquired the infection
through nosocomial transmission. The objective of
this study was to determine the transmission modality for the mothers.
Methods: We considered the child-mother pairs
involved in the epidemic as concordant if both
the mother and child were HIV-positive and as
discordant if only the child was HIV-positive.
Epidemiological data on the children, with
particular focus on the duration of breastfeeding
in relation to hospitalization periods, were
retrospectively collected by directly
interviewing the mothers at our Institution in
Rome, where Libyan HIV-infected patients underwent clinical follow-up in 2001.
Results: Of the 104 pairs, 20 were concordant and
84 discordant. In all of the children and in 5 of
the 20 infected mothers, an intravenous treatment
or a needle-stick injury during the epidemic was
documented. Information on breastfeeding was
available for 92 pairs. Breastfeeding during or
after the child's hospitalisation was reported by
87.5% of the HIV-infected mothers and 30.3% of
the HIV-negative mothers (OR 16.13; 95%CI
3.20-152.64). This association remained
significant after excluding from the analysis the
5 mothers who reported a possible at-risk
parenteral exposure (OR 23.04; 95%CI
2.87-1018.9). All of the 61 fathers tested for
HIV were negative. When repeating the analysis
only on the pairs with an HIV-negative father
(n=56), so as to exclude the possibility of
sexually transmitted infection, the association
between the mother's serostatus and breastfeeding
during hospitalisation remained significant (OR 12.76; 95%CI 1.38-593).
Conclusions: These results support the hypotheses
that HIV can be acquired by breastfeeding an
infected child, which could be of particularly
great concern in countries where wet-nursing is common.
--------------------------------
Date: Sat, 19 Sep 2009 09:39:45 -0400
From: Sam <[log in to unmask]>
Subject: HIV resources
Usually it's the HIV+ mom! I am working with an adoptive mom with an HIV+
baby. Does anyone have recommendations on breastfeeding or not (the party
line she's gotten is "not") and trusted sources?
Looking into anotherlook, but wondered if anyone had any favorites.
Thank you!
Sam Doak - RN IBCLC J
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