Hi Darillyn

I've found a  2012 review of the first Russian studies and the more 
recent HIV-infected babies in Libya, Kazakhstan.  It looks as if 
there is some risk to the nursing mother.  What it doesn't seem to 
cover is whether a definitively diagnosed HIV+ baby were to be 
receiving full and appropriate antiretroviral meds whether s/he would 
still be infectious to a nursing mother.  We need more 
research!  Also, an adoptive mom might need to consider the risk of 
HIV transmission to any other nursing children and her sexual partner 
should she herself become infected - and the implications for the 
rest of her family if she were to become sick or even die.  Another 
of the problems is that a baby infected during birth may not test 
positive for 6 weeks or so.  Would the nursing mom consider 
expressing and breastmilk-feeding in that time until a negative 
diagnosis has been obtained?   But meanwhile, here is the abstract 
from the 2012 review paper.  Hope it helps:

Little KM, Kilmarx PH, Taylor AW, Rose CE, Rivadeneira ED, Nesheim SR.
A Review of Evidence for Transmission of Human Immunodeficiency Virus 
from Children to Breastfeeding Women and Implications for Prevention. 
Pediatr Infect Dis J. 2012 Jun 4. [Epub ahead of print] 
<http://www.ncbi.nlm.nih.gov/pubmed/22668802>http://www.ncbi.nlm.nih.gov/pubmed/22668802

Source1Centers for Disease Control and Prevention (CDC), National 
Center for Viral Hepatitis, HIV/AIDS, Sexually-Transmitted Disease 
and Tuberculosis Prevention (NCHHSTP), Division of HIV/AIDS 
Prevention (DHAP) 2CDC, Center for Global Health (CGH), Division of 
Global HIV/AIDS.

Abstract
BACKGROUND: Child-to-Breastfeeding-Woman Transmission (CBWT) of HIV 
occurs when an HIV-infected infant transmits the virus to an 
HIV-uninfected woman through breastfeeding. Transmission likely 
occurs as a result of breastfeeding contact during a period of 
epithelial disruption, such as maternal skin fissures and/or infant 
stomatitis. Despite extensive epidemiologic and phylogenetic 
evidence, however, CBWT of HIV continues to be overlooked.

OBJECTIVE: This paper summarizes the available evidence for CBWT from 
nosocomial outbreaks, during which nosocomially HIV-infected infants 
transmitted the virus to their mothers through breastfeeding. This 
paper also explores the CBWT risk associated with HIV-infected 
orphans and their female caretakers, and the lack of guidance 
regarding CBWT prevention in infant feeding recommendations.

METHODS: We searched online databases including PubMed and 
ScienceDirect for English language articles published from January 
1975 to January 2011 using the search terms "HIV", "perinatal", 
"child-to-mother", and "breastfeeding". The citations from all 
selected articles were reviewed for additional studies.

RESULTS: We identified five studies documenting cases of CBWT. Two 
studies contained data on the number of HIV-infected women, as well 
as the proportion breastfeeding. Rates of CBWT ranged from 40 - 60% 
among women reporting breastfeeding after their infants were infected.

CONCLUSIONS: Poor infection control practices, especially in areas of 
high HIV prevalence, have resulted in pediatric HIV infections and 
put breastfeeding women at risk for CBWT. Current infant feeding 
guidelines and HIV prevention messages do not address CBWT, and fail 
to provide strategies to help women reduce their risk of acquiring 
HIV during breastfeeding.
PMID: 22668802  [PubMed - as supplied by publisher]

Pamela Morrison IBCLC
Rustington, England
------------------------------


At 03:16 18/02/2013, you wrote:
>Date:    Sun, 17 Feb 2013 20:11:07 -0700
>From:    Darillyn Starr <[log in to unmask]>
>Subject: HIV transmission from baby to mother
>
>I've had another question about whether it is safe for an adoptive 
>mother to breastfeed a baby who is known to be HIV+, or at risk for 
>it but still too young for a definitive test to be made.  In 1990, 
>at a European are conference of LLLI, a physician spoke about a 
>report of mothers in eastern Europe having been infected by their 
>nursing infants, who had contracted it from transfusions.  I've 
>heard some other things, over the years, but can't remember anything 
>definitive.  It's confusing that they say it can't be transferred by 
>kissing, even thought people often have small cracks in their lips 
>or small wounds inside their mouths.  I seems reasonable that, if 
>kissing is safe, breastfeeding would be too, but I certainly don't 
>want to encourage it without knowing for sure.
>
>Does anyone have any kind of recent evidence that I could pass on to 
>these mothers?  It is quite a common question.
>
>Thanks!
>Darillyn

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

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome