I would be suspicious of any presentation about HIV and breastfeeding from
anyone who has been involved with the formula companies' attempts to make
this a BIG ISSUE, and who suggests that the "solution" involves handing out
free formula to women in Africa. I do not know if this applies to Edith
White -- did she say?
I would be very suspicious about figures that suggest that anyone can tell
if a baby who is HIV+ got the virus from the mother during pregnancy, during
birth, or from breastfeeding. I don't think the data are available yet to
distinguish well among these, except comparisons of babies of HIV+ mothers
who were breastfed with babies of HIV+ mothers who were not breastfed, and
as I recall (do not have the study in front of me) the rate in the
breastfeeding babies was only a tiny bit higher than the rate in the
bottle-feeding babies. I.e., while HIV virus can be transferred through
breast milk, it is extremely rare.
The previous poster wrote:
>In fact the longer one nurses (if HIV+) the higher the risk of
>transmission. In fact it is DOUBLE that of babies that are bottlefed
>ABM. How can we ignore this!
At what point is it double? After one year of breastfeeding? After two
years? If HIV risk of transfer during pregnancy is low, and you double it,
it is still low. We need the specific data here.
>In the US the two most common modes of aquiring HIV are blood
>transfusion and right there in the number 2 position is mother to baby!
>Within the mother to baby catagory, aquired through breastmilk is in the
>number one position of mode of transmission!!!!
Sorry, I don't believe this. Not for a minute. Can you provide the
complete references for the peer reviewed publication of the study that
found this result? This is claiming that HIV risk from breast milk is
higher than HIV risk from sexual contact, including homosexual sexual
contact. I do not buy this, NOPE, NO WAY.
I would be very suspicious about figures that suggest that bottle-fed babies
do not have higher morbidity and mortality than breastfed babies in Third
World countries. For what length of time after birth did they collect
statistics? One year? In the parts of rural and urban-poor Africa where
CHILDHOOD mortality (birth to 5 years) rates are as high as 1/3 to 1/2 of
all children born dying by the age of 5 years, most of those deaths are
after one year of age. In other words, a comparison based on INFANT
mortality rates is basically meaningless. It is the protection that
breastfeeding gives children during years two, three, and four that often
means the difference between life and death, and between mildly and severly
malnourished, and between mostly healthy and mostly sick, and between OK
cognitively and impaired cognitively. It isn't until babies begin to crawl
and be exposed to pathogens in contaminated food that you see the really
high mortality, even in 100% breastfed children.
Just sign me, ever the skeptic. SHOW ME THE REFERENCES, and SHOW ME THE
AFFILIATIONS OF THE PEOPLE DOING THE STUDIES and SHOW ME WHO FUNDED THE STUDIES.
These are from the 1997 LLLI fact sheet put together by Betty Crase:
Tovo, P.-A., et al., 1996 Mode of delivery and gestational age influence
perinatal HIV-1 transmission. Journal AIDS Hum Retrovirol 11(1):88-94.
"Vaginal delivery and development of symptoms in the mother were
significantly and independently associated with a higher transmission rate
of HIV-1. In contrast, a history of maternal drug use, birth weight,
BREASTFEEDING, and child's sex did NOT have a significant impact on viral
transmission."
Guay, L., et al., 1996 Detection of Human Immunodeficiency Virus Type 1
(HIV-1) DNA and p24 antigen in breast milk of HIV-1-infected Ugandan women
and vertical transmission. Pediatrics 98(3)pt1:438-444.
"No correlation was found between the detection of HIV-1 in breast milk by
PCR or HIV-1 p24 antigen or the duration of breastfeeding (<12 months) and
transmission of HIV-1 infection in this cohort of Ugandan women. The data
should be viewed as strongly suggestive that a child's risk of HIV-1
infection by breastfeeding is low in a woman who was prenatally infected
with HIV-1."
Timbo, B., et al., 1996 Breast-feeding and HIV transmission: epidemiologic
studies and their limitations. Nutr Red 16(5):759-768.
"The mechanism and timing of HIV transmission via breastfeeding and the risk
factors for that mode of transmission are not well defined. Both HIV
infection and breastfeeding are important public health issues, and
recommendations concerning them should be based on reliabe public health data."
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Katherine A. Dettwyler, Ph.D. email: [log in to unmask]
Anthropology Department phone: (409) 845-5256
Texas A&M University fax: (409) 845-4070
College Station, TX 77843-4352
http://www.prairienet.org/laleche/dettwyler.html
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