Pamela, you responded to a request about an indiviudal baby and included these
remarks:  Would boiling "change" the milk?  Probably.  But surely boiled human
milk is still nutritionally superior and more physiologically suited to the
needs of
the human infant than the pasteurized, air-dried, powdered, reconstituted,
cow's-milk and heaven-knows-what-else mix which we call "formula" and
currently feed to babies without a qualm?  The protein is still *human*
protein, and will not give rise to allergies, and even though the milk is
boiled it will still retain some of its anti-infective properties, most
notably the fats.

You also mentioned the Coutsoudis paper (the importance of this paper, if it is
replicated cannot be overestimated at the moment, in my opinion) which showed
results from a trial in South Africa that HIV mother-to-baby transmission was
comparable for babies *exclusively* breastfed (no water, solids, or other milks)
as for that of babies *exclusively* replacement fed.

What I don't know that we have anywhere is any comparison of rates of
transmission for babies *exclusively* breast milk fed where the milk is heat
treated and babies *exclusively* breastfed.

Those who know more of the background could maybe say whether the heat treatment
would be theoretically likely to interfere with the protective effects of
breastfeeding that Coutsoudis and her colleagues postulate.  My understanding
would be that the UN recommendations might be based on the understanding --
before this paper came out -- of high rates of mother-to-baby transmission which
are usually found in studies -- which would seem, in the light of Cousoudis'
work, to be the effect of a *mixed* feeding regimen.

I guess what I am saying - or asking, if anyone has more info -- is the heat
treatment intervention when used with exclusive use of maternal milk to feed the
baby a studied intervention?

The point, I think, is that expressing and heat treating might turn out to be
more problematic in terms of transmission than direct *exclusive* breastfeeding.


I am struggling with these issues and I bet there is no written research on
this, but this is surely a comparison which needs making, in the light of the
South African study.

Magda Sachs
Breastfeeding Supporter, BfN ,UK

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