Dear Valerie,

If you reread my post, you will note that I also did not think that abrupt weaning was a good option.  From what I have understood from the posts from those who deal with this issue most frequently, in Africa, a good solution must not only protect the baby, but also the mother from the appearance of having HIV.  Perhaps I am wrong, but I seem to have the idea that most mothers are doing a certain amount of supplementing by the time the baby is in the 6-12 month period.  In some cases, the babies may actually grow better and be healthier if they are getting some quality supplemental food along with breastmilk - not all, but some.  The point is, what kind of recommendations are most likely to be followed by the majority of women whose babies are at risk?  Total formula feeding does not seem to be a good option for many obvious reasons.  I'm not convinced that exclusive breastfeeding for 12 months is a realistic option, either.  I'm not saying that babies who are exclusively nursed for 12 months are not healthy.  My son, due to his many allergies, did not begin to take in any appreciable amounts of anything but breastmilk until he was 14 months old.  My daughter, allergy-free, began at the age of 8-9 months.  I am also not saying that some moms might not be willing to exclusively breastfeed for 12 months.  But what would be realistic for the majority of moms?  If 12 months is set as the length of time that a baby must nurse exclusively in order to protect from HIV transmission and a mom does not feel that there is any way that she will be able to do this (how many first-timers do you think could conceive of this at the beginning of their nursing experience?), then it is more likely that she may give supplements at any time, including during those crucial first few months.  The point is, I think that it may turn out that neither abrupt-weaning nor extended exclusive breastfeeding will be necessary in order to give adequate protection.

Unfortunately, these babies are but the tip of the iceberg in the HIV epidemic in Africa and worldwide.  If lactoferrin is indeed a viable treatment for this horrible affliction, then I also hope that it will become available soon to all who need it.  If it is effective and there is a profit to be made, then it will appear.


Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
mailto:[log in to unmask]

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