On 23 November, Nancy wrote that " AZT does decrease HIV transmission 
from mother to  infant during pregnancy. That said, I respect a 
woman's right to an informed decision whether to be tested and 
whether to breastfeed with AIDS."

There have been some exciting research studies showing really low 
risk of HIV during the first six months of breastfeeding when mothers 
receive highly active antiretroviral therapy (as they do in the 
industrialized countries) and particularly when breastfeeding is 
exclusive.  For instance, Harvard's Roger Shapiro's Mma Bana study in 
Botswana has achieved an amazingly low risk of  0.3% transmission (2 
out of 709 babies) during six months' exclusive breastfeeding.   We 
are probably reaching the point where HIV+ mothers really can, and 
should, be given the choice whether to breastfeed.  It's likely that 
the risk of death from SIDS is greater than the risk of transmission 
of HIV through breastmilk for a mother who has adequate treatment for 
her own disease.  With pasteurization of her own milk, of course, she 
could cut the risk to NIL.

Pamela Morrison IBCLC
Rustington, England


  

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