Just got my new MS.  Bigh headline BREAST vs. BOTTLE.  Article about AIDS
and breastfeeding.  Mostly good, some LLL-bashing.  Quotes Miriam Labbok.
Check it out--my reply below.

--
Anne Montgomery, M.D., I.B.C.L.C.
[log in to unmask]
St.Peter Hospital Family Practice Residency
Olympia, WA


Ms:

I received my issue today and immediately read the "Breast vs. Bottle"
article.  I am a physician, family practice educator, and lactation
consultant, and a long-time Ms. subscriber.  I consider breastfeeding a
feminist issue and am pleased when Ms. addresses breastfeeding issues.

It is true that AIDS adds complexity to the issue of infant feeding in the
world, and requires breastfeeding advocates to examine their "breast is
always best" stance.  However, the issue is even more complex--even
beyond the politcal issues--than you indicate in your article.

Without AZT treatment, approximately 25 % of babies of HIV positive
mothers become infected perinatally if they do not breastfeed;
approximately 30% if they do breastfeed.  The risk of transmission through
breastfeeding is higher if mom is in late stage AIDS, or *very
importantly* if mom has a primary HIV infection during breastfeeding.  HIV
positive babies do better if they are breastfed; ideally we will soon have
a reliable test to tell if babies are infected at birth but this is
unlikely to be available or affordable outside the industrialized world.
AZT treatment during pregnancy may reduce the transmission rate to about
8%;  your article correctly states we don't have information yet about AZT
and breastfeeeding.

Breastfeeding prevents many infectious diseases in babies, and has many
other benefits for babies and mothers. It also increases the interval
between births, which is better for both the baby and the mother.  Using
formula as an "easy answer" to the issue of breastfeeding transmission of
HIV may even lead to a HIGHER rate of infant HIV because of a higher birth
rate in HIV-positive mothers who do not have a period of reduced fertility
related to breastfeeding.

Yes, more resources need to be dedicated to HIV education and prevention
throughout the world.  However, it seems to me that the proper feminist
response should be to educate and empower women to AVOID HIV infection in
the first place, especially if they are already pregnant or breastfeeding,
to empower HIV-positive women to avoid pregnancy, and to provide access to
medical treatment, including AZT during pregnancy, to HIV-infected women.
This will also prevent infant HIV illness and death without the expense or
other risks of increasing the use of formula.

 --
Anne Montgomery, M.D., I.B.C.L.C.
[log in to unmask]
St.Peter Hospital Family Practice Residency