I think part of the problem is we're trying to balance an equation for
which we lack a number for either side. We haven't pinned down when and
how often HIV is transmitted thru milk. And just as importantly, we
haven't pinned down ABM mortality rates.
A young man is diabetic from childhood. He goes into insulin shock and
has a fatal car crash. I doubt that he's even counted as a diabetes
fatality. He certainly would never be considered an ABM fatality. And
what if he took a carload of people with him?
Does different myelinization mean different reaction times, resulting in
more accidental deaths for those who were artificially fed? Are there
differences in smoking rates? Abuse rates? Suicide rates? What about
the brain abscess that results from a sinus infection that results from
allergies that derive from artificial feeding in infancy? What about those
flukey post-surgical deaths after tonsillectomies, wisdom tooth
extractions, and so on? How many major and minor illnesses have higher
death rates among those who were artificially fed. The differences might
all be very, very small, but it seems to me there must be a lot of them.
I can't think of any way to come up with a realistic figure on deaths
whose ultimate cause was artificial feeding, although it sure would be
interesting to try!
An HIV+ person might have a longer survival time if he were totally
isolated from all human contact - but we'd never do it because that would
wreak havoc with quality of life. Isn't there a quality of life issue in
breastfeeding, too? How does that figure in the balance?
I try to stay reasonably current on HIV and bf, but if I found myself HIV+
and pregnant, I don't know whether or not I could bear not to nurse - or
even if not nursing would be the correct decision. When
and if the time comes that I have to advise a client, I'll offer the WHO, CDC,
and ILCA statements, but then I'll speak from the heart and say that I
just don't know. I just don't know.
Diane Wiessinger, MS, IBCLC, LLLL Ithaca, NY private practice
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