I just had the mom of a 3 mo old come in after learning that her
husband is HIV+ (exposure last April, test just done). She had her test
drawn today and should know the result by next week, at which time the baby
will be tested.  Mom knows she was HIV neg. at the beginning of the
pregnancy, but dad may well have converted during the pregnancy. Her
obvious question at this very stressful time is what to do about her
breastfed baby.  I gave her the recommendations about HIV+ moms not BF in
the US, and told her the virus can be transferred via breast milk, but
could not advise her about what to do while she waits.  Is there a great
risk of waiting a week if weaning is necessary, since baby is already at
risk? (I found an article saying that freezing milk at -20 kills the
related HTLV1 virus, and offered to share that reference with her MD if she
desires)
     Does anyone know of any studies of transmission from Dad to baby, or
whether BF is recommended when mom's partner is HIV+?  What if mom and baby
are both positive? Do the risks of BF in that case still outweigh the
protection of BF?  I suggested that she call her OB doctor (baby is being
followed by the Navy clinic) and see if he will help her sort out all the
factors in her decision making at this time.
     This is my first experience with this situation, and I'd appreciate
any thoughts you have, and especially any references that can be shared
with the family and/or their MD if they choose.
Anne Stiller, RNC, IBCLC