Sharon wrote that exclusive breastfeeding for one year is an unrealistic goal
at this point in time.  How is that any more unrealistic than abrupt weaning?
 In the area that I live in I have met with a number of women who exclusively
breastfeed their infants for 9 months or longer (mostly longer).  They had
babies who refused solids and they had concerns and questions about what to
do.  My last 2 babies refused solids until one was 9 months old and the other
was 8 months old.  The most difficult time these mothers and I include
myself, too, had is explaining to other people (particularly HCPs) that this
refusal was real and not mother-imposed. I suppose because I have seen so
much of it, I don't consider it unusal or something that is unrealistic in
the exclusively breastfed infant.  It seems to me that alot of babies, if
left to their own wishes, do not start solids at the 4-6 month mark that has
been ordained by the experts.  Most mothers have infants eating full- course
meals at 4 months, 5 months or 6 months of age because it is expected.  Is
that really a norm?  Or might our childhood obesity problems be fueled by
this early push to get infants eating so much.  I don't think it is
unrealistic to have infants exlusively breastfed for close to a year.  I
think it far more unrealistic to expect mothers and infants to wean abruptly
at 6 months because of "supposed" transmission concerns.

Amal, wrote, "Could it be that hiv positive mothers who were in a better
state of health chose to breastfeed exclusively?" in regard to the Coutsaudis
study. One might look at the Nduati et al. study ("Effect of breastfeeding
and formula feeding on transmission of HIV-1, JAMA, 283:1167-1174) done last
year that actually randomized the feeding options.  This randomization for
some strange reason seemed to put many of the very ill mothers in the
"supposedly" exclusive breastfeeding group. Despite this interesting
randomization, one would think that the infants of these mothers would be in
worst shape.  Actually, I do believe that there was not much difference in
health outcomes between these infants and the infants who were formula-fed in
the long term.  This is the study that showed a high rate of maternal
mortality in the breastfeeding group.  Which shouldn't have been a surprise
since the breastfeeding group of women had the highest rates of syphilis and
were the sickest group.  So the sickest women breastfed and yet the outcomes
weren't much different than women who formula fed.  And to top that off, I do
believe that the Nduati et al study definition of "exclusive" was not the
same as the Coutsaudis study (meaning it wasn't a strict exclusive).

Again, human lactoferrin, a natural broad spectrum antibiotic, is being used
to prevent and treat hiv/aids.  At least one infant formula company has a
patent to this "invention."  I don't understand why we need to look at or do
more studies.  Why don't we just get the health experts, the people who
determine policy to look at all the patents on human milk/human
lactoferrin/HMFG-Human Milk Fat Globule to prevent and treat hiv/aids?  Why
would companies spend thousands of dollars for patents and build businesses
based on the wonders of human milk? Someone tell me when I can wake up from
this nightmare.  Valerie W. McClain, IBCLC

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