I just want to chime in and say thank you for your informative post Sarah Vaughan. I agree with you. The WHO states that women should not breastfeed when they are HIV positive if formula feeding is acceptable, feasible, affordable, safe and sustainable, (AFASS) which it is in most cases in developed countries. Because when mothers can afford formula and prepare it safely, there is a lower health risk to infants during formula feeding than receiving breastmilk from an HIV positive mother. And although they give guidelines for women who choose to continue breastfeeding anyway, against medical advice, it's not the same as recommending it. We are supposed to recommend against it, the same as recommending against not putting a baby in a car seat. Also, although it may not happen in other developed nations, it's likely that in the United States if the authorities found that an HIV positive mother was breastfeeding her baby, social services may be involved and the mother could lose custody of the child. I did see an article from WHO recently that with AZT prenatal and postnatal treatment, it greatly reduced the transmission rate for those in which formula-feeding is not AFASS. But they still recommend formula if it is AFASS, not breastfeeding.  
Tricia Shamblin, RN, IBCLC


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