Dear Lactnetters: Just spent several hours catching up on digests. I appreciate hearing that other lactnetters have trouble keeping up...sometimes I feel like I am the only one and wonder why I am so unorganized with my time. Maybe there is just too much out there! I received my lateset Journal of the American Dietetic Assoc. yesterday and there is an interesting research article in there "Transmission of HIV-1 in the breastfeeding process". The work was done by Rebecca Black, an R.D. and an IBCLC. I have only perused the article so far but wanted to mention it to any of you who might be interested and who have access to this journal. Here is the abstract: Current laboratory techniques cannot distinguish the mode of vertical transmission of HIV type 1 from mother to infant. The ability to transmit HIV-1 via breastfeeding has been established in 24 case reports, primarily involving mothers who seroconvert after delivery. Whether breastfeeding adds a notable additional risk of HIV-1 infection to the risk from pregnancy is controversial. The importance of the duration and intensity of breastfeeding in modulationg the outcome of HIV transmission via breastmilk is also unclear. Factors in breastmilk play play important roles in an infant's susceptibility to infections with HIV and in the expression of the virus. Pasteurization and storage enhance the intrinsic, antiviral properties of human milk. Banked human milk is pasteurized to destroy the HIV-1 virus but retains properties that may be helpful to infants of HIV-1 postive mothers in developed countries where breastfeeding is not recommended. For infants in populations where the infant mortality rate is high, the risk of death associated with HIV infection acquired via breastmilk is lower than the risk associated with not being breastfed. J AM Diet Assoc. 1996; 96:267-274. The article also contains a very good flowchart designed to help clinicians and others working with this population make infant feeding decisions based on HIV status. -Laura Aldag [log in to unmask] Laura Aldag, M.S.,R.D. Assistant in Extension "Never doubt that a small group of thoughtful, committed citizens can change the world; indeed its the only thing that has" Margaret Mead