It is certainly interesting to see the requisite damaging article each summer before World Breastfeeding Week. This year we see the spectre of HIV--always good to scare people away from breastfeeding. Notice how this article never mentioned that formula should be fourth on the list of what to feed babies of HIV positive mothers, behind the mothers' own pasteurized breastmilk, breastmilk from a milk bank, breastmilk from a screened wet nurse, etc. I guess no one makes money off of these options! Did the formula companies inspire this article? Read on! I am posting the following letter to the editor of the NY Times for Dr. Naomi Baumslag, author of Milk, Money and Madness who was interviewd for the artice but never quoted. Other international pediatric experts were interviewed but because their input did not fit the agenda of the reporter and the formula companies, their input was not mentioned. Nestle has been looking for a way to provide one-use disposable formula feeds as a new market--here it is!!! Dear Editor: Barry Meier's simplistic analysis of pediatric AIDS is sensational but skewed. His use of questionable, non-randomized, non-peer reviewed, unpublished studies leaves a lot to be desired. AIDS is a terrible disease and the solutions complex. It is still not possible to accurately differentiate between intrauterine and breastmilk tramsmission in HIV positive mothers. Glenda Gray's unpublished study in Soweto, South Africa which was supported by a leading formula company, has not been available for scrutiny of either the methodology or the data. At present, NIH is funding a ramdomized clinical trial in Nairobi, Kenya on HIV and breastfeeding, which may provide quality scientific evidence to formulate health policy. It is estimated that the risk of HIV transmission from a HIV positive mother to her infant is one in seven. It is, however, a fact that the mortality from diarrheal disease for bottle-fed infants in developing countries is doubled if they do not breastfeed. Meier's report is biased. The interviews with internationally recognized pediatric experts were ignored but interviews with Rod Leonard (director of the Community Nutrition Institute) and Edith White, both board members of Action for Corporate Accountability were reported. It should be noted that this organization is no longer associated with IBFAN (International Babyfood Action Network) as it is working with industry and has conflicting interests. Thad Jackson, an advisor to CNI and Action, has been an employee of Nestle's for years as director of special issues relating to formula. The opinions of Nestles cannot be objective considering their violations of the WHO International Code of Marketing of Breastmilk Substitutes recently reported in the British Medical Journal. It will be important to ascertain the effects of exclusive breastfeeding compared to partial and full bottle-feeding on the transmission of AIDS as well as timing of transmission through breastfeeding. In infants of HIV positive mothers, if breastfeeding is a risk factor, expressed pasteurized breastmilk, screened wet nurses, milk banks, and other more affordable breastmilk substitutes other than formula will have to be developed and made available. Peer reviewed randomized studies are needed to forlumate policy that will be in the best interest of mothers, not formula company-driven research for new markets. Naomi Baumslag, MD, MPH Clinical Professor Pediatrics Georgetown University Medical School