Holiday Greetings to Everyone! This in in response to Roni report on birth practices and HIV in her institution, and Naomi's questions. There is so much that is unsure about HIV...for example, there was a study showing that the firstborn twin of a vaginal birth would get it, but not the secondborn twin. Folks are trying all sorts of different things to reduce transmission, including intensive washing of the vagina before birth. There are always new things being published. Am J Pub Health 87 no. 6, June 1997: "For known HIV-seropostive mothers, fewer adverse outcomes reult from early cessation of breastfeeding than from prolonged breastfeeding....." It may be that in some parts of the world, the infant's survival is enhanced with some breastfeeding for a short time (this study mentioned 3 months). Other studies have mentioned withholding colostrum, and then starting breastfeeding after some days have passed. Time of initial HIV infection, mother's nutritional status (Vitamin A has been shown to reduce maternal risk of HIV infection), when membranes rupture. Another study (AIDS vol 9 no 8, August 1995) found that HIV postive mothers are at increased of post-operative complications when delivered surgically. This whole area is so fraught with emotional responses, and unknowns. Sad thoughts at a Happy time. Warmly, Nikki Lee