Regine - my apologies for the delay in replying to your post on the possibility of an HIV+ mother providing her own milk for her baby. Yes, you are quite right, the UNAIDS HIV and Infant Feeding Guidelines includes the possibility of pasteurization (holding the milk at 62.5 degrees C for 30 minutes) to inactivate the virus. This was researched by Orloff et al, and reported in the JHL 1993, but this might be difficult for a mother to do at home. The possibility of an HIV+ mother providing her own boiled breastmilk for her baby seems very feasible. It seems that the virus is heat-labile and that briefly bringing the milk to the boil would kill the virus, so that the cooled milk could safely be fed to the baby. Dr Felicity Savage King seems to have been the first to have suggested this in her book, "Helping Mothers Breastfeed". The Zimbabwe National HIV and Infant Feeding Guidelines have also included this as the *first* choice of "replacement feeding" if an HIV+ mother chooses not to actually breastfeed her baby. A mother wishing to provide EBM for an extended time would use the same methods as we use for providing EBM to a premie baby - frequent, thorough expressing/pumping from 6 hours after delivery, preventing any hint of engorgement, and just continuing to drain the breasts well. Some time ago Lactnetters sent me some amazing case histories from their files of mothers providing EBM for babies in special situations - sometimes for months, and sometimes for years (thank you ladies), so we know it can be done. Would boiling "change" the milk? Probably. But surely boiled human milk is still nutritionally superior and more physiologically suited to the needs of the human infant than the pasteurized, air-dried, powdered, reconstituted, cow's-milk and heaven-knows-what-else mix which we call "formula" and currently feed to babies without a qualm? The protein is still *human* protein, and will not give rise to allergies, and even though the milk is boiled it will still retain some of its anti-infective properties, most notably the fats. Would I recommend this method of feeding for the baby of an HIV+ mother? Yes! The next issue of Breastfeeding Review will have an article about this. Best wishes to this brave mother, who obviously wants to give her baby the very "best". Incidentally, there was a paper (Coutsoudis et al, Lancet, August this year) which showed that babies who were *exclusively* breastfed by HIV+ mothers had a *lower* rate of transmission, on average, at three months, than babies who were never breastfed. The possibility has been put forward that breastfeeding may provide a protective factor against virus acquired at delivery. Pamela Morrison IBCLC, Zimbabwe mailto:[log in to unmask] *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html