>I guess I'll go out on a limb here and argue for the position that it should be the mother's (or parents') decision to make whether she takes the risk of the baby getting HIV from breastfeeding < Welcome out here on the limb, Kathy. I agree that issues of choice should not be thrown out in the face of HIV. I also think it is vital that those of us involved in the field of breastfeeding support / lactation management should begin to familiarise ourselves with the practical ways we might support HIV+ women who choose to breastfeed. The research is scanty, but the interesting implications for practice *I am aware of* so far are: * *exclusive* breastfeeding offers a different transmission rate than using water / other milks/ teas, etc alongside breastmilk * the onset of mastitis -- even sub-clinical mastitis, it is suggested, may increase rates of transmission * there is a theoretical risk of increased transmission if the mother has a cracked nipple * there is a suggestion that there could be a risk of increased trnasmission if the mother (???or infant???) has a thrush overgrowth (I don't know much about the dabate on expressed, treated milk. One question I woudl have is, if treated, would the consideration about exclusivity still apply?) What does the above tell you? That if a mother who is HIV+ chooses to breastfeed, she will need A1 support to get breastfeeding going pretty optimally!! HIV poses huge threats to breastfeeding for all women -- I heard a presentation from the Mass Media unit in Glasgow which included comments from a woman in a focus group doubting the benefits of breastfeeding because she had heard that it could transmit HIV -- and this confirmed her choice not even to try breastfeedign her baby. But -- it also provides a huge opportunity to recognise the skills involved in enabling women to get breastfeeding going while avoiding supplements, breast over-fullness/mastitis, etc etc. If we can make the case that enabling successful establishment of breastfeeding is going to be important in the context of child health and HIV, maybe it will improve the lot of breastfeeding women everywhere. Magda Sachs (the millenarian) Breastfeeding Supporter, BfN, UK *********************************************** 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