David

You ask some challenging questions:

"Is it possible that "dehydration" of the mother could adversely affect the
immune system in such a way as to hasten AIDS? I see lactating women often
that "seem" to have dry mouth....i.e. maybe dehydrated.....which is why I ask."

It's true that nursing mothers often *feel* the mouth suddenly go dry,
particularly as the milk lets down during a breastfeed.  I see this as
nature's way to ensure that women take enough fluids.  However, I think it
is unlikely that any woman, HIV+ or not, lactating or not, would remain
clinically dehydrated and survive for very long.

But your second question ties in nicely with the first,

"I also recall a study showing that the more overweight one is, the longer one
would live with HIV....thus lactating women may lose weight faster, again
just hastening the outcome of AIDS.????"

This is an interesting interpretation.  HIV has been called the "slim"
disease.  And I regret that, living where I do, I am likely to suspect that
thin mothers might be HIV-infected mothers, although I know that this is not
necessarily so.  People who are immune-compromised would be more likely to
fall prey to opportunistic infections, including various gastrointestinal
and other infections, which would cause them to lose weight. Since there is
a relationship between good nutrition and immune status, thinner already
HIV-infected people would conceivably either be more at risk for developing
AIDS sooner, or might be at a later stage of the disease.  Whereas fatter
people would be more likely to be healthier, and at an earlier stage of the
disease.  I don't see this so much as cause and effect as a marker for HIV
infection.  Also thinner HIV-infected women are more likely to be at risk
for diarrhoea and dehydration too. If you see what I mean....

However, lactating women who are losing so much weight that they start to
look "thin" simply need more calories.  I don't think lactation, as such,
has been shown to "drain" women - even though this is often cited as a
reason not to breastfeed ...

Pamela Morrison IBCLC, Zimbabwe
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