Jacquie
You said >"I wondered if the researchers meant that when
the mother is HIV+, breastfed babies would receive a lactoferrin boost (as
in medicine drops), while bottle fed babies would receive enriched formula.
(Do you think I am too optimistic?!)  And my further thought was that "If it
makes doctors comfortable with an HIV+ mother breastfeeding, then
lactoferrin drops might be a good thing."

>I am extremely uncomfortable with anything that alters the balance of the
natural course of breastfeeding, but I would rather see a baby receiving a
little lactoferrin drop X times a day and continue breastfeeding, than be
put on to artificial milks.<

The thing is, we don't really know why exclusive breastfeeding makes a
difference to the rates of HIV transmission.  The Coutsoudis work used the
WHO definition of ebf, which allows the use of vitamin drops and medicines.
But, what if using these is also harmful and transmission rates would be
different if babies received NOTHING other than their mothers' milk?  [W
seem to have no research on this point].  In that case, could it be
counter-productive to use a dropper of something (genetically engineered
lactoferrin, bovine lcatoferrin or whatever)???  When we understand the
etiology (etiologies) of the difference between ebf and mixed feeding
transmission rates, we might know more.

Might part of the difference be that a baby who is given nothing else
receives higher concentrations of maternal lactoferrin than a baby whose
mother may replace some of the fatty dibbles of milk with 'pacifying' drinks
of water, juice, etc etc.  We don't really know what we are seeing, IMO.
Could feeding techniques that maximise the transfer of maternal lactoferrin
to the baby actually offer the best outcomes?  (Though not to any commerical
producer, of course).

Magda Sachs
Breastfeeding Supporter, BfN, UK

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