Sam

Interesting question.   There have been a few 
reported cases of child-to-mother transmission of 
HIV through breastfeeding, mostly from Eastern 
Europe.  My concern would be that an HIV+ child 
would be at risk for oral thrush and that nipple 
thrush for the mother might result in tissue 
breakdown, bleeding and contact with the 
virus.  When a mother is at risk of HIV, it would 
need to be borne in mind that her sexual partner 
would also be at risk, and if there are any other 
children in the family, the implications for them 
if the mother were to become infected.

So the HIV+ adoptive baby would not be the sole 
concern.  But there is no doubt that breastmilk 
would be a huge health advantage to a baby with a 
compromised immune system.  Perhaps the adopting 
mom would consider inducing lactation and 
breastmilk-feeding by bottle for the little one?

I'm pasting below an abstract from the 2006 IAC 
conference, which may be relevant.  I have a 
couple more abstracts documenting HIV 
transmission from an HIV+ baby to an HIV- mother 
- let me know if you would like them.

Pamela Morrison IBCLC
Rustington, England
-------------------------------------------
 From IAC 2006 Toronto Conference Abstract
Child-to-mother transmission of HIV by 
breastfeeding during the epidemic in Benghazi, Libya
B Longo1, G Liuzzi2, V Tozzi2, G Anzidei2, M A 
Budabbus3, O A Eljhawi4, M I Mehabresh4, A 
Antinori2, E Girardi2, U Visco-Comandini2
1Centro Operativo AIDS, Istituto Superiore di 
Sanità/National Institute Infectious Diseases 
"L.Spallanzani", Rome, Italy; 2National Institute 
Infectious Diseases "L.Spallanzani", rome, Italy; 
3Embassy of the Popular Jamajria of Lybia, Rome, 
Italy; 4"El Fath" Children Hospital, Benghazi, Libyan Arab Jamahiriya
Via di Torrevecchia 298,

Background: In the HIV-1 epidemic that occurred 
in the Benghazi Children Hospital in Libya in 
1998-99, at least 402 children and 20 mothers 
were infected by a monophyletic CRF2-AG strain. 
The children had clearly acquired the infection 
through nosocomial transmission. The objective of 
this study was to determine the transmission modality for the mothers.
Methods: We considered the child-mother pairs 
involved in the epidemic as concordant if both 
the mother and child were HIV-positive and as 
discordant if only the child was HIV-positive. 
Epidemiological data on the children, with 
particular focus on the duration of breastfeeding 
in relation to hospitalization periods, were 
retrospectively collected by directly 
interviewing the mothers at our Institution in 
Rome, where Libyan HIV-infected patients underwent clinical follow-up in 2001.
Results: Of the 104 pairs, 20 were concordant and 
84 discordant. In all of the children and in 5 of 
the 20 infected mothers, an intravenous treatment 
or a needle-stick injury during the epidemic was 
documented. Information on breastfeeding was 
available for 92 pairs. Breastfeeding during or 
after the child's hospitalisation was reported by 
87.5% of the HIV-infected mothers and 30.3% of 
the HIV-negative mothers (OR 16.13; 95%CI 
3.20-152.64). This association remained 
significant after excluding from the analysis the 
5 mothers who reported a possible at-risk 
parenteral exposure (OR 23.04; 95%CI 
2.87-1018.9). All of the 61 fathers tested for 
HIV were negative. When repeating the analysis 
only on the pairs with an HIV-negative father 
(n=56), so as to exclude the possibility of 
sexually transmitted infection, the association 
between the mother's serostatus and breastfeeding 
during hospitalisation remained significant (OR 12.76; 95%CI 1.38-593).
Conclusions: These results support the hypotheses 
that HIV can be acquired by breastfeeding an 
infected child, which could be of particularly 
great concern in countries where wet-nursing is common.

--------------------------------
Date:    Sat, 19 Sep 2009 09:39:45 -0400
From:    Sam <[log in to unmask]>
Subject: HIV resources

Usually it's the HIV+ mom! I am working with an adoptive mom with an HIV+
baby. Does anyone have recommendations on breastfeeding or not (the party
line she's gotten is "not") and trusted sources?



Looking into anotherlook, but wondered if anyone had any favorites.



Thank you!



Sam Doak - RN IBCLC J



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