A few weeks ago, I asked what you would do about breastfeeding if you
were pregnant and discovered you were HIV+ (not a new infection and not
AIDS).  I wondered what those of us who know breastfeeding *intimately* -
would do.

Eleven people answered.  8 would breastfeed, 2 would not, 1 was unsure.
But there was real uncertainty among all, and I'm not even sure I've
categorized these 11 appropriately.  One asked, "Was your question
to women who intimately know breastfeeding like asking a person whether
or not they would give up coitis if the found out they were hiv + ??  Is
bf as risky as sex with a condom?"  I guess that was my point.  Are the
CDC guidelines as negative as they are because the authors don't know
breastfeeding intimately and thus can't evaluate the risk/benefit
effectively?

Susan Barber wrote, "I saw your note and the subsequent responses on
LACTNET. In Dr. Mary Applegate's presentation at the Lactation Institute
in Albany (oct) she discussed a new PCR test available through Wadsworth
Lab here at the state that would determine if baby was positive in utero.
In her explanation she said if the baby was positive with this test, the
mother should go ahead and bf since the baby already had the virus. If
negative, the DOH recommendation is not to breastfeed due to the risk of
transmission through breast milk. This test is done at or after delivery.
Didn't mean to mislead you above. The problem she saw with this test, was
getting it back in time to bf. Hope this helps."  Susan Barber, RD,MA NYS
WIC Breastfeeding Coordinator Bureau of Supplemental Foods II University
Place, Albany, NY 12203 518-458-6836"  (posted here with her permission).

For me, this still leaves the dilemma of the HIV+ healthy mom and the
HIV- baby, who is at probably-some-but-still-unknown-risk thru bf, but at
known (and unknown) risk for all sorts of other things thru af.

And I still wonder:  if *we're* up in the air about it, then perhaps
policy makers should be as well.

Diane Wiessinger, MS, IBCLC, LLLL  Ithaca, NY