Pamela, thanks for this pointer.  The woman has also contacted me, as I am one of the people in Melbourne who have been actively pushing for milk banking, and I am now trying to put together up-to-date information.  The MIDIRS article looks good.  

I do not consider myself an authority on HIV and breastfeeding.  Anyone who has useful information / website/ case studies - this will be most appreciated.  I have been printing the responses as they come, and each is very worth-while.
With thanks
Joy Johnston, FACM IBCLC
Midwife and Lactation Consultant
[log in to unmask]
www.webrider.net.au/~aitex/joy.htm


-----Original Message-----
From:   Pamela Morrison IBCLC [SMTP:[log in to unmask]]
Sent:   Friday, March 13, 1998 8:48 AM
Subject:        Hiv+ mom

Anne has just asked, "Do you have access to a PCR test there?  This is a
test for VIRUS rather than ANTIBODY.  This may be able to determine if her
baby is already infected with HIV within a few days after birth ..."

I have just seen in MIDIRS Midwifery Digest (Dec 1997) 7:4, p 471, first
column, second para, the sentences (capitalized for emphasis ) " .. and it
is now assumed that in non-breastfeeding populations most infection is
acquired around the time of delivery.  Circumstantial evidence to support
this includes ...THE ABSENCE OF DETECTABLE HIV IN THE FIRST WEEK OF LIFE IN
OVER 50% OF CHILDREN SUBSEQUENTLY SHOWN TO BE INFECTED .."

Does this mean that it would take *a whole week* after delivery before the
baby's HIV status could be determined by PCR?  And can anyone explain why
there would be no detectable HIV in the first week of life if a child *was*
shown to be infected?  How could this be?  Perhaps because it takes a week
for the quantity of virus to replicate sufficiently to be detectable on the
test??

Pamela Morrison IBCLC, Zimbabwe