From:  Shanon Parisien
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Date:  02/24/99

Hi, my name is Shanon Parisien.  I am a BSN nursing student at the
University of North Dakota.  We have now completed our second rotation of
obstetrical nursing and I have had some very interesting situations with
assisting my clients with breastfeeding.  One of my clients was worried
about being HIV positive and wanting to breastfeed her newborn child.
This has urged me to seek more information about the topic of AIDS/HIV and
breastfeeding.

"Recent reports from throughout the world have documented the
transmission of HIV through human milk" (Pediatrics, 1995).  This article
further states that HIV positive women or women at high risk for HIV
infection should be educated and counseled based on each individual case.

Lancet (1998) states that "....breastfed children have a higher risk of
mother to child transmission than those who have never been breastfed, and
perspective followup of children born to HIV1 infected mothers has shown
that some infants become infected postnatally after loss of maternal
antibodies".  It seems that the risks involved with breastfeeding with
HIV infection outweigh the benefits of breastfeeding.

In addition, JAMA (1998) has statistical data showing a research
experiment where HIV1 infection status was determined for 434 children out
of 558 breastfed children.

The literature that was reviewed stated that HIV positive mothers should
not breastfeed.  A question that comes to mind is whether a nurse has been
exposed to a legal/ethical dilemma where an HIV positive mother wanted to
breastfeed her child?  Does anyone have knowledge of this dilemma?

        American Academy of Pediatrics (1995)  Pediatrics.  "Human milk,
breastfeeding, and transmission of human immunodeficiency virus in the
United States" Volume 96 n5 p977 (3)

        No author (1998) Lancet.  "International Multicenter Pooled
analysis of late postnatal mother-to-child transmission of HIV-1
Infection".  Volume 352 n9128 p597 (1)

        Tess, B. (1998) Journal of American Medical Association,
"Breastfeeding, genetic, obstetric and other risk factors
associated with mother to child transmission of HIV-1 in Sao Paulo State,
Brazil". Volume 280n1 p4k(1).