I can't let the following statement go unexplored on Lactnet:

"Universal breastfeeding is not recommended in the United States. Women who
use illicit drugs, who have active, untreated tuberculosis, or who test
positive for HIV, as well as those who use certain prescribed drugs, should
not breastfeed."

I am not sure if it was a direct quote from the CDC guidelines, but it read
as the opinion  of the poster.

Exclusive breastfeeding causes no more transmission of HIV than exclusive
formula feeding. (Coutsoudis et al, 1999, 2000, 2001 and probably more).
In addition, babies are protected from all sorts of other illnesses by
exclusive breastfeeding.   If a baby was to have been infected in
utero/delivery, breastfeeding is the most normal and*humane* way of feeding,
to ameliorate the symptoms the baby will suffer in his/her short life.

Since it appears that people are most likely to transmit HIV at time of
sero-conversion (ie newly infected, or with AIDS), timing of infection could
be discussed and use of anti-retrovirals if the mother chooses that route.
These past few weeks have seen out-of-the-box thinking on adding certain
pro-biotics to the baby, though I'm not sure how this ties in with exclusive
breastfeeding.

At the very least, the CD4 counts of the mother could be investigated, as
well as an assessment of her circumstances, before a decision is made as to
whether her HIV infection constitutes a bigger risk to her infant than other
infections that breastfeeding prevents.

Almost universally, it is recognised that it is the mother's choice to
breastfeed or not.  It is my understanding that there is no formal law in
USA to stop HIV+ mothers breastfeeding, just an unwritten rule.  If
lactation experts can't speak up for breastfeeding, who will?  We do not
need guidelines against breastfeeding with HIV, we need information on the
importance of exclusive breastfeeding, and support for mothers who want to
breastfeed.

A question: Why would an American woman have untreated TB?  And wouldn't any
mother with untreated TB caring for a baby be at risk of passing it on?   My
mind is just boggling at someone telling a mother that she couldn't
breastfeed her baby because she has untreated TB, instead of just treating
her.

Jacquie Nutt IBCLC
South Africa
Where official government policy is to encourage and support exclusive
breastfeeding OR exclusive artificial feeding, according to the mother's
choice, but admittedly there are health workers who push their own choices
on to the mother.

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html