Dr. Jack Newman MD

Jack,
I would like to respond to your note concerning the new UNICEF program that
is supposed to be providing free infant formula to babies of HIV infected
mothers.  As you wrote, there are surely people in UNICEF who do not agree
with this approach and would appreciate support from others with similar
beliefs. I agree.   I would suggest that we in Lactnet express our concern
to the following
officers in the UNICEF New York headquarters, keeping in
in mind that we do not know the details of the project that has been
referred to and that it is possible that the media has put out an
announcement that may not be completely founded in fact.

UNICEF New York Nutrition Section Officers      E-mail address

        Roger Shrimpton, Head                   [log in to unmask]
        Joanne Csete                            [log in to unmask]
        Lida Lhotska                            [log in to unmask]
        David Clark                             [log in to unmask]


I have just recently established e-mail contact with Joanne Csete, who has
visited the Pacific region and thus has particular understanding of this
region of the world.  Also recently, I have been in contact with Lida
Lhotska, who is in charge of breastfeeding in the nutrition section, and
with David
Clark, a lawyer  who is in charge of follow-up on the Code of Marketing of
Breastmilk Substitutes.

Although this will be my first contact with Roger Shrimpton, recent
new Head of the UNICEF Nutrition Section, I was very impressed with an
interview with him by the BFHI News, the Baby Friendly Hospital Initiative
Newsletter put out by UNICEF New York.   Roger explained his strong
personal feeling about breastfeeding and the
experience he had when they were awaiting the delivery of their baby in
Brazil, where he and his wife had to fight at the hospital for rooming in
rights to
further support breastfeeding for their own child.  He also emphasized in
that short section about the importance of breastfeeding in growth/survival
of
the child in the first year of life.  Roger has spent many years in
developing countries, also working with UNICEF in Indonesia, as I recall
from that article.

My concern about the distribution of free formula to the babies of HIV
mothers in developing countries is related to:
         -the contaminated water supplies of the families involved
         -poor sanitary practices and inexperience in using formula
         -encouragement of formula feeding in mothers not HIV positive
         -ability of funding organizations to keep up with the supply of free
formula
         -all the health problems and risks involved with bottlefeeding
         -lack of research in the area to warrant such a program

Note is also made that 2/3 of the babies of HIV infected mothers do not
become
infected with HIV, it would be a pity that they now be put on formula and
be
subjected to all the health risks associated with bottle-feeding, thus far
increasing their risk of health problems, poor growth, and possible death.

My experience involves over 25 years living and working in developing
countries
including India, Yemen, Tonga, and Micronesia.

I am copying this letter to my UNICEF colleagues, and also my Cornell
professor Dr. Michael C. Latham and colleague Ted Greiner, Phd, both who
are leaders in international nutrition and in support of breastfeeding
globally.  I hope that there will be a response that may perhaps clarify
this issue, or that may lead to a more satisfactory solution.

Lois Englberger MNS
UNICEF Health and Nutrition Advisor
Federated States of Micronesia
E-mail:       [log in to unmask]