Here is a situation that I can't go into detail about due to legal issues:

A mom delivers a baby at one of our hospitals. When I see the mom and the
baby she tells me her plan is to breastfeed exclusively since she breastfed
her other children. I tell her she does not need to supplement, the baby was
nursing well and to keep up the good work. The next morning I come in to
find the baby has been given a bottle of formula overnight. When I ask the
mom about it she tells me that the night nurse recommended doing that so she
could "get some sleep". This has been a long standing problem with certain
nurses.

Here's the rest of the story:
She went home and breastfed exclusively for almost 3 months, until one night
when her husband told her he had tested positive for HIV and that she should
get tested. [She had tested negative on prenatal labs.] She immediately
stopped breastfeeding. Her test results came back positive. As we were
waiting for the results to come back she asks about the chances that the
baby has gotten HIV. I had to tell her that from the latest information we
had, it appears that exclusive breastfeeding carries the same level of risk
as formula feeding, but mixing formula and breastfeeding exposes the baby to
more of a risk. I told her that I did not know how much more of a risk that
one bottle of formula placed the baby in, but that from what I had read, one
bottle of formula changes the flora of the baby's digestive system for
somewhere between 2 to 3 weeks.

Not a pleasant situation to be a part of.

Gail Hertz, MD, IBCLC

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