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.  I have noticed
that there references in the literature concerning breastfeeding and AIDS.
I guess I was not aware a women who is HIV positive should not breastfeed.

In an article by Tess, 1998 JAMA a study was done on 558 women identified
as HIV-1 infected.  The article findings suggested the importance of
reducing transmission of the virus by avoiding breastfeeding.

In another article written for the Pediatrics journal 1995, the committee
listed the World Health Organization listed eight recommendation's for
breastfeeding six of which related to HIV.  Those six recommendations are
as follows; 1) Women and health care providers need to be aware of HIV
               transmission to infants.
            2) Routine testing for HIV for women seeking prenatal care.
            3) At delivery provide education about HIV testing with
               consent of mother, HIV status should be known in order to
               counsel on breastfeeding.
            4) Women who are known to be HIV positive are taught not to
               breastfeed.
            5) Women who are HIV negative should be encouraged to
               breastfeed however, if they are high risk of
               seroconversion breastfeeding may be discourage.
            6) Women whose HIV status is unknown should be informed of HIV
               transmission in peripartum and human milk.

My question concerns the legal aspects of women who are HIV positive and
breastfeeding?  Does anyone know of any case law that mandates a
mother to bottle feed her baby if she is HIV positive?