Dear Kathleen:  I've recently done a literature search on HIV and
breastfeeding.  In the United States, the CDC has only contraindicated
breastfeeding in HIV positive women.  Although some states are trying to
include women at risk of HIV, this is still very controversial.  The
reports of transmission clearly through breast milk were from women
previously HIV negative who became infected while nursing.  Although
there appears to be some transmission through breast milk from previously
HIV positive women, the studies have not always been able to separate
transmission during pregnancy from breastfeeding transmission.  Your
patient, if she has not engaged in high risk behaviors since this guy
disappeared,(i.e sex without a condom, and of course no IV drugs)is not at
risk of becoming infected while nursing.  As far as risk of seroconverting
more than nine months after his departure, unless I am behind the time, I
believe she would have seroconverted within 6 months if he had infected
her. I just want to clarify again the difference between becoming
infected, i.e. getting the virus into one's system, and seroconverting,
i.e. having a positive blood test for HIV. I will be attending an HIV
conference tomorrow, so I'll ask the experts about the outside limit for
seroconversion.  Only if it's longer than 6 months is there any chance
that this mother could still have the HIV virus.  So unless I'm wrong,
she has no reason for concern.  I'll try to get back with the info as
soon as possible, since time is of the essence in this situation.  Good
luck, Alicia.  [log in to unmask]