I have been reading this with interest.  I just thought I woud remind you
all that the official line (here in the UK from the Deaprtment of Health,
supported by Royal College of Midwives, etc -- don't know the precise
structures in the USA or elsewhere) is that this form of feeding --
breastmilk replacements by bottle (occassionally by cup) is considered to be
the *only safe form of feeding* for babies born to women diagnosed HIV
positive.

But the research on HIV transmission rates is equivocal --  almost all
studies have been done with *no* attention to breastfeeding style -- and the
only study, to date, to distinguish exclusive breastfeeding from mixed
breastfeeding, showed completely different transmission patterns.  Yet in
the face of such poor evidence, interventions to avoid breastfeeding are
being imposed not only on women in Western countries but on women in Africa,
Asia and many places around the globe.  (And I should mention that studies
have largely looked only at transmission rates, not at health outcomes.)

If we treat this debate as seperate from discussions of other kinds of
promotion of bottle (as in replacement) feeding we are going to wake up one
day and find that we are living in a world in which it is *accepted* that
there is a very big 'advantage' of bottle feeding in terms of HIV
transmission.  Or -- are we there already?

Magda Sachs
Breastfeeding Supporter, BfN, UK

ps I will just remind you that there are some good papers on HIV and
breastfeeding at:
http://www.anotherlook.org/
http://www2.hawaii.edu/~kent/
http://www.geocities.com/tedgreiner/

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