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Subject:
From:
"Valerie W. McClain, IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 11 Mar 2000 18:57:27 EST
Content-Type:
text/plain
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I believe Magda's comments in regard to breastfeeding and hiv, as well as
Heather's comments about a mother's and infant's right to breastfeed, are
important.  I believe we, breastfeeding advocates, are standing on the edge
of a "new world."  We have many choices in front of us.  It is clear that our
beliefs in breastfeeding have been tested and will continue to be tested.

The only think I would add to Magda's post is that we all need a better
understanding of the CDC's decision to discourage breastfeeding in 1985.  My
understanding is that it was based on Thiry et al 1985 and Ziegler et al
1985.  Thiry et al is a letter to the Lancet relating the finding of hiv in
three samples of cell-free breastmilk from diagnosed hiv-positive women.
Ziegler et al is about 1 infant who was diagnosed hiv positive at 3 or 4
months of age.  The mother breastfed the infant for 6 weeks.  The mother had
had a c-section and required a blood transfusion.  The CDC web site has this
1985 breastfeeding policy decision and these are the only "studies"
mentioned.  The conclusion one is left with is that 4 cases are the basis of
this decision.  Was this decision reviewed?  Anyone know?  If this decision
has never been reviewed, it can only make one wonder.  Nduati in her recent
study in JAMA(March 2000) sites the CDC decision in 1985 as the standard for
all industrialized countries.  A standard based on 4 cases and now being
pushed as a standard for the rest of the world.  Fear closes the mind to many
ideas.  Fear surrounds the issue of hiv and breastfeeding.  I am hopeful that
we can collect our courage and open the light into this issue.  Valerie W.
McClain, IBCLC

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