It is very appropriate to comment on these forthcoming documents when
you have read them in full. The reluctance of LactNetters to provide
comments based on the various media reports, which are of necessity
partial and do not have the perspective of breastfeeding specialists, is
greatly appreciated.

The documents are the product of many months of consultation and
discussion among the UN agences which co-sponsor UNAIDS, and are
principally the joint work of the UNAIDS secretariat, WHO and UNICEF.
They will as Maureen Minchin points out soon be published, and can be
ordered in advance from Dr.A.Wieboldt, Chief, Distribution and Sales
(DSA), WHO, CH-1211 Geneva 27, Switzerland or <[log in to unmask]>.  They
will come in a folder of three documents, including a review of the
scientific evidence fcr transmission of HIV through breastfeeding.  The
latest information we received from WHO suggests that the price will be
US$7.00, but LactNetters may want to verify this and learn the postage
cost.

In a cover letter for preliminary distribution of some photocopies of
the documents, Lida Lhotska and I have summarised their emphasis on:
    Ensuring access to voluntary and confidential counselling and
testing for HIV
    Fulfilling each woman's right to make her own decisions, on a basis
of full objective information
    Offering a range of options for infant feeding to HIV positive
women, including breastfeeding and alternatives among which commercial
infant formula is only one
    Taking measures to minimize spillover of artificial feeding to women
who are HIV negative or whose status is unknown
    Specifying that donation of supplies for replacement feeding be done
outside the health care system, and that each infant must be assured a
minimum of six months' supply
    Implementing the International Code of Marketing of Breastmilk
Substitutes and subsequent WHA Resolutions in full, and
    Recommending cup feeding and opposing use of bottles.

LactNetters may wish to consider practices in their own countries, to
determine which of these emphases are well implemented, and which might
not yet be in place, while they wait for the full set of publications to
be available.

May I draw attention to Leroy V et al, International multicentre pooled
analysis of late postnatal mother-to-child transmission of HIV-1
infection, The Lancet Aug 22, 1998: 352:597-600. Available also on
http://www.thelancet.com/newlancet/sub/issues/vol352no9128/body.article597.html

Helen Armstrong, IBCLC, Training Coordinator BFHI, UNICEF New York