It is certainly interesting to see the requisite damaging article each summer
before World Breastfeeding Week. This year we see the spectre of HIV--always
good to scare people away from breastfeeding. Notice how this article never
mentioned that formula should be fourth on the list of what to feed babies of
HIV positive mothers, behind the mothers' own pasteurized breastmilk,
breastmilk from a milk bank, breastmilk from a screened wet nurse, etc. I
guess no one makes money off of these options! Did the formula companies
inspire this article? Read on! I am posting the following letter to the
editor of the NY Times for Dr. Naomi Baumslag, author of Milk, Money and
Madness who was interviewd for the artice but never quoted. Other
international pediatric experts were interviewed but because their input did
not fit the agenda of the reporter and the formula companies, their input was
not mentioned. Nestle has been looking for a way to provide one-use
disposable formula feeds as a new market--here it is!!!

Dear Editor:

Barry Meier's simplistic analysis of pediatric AIDS is sensational but
skewed. His use of questionable, non-randomized, non-peer reviewed,
unpublished studies leaves a lot to be desired. AIDS is a terrible disease
and the solutions complex. It is still not possible to accurately
differentiate between intrauterine and breastmilk tramsmission in HIV
positive mothers. Glenda Gray's unpublished study in Soweto, South Africa
which was supported by a leading formula company, has not been available for
scrutiny of either the methodology or the data. At present, NIH is funding a
ramdomized clinical trial in Nairobi, Kenya on HIV and breastfeeding, which
may provide quality scientific evidence to formulate health policy.

It is estimated that the risk of HIV transmission from a HIV positive mother
to her infant is one in seven. It is, however, a fact that the mortality from
diarrheal disease for bottle-fed infants in developing countries is doubled
if they do not breastfeed. Meier's report is biased. The interviews with
internationally recognized pediatric experts were ignored but interviews with
Rod Leonard (director of the Community Nutrition Institute) and Edith White,
both board members of Action for Corporate Accountability were reported. It
should be noted that this organization is no longer associated with IBFAN
(International Babyfood Action Network) as it is working with industry and
has conflicting interests. Thad Jackson, an advisor to CNI and Action, has
been an employee of Nestle's for years as director of special issues relating
to formula. The opinions of Nestles cannot be objective considering their
violations of the WHO International Code of Marketing of Breastmilk
Substitutes recently reported in the British Medical Journal.

It will be important to ascertain the effects of exclusive breastfeeding
compared to partial and full bottle-feeding on the transmission of AIDS as
well as timing of transmission through breastfeeding. In infants of HIV
positive mothers, if breastfeeding is a risk factor, expressed pasteurized
breastmilk, screened wet nurses, milk banks, and other more affordable
breastmilk substitutes other than formula will have to be developed and made
available.

Peer reviewed randomized studies are needed to forlumate policy that will be
in the best interest of mothers, not formula company-driven research for new
markets.

Naomi Baumslag, MD, MPH
Clinical Professor Pediatrics
Georgetown University Medical School