I have not worked with any mothers who are HIV+ and have followed with interest all the comments in recent days on this topic. One thing I was thinking about is that pasteurizing her milk so she could feed her baby with her own breastmilk would give her satisfaction in one sense. But I think it would also be important to explore with such a mother her feelings about breastfeeding in its other dimensions. While it sounds like she could possibly safely give her baby her pasteurized breastmilk, she would not be able to feed her baby at her breast. She might need a chance to talk about her sense of loss in this regard. Other ways of nurturing her baby (shared sleep, "wearing" her baby, and other ways of enhancing attachment parenting) could be shared with her. I don't know whether it would be helpful to try cup feeding, because a baby in this situation would need some way to satisfy his sucking needs. Use of a pacifier/ bottle nipple for feedings would give this, but of course this baby wouldn't derive the benefits of breastfeeding in terms of tooth and jaw development. The mother could be encouraged to vary the sides on which she holds the baby, so the eye and facial muscles develop equally (just like we encourage bottle feeding mothers to change sides). Still, I would think a caring listener would be important, just to be there if she wants to talk about her feelings of loss about not being able to provide all the aspects that are a part of breastfeeding, and to acknowledge how much she wants to give all she can to her baby. Anne Altshuler, RN, MS, IBCLC