Thanks to so many who wrote supportive notes in response to my HIV and donated formula rant. In particular, thanks to Kathleen Miller for opening the door for me to express my concerns on this very vexing topic by asking about donations of formula; to Jack for outlining some of the logistical and administrative glitches that would ensue; and to Heather for her vision of how formula-feeding could take hold in Africa. The words "disaster", "catastrophe" and "sick at heart" are all apt. You cannot mention breastfeeding anywhere without being quizzed about the risks of HIV-transmission. Our national World Breastfeeding Week has been toned down so that breastfeeding is not promoted *too* vigourously. Our beautiful new Code has no Committee to enforce it, no doubt to leave the door open for the donations of formula that are about to land in our midst. Heather makes some excellent points, "Please don't lets suggest that ABM manufacturers donate their product to Africa free of charge... multinationals .. who could easily cope with the temporary blip in profits. Then, when bf is virtually destroyed as a cultural option, they can start charging realistic prices once more - with a market they have created themselves...I asked the list yesterday if it was a practical option for rural mothers to heat-treat their own EBM. If it is, should we be pressing UNICEF and the aid agencies to help mothers do just that? Can we write to relevant organisations urging this?" There are a few of us here who have been thinking along similar lines. In the absence of further research, and with the knowledge that the HIV virus is heat-labile, the mother's own EBM, which has been brought just up to boiling point, would seem like the safest feeding alternative for the HIV+ mother who is advised not to breastfeed. Mothers can be taught how to manually express their milk, and they *can* maintain breastmilk production for many months and sometimes even for years according to Lactnet subscribers who have so kindly responded to my request for case-histories. Rural mothers cook on wood fires two or three times per day so a little container of EBM could be heated at the same time. If mothers were encouraged to provide their own EBM for their babies, there would be no need for dependence on outside sources of supply which could "dry up" at any time, as Jack points out. There would be virtually no cost to mothers, communities or governments. Furthermore (and probably best of all) mothers could retain control over their babies' food security while still providing the safest alternative. So YES, let's press UNICEF, WHO, UNAIDS and other aid agencies to support the research and the feasibility studies. (Does breastmilk need to be boiled, or will a lower temp kill the virus? How long can you keep boiled EBM at temps ranging from 22 - 35 degrees C before bacterial proliferation makes it unsafe to be fed to the baby? What kind of bacteria is found in EBM expressed in a little hut in the bush, or a little tin shack in the city? Do HIV+ mothers see this as an option if we can assure them it is safe? What kind of assistance do they need? And, good Heavens, if this option proves to be the safest alternative for African babies, should we not be promoting it for American and European babies too?) And YES please. Do let's write to the relevant organizations requesting them to take up this issue. I have already written to ILCA. LLL South Africa has already issued a statement from their recent Conference. I have been told that breastfeeding advocates are speaking "in whispers", and that their voices are "muffled". It is time for us to start speaking up. Pamela Morrison IBCLC, Zimbabwe (hoping that all is not lost yet, while we can still keep asking questions!)