Hello and Warm Wishes to All; I posted about 10 days ago with a request for references on HIV+ mothers pumping and heat-treating their own milk as an alternative to using formula. I have found no studies that will back this practice; although I did learn that the Ministry of Health in Zimbabwe is recommending this to HIV+ moms there (thanks, Pamela). So, I got a call from the mother in question today and she thinks it is a great idea to post her whole story on LACTNET, as all of us thinking together may come up with some as yet undiscovered solutions/opinions/ideas. This mom first tested positive for HIV during this pregnancy. Her husband of 11 years and her 9 year old daughter have both tested negative. After her diagnosis, she went on the recommended treatment regimen for several months. About 34 weeks along, she read the recent Mothering magazine article which raises lots of questions about the safety of AZT and the accuracy of available HIV tests. She followed up with a good deal of research on her own, including several web sites on HIV/AIDS. About 3 weeks later, she discontinued all her meds, and at around 37 weeks, told us that she'd decided to breastfeed. This was against our recommendation to her. She went into labor at 38 weeks with an occult cord prolapse, had an emergency c/s, and proceeded to breastfeed her son for about the first 8 hours, with the knowledge of the hospital nursing staff and pediatrician. Then she got a visit from the pediatric infectious disease specialist to whom she'd been referred antenatally. The specialist reiterated standard recommendations to the parents, and made a referral to the child protective service, who told the mom that if she breastfed even one more time, her baby would be removed from her physical custody. So she quit, and has been feeding formula. At this point, the child protective service has legal custody of the baby, but the parents are allowed to keep physical custody if they follow the recommended medical treatment plan. She is interested in getting banked human milk for her boy as a more physiologic alternative to formula, and we are looking into that. She is also very interested in donating her milk for research purposes, and my co-worker posted last week about that, I believe. Anybody interested, or have leads for me? IMHO, the research we have available on transmission by breastfeeding is epidemiological, and nobody really knows how to estimate the relative risk to a given baby and mom. It is my feeling that although this mother went against our recommendations, she was making an informed choice. Your ideas and comments are most welcome. And Happy Hannukah, Merry Christmas, Joyous Solstice to ALL From: Martha Johnson, RN IBCLC, in Frozen Eugene Oregon