HIV and breastfeeding

[smeep]

I hope it's okay to post this here but since a lot of the lactivists tend to read a lot of articles and do a lot of research (and nitpicking on them! ) I thought maybe this would be a good spot.

I'm doing a research on HIV and breastfeeding. I need links, links, links! I've already dug pretty far but I've got more to go. And what I'm looking MORE for is things on the "other side" of the debate (i.e., leaning more towards nursing than not nursing...however it goes about that). And if anyone knows of any articles or anything that talks more about nursing with HIV against the risks of not breastfeeding in the US or other places that would really, really help! The most I can find is only in regards to Africa where it's far clearer that the risks of not breastfeeding outweigh the possible risks of nursing while HIV+.

So, yeah, gimme all ya got!

[Momily]

I don't have a whole lot of information or a whole lot of time, but this is an issue that's dear to my heart for a variety of reasons.

I think most of the information

One thing to keep in mind, that I think is often obscured when people talk about research in this area, is that the research that shows benefits in terms of transmission rates for breastfed infants are very specific to exclusively breastfed infants. I think this research is actually a very potent example of the power of the "virgin gut" in that even a single bottle of formula or taste of solids changes the statistics -- pretty dramatically as I recall.

One of the reasons why this research is hard to transfer into practices in the USA is that pretty much all infants who are identified as HIV exposed before/at birth in this country are given antiretroviral treatments. This treatment is pretty miraculous in that the number of infants who contract HIV in the US these days is miniscule. However, I would imagine that it's likely that even a single dose of powerful medications like AZT would be enough to destroy the protection of the "virgin gut".

In addition, of course there's the fact that while EBF protects babies from the risk of pre or peri-natal infection, it carries with it the risk of exposure/infection via breastfeeding. In EBF infants who don't have access to preventative treatment the overall risk of contracting the virus is still lower than in formula fed infants, however in infants who take prophylactic medications, the risk of pre/peri-natal transmission is already almost zero, so adding any kind of risk of transmission via breastfeeding is going to result in increased risk.

It's all so confusing, and I'm barely scratching the surface of the issue here, but I wanted to throw those ideas out there because I don't think they're always obvious to people looking at the research for the first time.

[smeep]

Thank you, Momily! I've already thought of that except the drug/gut thing. And weighing the risks of the meds and the flawed and really iffy studies on them further complicate it. What I'm having a hard time with is risk of not breastfeeding in the U.S. by percentage vs. risk of death or serious complications from possible HIV transmission in the U.S by percentage. And better numbers of false test results.