HIV, lactation and the States

[nsnvbella]

Hi, I’m a nursing student currently doing my BSN. First off I want to thank anyone who chooses to respond. This posting is part of an assignment for class and your input would be greatly valued.

The WHO recently published a research study (Bull World Health Organ. 2005 Jun;83(6):418-26. Epub 2005 Jun 17) that determined the association of different feeding patterns for infants with HIV infected mothers, with mortality and hospital admissions. The study used populations from three developing countries (Ghana, India and Peru) and showed that in the 9424 infants monitored mortality was higher in those who did not breastfeed than those who did (predominantly breastfed and exclusively breastfed). Death in non breastfed infants were mostly related to acute lower respiratory infections and diarrhea.

As I have learned in class (and from Dr Green, http://www.drgreene.com/21_552.html) breastfeeding is far superior to any other means of infant feeding. Due to that fact that its composition includes immunoglobins, lactoferrin (which have an antibiotic effect on bacteria such as Staph and E.coli), Lysoszyme, Growth Factors, Allergic factors, Carnatine, and DHA & AHA, in relation to formula there is no comparison.
The American Academy of Pediatrics stated in their policy concerning breast milk that they have found it to reduce the incidence and/or severity of diseases such as diarrhea, lower respiratory infections, ear infections, bacterial meningitis, and urinary tract infections. (American Academy of Pediatrics Work Group on Breastfeeding, Pediatrics 100:1035-1039, 1997)].

As searching previous posts from Lactnet as well as searching PubMed I found many entries on breastfeeding and HIV in developing countries but not many specific to the States. My question is what are the current practices concerning lactation and the HIV infected mother here in the States (for nurses, midwifes as well as nurse practitioners) and/or what have you personally experienced or seen in the clinical setting concerning this subject?

Once again thank you for your input.
Isabella, RN to be.

[qcumba]

I dont know about the states but here in S.A we advocate breastfeeding for mothers who have H.I.V, but if they are going to breast feed they are advised to breastfeed exclusively, the baby is not even allowed water, as the introduction of other fluids eg water, formula damage the flora and lining of the GI tract and only then will the baby become susceptible to the virus, it is also cheaper for the more disadvantaged moms.