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  • Title: The breastmilk controversy.
    Author: Panos Institute.
    Journal: WorldAIDS; 1992 Jan; (19):11. PubMed ID: 12284776.
    Abstract:
    In 1991, researchers followed 212 mothers and infants who tested HIV-1 negative at delivery in Rwanda. Later 8 infants tested HIV positive. Both the infants and mothers became infected simultaneously. They ruled out other routes of infection and concluded that the colostrum and breast milk were possibly the route of infection for 4 infants and positively the route for 4 infants. They postulated that when one 1st becomes infected with HIV, one may have high levels of HIV in the blood and thus be more infectious in the time period between 1st contracting HIV and development of HIV antibodies. All the mothers were vulnerable to sexual exploitation because they were either unmarried or widowed or had absent husbands and unstable sexual partnerships. Thus the risk factor of economic and social instability enhanced their vulnerability to exposure to HIV. The researchers suggested that heal professionals should counsel HIV negative mothers who are at high risk about the possibility of transmitting HIV via breast milk if they happen to seroconvert. In some developing countries like Rwanda, no alternatives to breast feeding exist so the researchers advocated intervention studies to assess the efficacy and feasibility of alternative nutritional practices, such as wet nursing, for mothers at high risk of acquiring HIV after delivery. They did not conclude that already HIV infected mothers should not breast feed since research had not yet proved that infants acquire HIV from breast milk of infected mothers. In fact, other research showed that HIV positive infants who are breast fed live longer than bottle fed HIV infants. After publication of this study, WHO continued its commitment to promote, protect, and support breast feeding no matter what the HIV prevalence of a country is.
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