World Health Organization: hiv and breastfeeding

In November of 2009, the WHO (World Health Organization) issued a document called, "HIV and infant feeding: Revised Prinicples & Recommendations." There was alot of jubilation from breastfeeding advocates who believe this is a breakthrough document encouraging hiv positive mothers to breastfeed exclusively. Well..................yes, the recommendation is, "mothers known to be HIV infected (and whose infants are HIV uninfected or of unknown status) should exclusively breastfeed their infants for the first 6 months of life, introducing appropriated complementary foods thereafter, and contine breastfeeding for the first 12 months of life." But the recommendations also state that "HIV infected mothers to either breastfeed and receive ARV interventions or avoid all breastfeeding." This recommendation is not directed at developed nations like the US. In fact there is a scary comment regarding "highly resourced countries." "In some of these countries (highly resourced) infants have been removed from mothers who have wanted to breastfeed despite being HIV infected and even being on ARV treatment. In these settings, the pursuit of breastfeeding in the presence of safe and effective alternatives may be considered to constitute abuse or neglect." So if you are a hiv-infected mother living in Africa you can breastfeed your baby as long as you take meds. If you are a hiv-infected mother in the USA, you will be considered abusive or neglectful if you breastfeed your baby. Geography is the key to recommendations regarding breastfeeding and hiv. Does this make any logical sense? Does this clarify the situation? One way or another, this issue makes enormous profits for the pharmaceutical and infant formula industry (which often are one and the same companies). For information on studies regarding the safety of these drugs for mothers and babies readers may want to go to the website of Alberta Reappraising AIDS Society:

http://aras.ab.ca/art-perinatal.html

and

http://aras.ab.ca/haart-perinatal.html

I would highly encourage breastfeeding advocates to read the beginning of this document regarding the declared interests of the writers of this document.

http://www.who.int-child_adolescent_health/documents/hiv_if_principles_recommendations_112009.pdf

The writers and researchers have financial ties to: Nutriset, Bristol Myers (infant formula and pharm company), Centoceor, Johnson & Johnson, Ortho Biotech, Ortho-McNell Janssen, Purdue Pharma, Roche, Sanofi-Aventis, Schering Plough. But boldly they state, "The Group unanimously agreed that none of the declared interests were likely to influence the discussions of the meeting." So by making this statement the readers are to believe that how one is funded makes no difference? Years ago, I believe no one could have gotten away with such statements. But now one can make such statements and the document gets hailed as a breakthrough because it recommends that hiv positive women in resource-poor nations breastfeed. Of course they can only do so as long as they take meds. And now we have an international document that states that hiv-infected mothers in resource rich nations are abusive if they breastfeed. I call this a serious step backwards and one that needs to be questioned. Why should we believe that this decision was not influenced by the pharmaceutical and infant formula industries?

Copyright 2009 Valerie W. McClain