Here I am, winding up the end of my time on medical leave from my latest surgery. Good thing too. My butt is getting awfully sore from sitting on it at my computer most of the day (doing various homework assignments, studying, and generalized computer time).
I'm missing births too!
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Have you heard the latest buzz? It's world HIV/AIDS day today. According to this site, HIV infections are down by about 20% in the past 10 years, but we still have quite a way to go at improving national and world HIV statistics. There is also this site: No Child Born With HIV by 2015. What bugs me a little bit is this medical fact: babies usually are not born with full blown HIV (in fact, they simply aren't born that way); instead, they can contract the HIV virus during pregnancy or the birth itself. However, they may not show up as positive with HIV antibodies until months or even years later. (Please, someone correct me if I'm wrong on this!)
With the latest progress in preventing transmission of HIV from mother to neonate, there is a very slim chance of a baby becoming infected with HIV from his/her mother during pregnancy or the birth process. I mean, a super, duper, LOW risk of it happening. IF the mom's viral load stays low/undetectable during pregnancy, IF mom receives proper anti-viral therapy during pregnancy, IF mom receives proper AZT infusions before labor and during labor. THEN the chances of HIV transmission from mom to baby are slim to nil.
Thank goodness for that, at least.
12 comments:
Glad you're getting back to your baseline!!
Great timely post, AYC! I hope you are well.
Jim
Babies born to hiv positive mothers all test positive for the antibodies.
They no longer test positive after the age of 18 months, unless they are, in fact, infected with the virus.
All hiv positive mothers should not breastfeed their babies as they can be infected that way as well. Also, newborns born to hiv positive mothers must have a dose (which increases as they grow) of AZT every 6 hours for their first 6 weeks of life.
Vertical transmission can be reduced to less than 1% if current protocol is followed. Birth defects run a risk of 3%. So babies born to hiv positive mothers have excellent odds in developed countries where testing and treatment are readily available.
Anonymous - thank you for the info about HIV transmission and antibodies in the newborn. I didn't know some of that info.
I believe I read that as long as mother and baby are medicated, HIV+mothers CAN nurse their babies.
However it is very important that the baby not be fed anything else. I think this has to do with gut permeability. This research was done in Africa, where not breastfeeding can also be a death sentence for babies. This is just from my memory, but anyone in this position or advising a woman in this position should find out about it before telling her she can't breastfeed at all.
Susan Peterson
http://www.buanews.gov.za/news/10/10120310351001
http://www.timeslive.co.za/local/article795105.ece/KZN-breastfeeding-gets-Unicef-thumbs-up
http://www.afriquejet.com/news/africa-news/kenya-sets-aside-sh-450m-to-fight-paediatric-hiv-2010112662045.html
I haven't found one yet which says why *exclusive* breastfeeding is important to reduce transmission.
Susan Peterson
Susan- I think you were on the right track with the gut bacteria- we know that exclusive breastfeeding is the only way to boost your babies immune system- any bit of formula will change the makeup of the bacteria in the babies' gut for the worse and makes transmission of the disease much more likely. I'm sure that doctors tell HIV positive mothers not to breastfeed because so many women end up supplementing and they may not be up on the current research that supports breastfeeding.
I agree with Susan - from what I've read, it is the combination of formula (or possibly table food) plus HIV-infected breastmilk that is bad, while transmission from breastmilk alone or formula alone is low. What I remember is that breastmilk is so easily digested, that the baby's alimentary canal stays completely whole, but that formula (and possibly "real" food) is so much harder on the baby that it can or does open up microscopic tears in the gut, thus allowing the HIV that is present in the breastmilk to enter into the bloodstream.
-Kathy
I should have specified that hiv positive mothers with access to clean water and formula or donor milk from a safe source are told not to breastfeed their babies. Exclusive breastfeeding for the first 6 months is recommended for the reasons listed above, but only to women in developing countries.
An HIV-positive woman in North America who breastfeeds and discloses that choice could possibly face a legal threat of having her children removed by authorities and being charged with a crime.
Well, anonymous, since the risk of transmission is so low if mother and baby are medicated, I think this should be the mother's choice.
I can think of one situation in which I would agree with intervention to prevent a mother from nursing her baby, and that is the situation someone I know was in. Her baby was found by those metabolic tests done on newborns to have galactosemia. The baby was already lethargic when the state health department called her. She had to feed the baby a meat based formula. (Soy also has lactose in it.) If a mother refused to understand in such a case that breast milk would soon kill her baby or cause it to be retarded, in that case I can see state intervention...briefly, while someone worked with the mother to help her understand, teaching her about the baby's problem and what would happen to the baby.
When I heard my friend's story I thought how awful it would be to know that your own milk would kill your baby or injure its brain, and how very difficult I would find that.
But the HIV situation just isn't that clear cut.
Susan Peterson
Susan, the risk of infecting the baby is only 1% if current protocol is followed- including abstaining from breastfeeding. The risk of infecting the baby through breastfeeding was 14% the last time I reviewed the statistics. That seems awfully clear cut to me.
What Mother would knowingly risk it if she had a choice?
Flash-heating can kill HIV, while keeping the immune factors of breastmilk alive: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779733/pdf/nihms126967.pdf.
-Kathy
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