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Saturday, March 31, 2007Nope, I'm not just being sensationalistic...
Before you read any further, go and look at this German ad.
The rough translation of that ad is:
"the chin from grandpa, the eyes from dad and AIDS from mum"
Now, go and view the second ad from the campaign.
Rough translation of that ad:
"same as mum - having AIDS" as the headline
"the babies get infected during birth or through breastfeeding" in the text.
Now, this ad has the breastfeeding community up in arms. Absolutely 100% up in arms. How DARE those ads tell women that breastfeeding will cause their babies to get HIV. Don't they know that exclusive breastfeeding lowers the risk of HIV
Well, once again, I'm going to take the unpopular view point...
You see, these ads are tasteless...there's no doubting that. (Especially since you can't deny that mom sometimes gets AIDS from dad, so let's keep the "blame" where it belongs...) I liken them to the American campaign for breastfeeding that had pregnant women competing in log rolling or riding bulls and compared it to not breastfeeding. It's sensationalistic and does far more to offend than it does to convince.
However...I'm a little astonished at the fact that all of the email lists that I'm on that feature breastfeeding professionals are focusing in on one theme...
Exclusive breastfeeding reduces the risk of HIV transmission.
From Science Daily:
A study by scientists at the Africa Centre for Health and Population Studies, South Africa, has shown that exclusive breastfeeding can significantly reduce the risk of HIV transmission from mother to child in infants aged under six months when compared to those also given solid foods or replacement feed (i.e. formula milk).
Now...go back and read that again and notice the word "also" in the last sentence.
I've taken a look at the study and to save you the time, here's the deal.
HIV positive mothers that EXCLUSIVELY breastfeed their babies for a full six months have MUCH lower transmission rates than HIV positive mothers that introduce formula or solids IN ADDITION TO BREASTFEEDING during the first six months. The theory is the introduction of formula or solids causes some damage to the virgin gut. These tiny spots of damage make it easier for the HIV virus to pass through the digestive system and into the blood stream. Makes perfect since when you think about it. Secondary causes are that a mom that does not exclusively breastfeed is more likely to have mastitis, plugged ducts and other breast issues that could pass blood (which more easily transmits HIV) into the mother's milk.
So here's how the results break down.
Exclusively breastfed: 4% risk of transmission
Breastfed AND formula fed: 8% risk of transmission
Breastfed and fed solids: 40%+ risk of transmission
Now, let me inject a little bit of reality into the situation...
NOT breastfeeding (i.e. going straight to donor milk or formula) carries zero risk of transmission once the baby is born.
So let's break this down further, because there are two issues at play here...
In African nations (and other developing nations) where HIV is running rampant, people are poor and clean water sources are scarce, breastfeeding can mean the difference between life and death. While there are obvious risks to formula in developed nations, those risks are multiplied significantly in third world countries. Without clean water sources to prepare formula and without the income to actually afford formula, the risk of a baby dying from intestinal diseases is extremely high.
In fact, in Indonesia, one in ten children dies each year from diarrhea.
Consider the following from an article on the state of health in third world countries.
Formula is relatively expensive: for a three-month-old child, it can cost 50 to 60 per cent of the minimum wage in some developing countries, plus the price of the equipment. Because of the high cost there is a tendency to stretch the formula by overdiluting it. This practice leads to nutritional marasmus, a condition resulting from severe protein and calorie deprivation.
Breast feeding is cheaper and always nutritious; the only added cost is for the mother’s extra nutritive needs. Although the components of breast milk will vary depending on the woman’s health, even an undernourished mother is a remarkably efficient producer of nutritious human milk.
Contamination of the formula, the bottle or other equipment leads to infectious diarrhea. Breast milk comes sterile from the breast. And anti-infective properties cannot be put into formula, nor is there any indication that such a process will be possible in the near future. Conversely, at least a dozen anti-infective factors are found in breast milk, including antibodies, lysozyme, lactoferrin and interferon.
In other words, even for mothers that are HIV positive, the risk of disease transmission is much lower than the very real risk of death simply due to not being breastfed. In these situations, breastfeeding is a no brainer.
Now, with all of that said...where exactly is it that I differ from many people on this issue?
Well...I'd just like to note that the ads are running in Germany, not in a third world nation. In Germany, much like in the United States, the risk of HIV transmission from a pregnant mother to a baby can be reduced to about 2% through the use of anti-virals. Once baby is born, formula is easily available, as is a clean water supply. Children in Germany and the United States are at extremely low risk for dying from diarrhea and other intestinal diseases. In fact, even if they contract them, treatment is available that virtually assures they'll come out healthy on the other side.
So knowing that breast milk is the BEST form of nutrition, but that formula is extremely likely to result in a healthy baby as well...
Why in the WORLD would you encourage a mother to risk a 4% transmission rate of a disease that kills every single person that contracts it? When the risk of death from using formula is far, far lower than that?
It's called the risk/reward ratio people.
So could someone please explain to me how the 4% risk of HIV transmission is worth the reward of what breast milk gives? Sure, it's great for that 96% of babies that end up healthier and HIV free...but what about that 4%?
To be completely blunt, let's put it this way...
If your child was born and you were told that if you chose to breastfeed instead of formula feed, that your baby would be lined up with 24 others and one of them would be randomly killed.
What would you choose?