Breastfeeding and HIV [letter]

This paper presents comments on the report of Dunn and colleagues on the estimates of risk of HIV transmission through breast- feeding. It questions the validity of extrapolating such estimates to developing countries. It is assumed that the risk of transmission through breast-feeding differs between traditional societies with predominant breast-feeding practice and industrialized societies where bottle-feeding predominates. Moreover summary estimate obtained by Dunn and colleagues would be higher and with wider confidence interval if it was not assumed that seropositive babies were infected via breast-feeding. The author also suggests the need to determine whether cultural practices affect the risk of transmission via breast-feeding. Moreover another author commented that the estimates of Dunn et al restrict the balance of their argument to the index infant in area with low infant mortality as well as noted the failure of Dunn et al to mention other beneficial effects of breast-feeding.