HIV infection breastfeeding and human milk banking [letter]

Milk from HIV-infected mothers can and will infect newborn infants. There is no way to know how many uninfected newborns of infected mothers would have remained uninfected had they not been breast fed since studies of milk substitution in uninfected newborns of infected mothers have not yet been done. Milk substitution implies that the mothers must be told of her HIV status. She should be told in any case so that she can prevent infection spreading to her spouse and future children. It is also appropriate to inquire as to race and social and sexual behavior of potential milk donors since persons with increased risk of exposure should be excluded as donors. 2 cases are known in which recently infected mothers were advised not to breast feed although their serum was negative because HIV activity might commence in the puerperium.