I’m HIV+ : Can I Breastfeed?

The answer to this may depend more on where you live than how safe it is. 


In a recent podcast with How Positive Are You, Marian Tompson, a co-founder of La Leche League International, talks about her long-time search for answers to questions about breastfeeding and HIV.

Marian remembers back in 1997 when the World Health Organization (WHO) published its recommendation that HIV+ women should not breastfeed. Period.  Marian questioned the science behind these recommendations and began the online chat group, Another Look, to examine current research on HIV and breastfeeding. She invited doctors, nurses, and policy-makers from both sides of the issue to participate in the discussion “because I felt that we really needed to listen to each other.”  

I interviewed Marian while doing research for This Child of Mine in 2000.   Back then, one of her biggest concerns was that the lack of compelling evidence that breastfeeding while HIV+ was dangerous. In fact at least one study showed that among mothers who exclusively breastfed, there was no higher risk of HIV transmission than among mothers who formula fed. 

Someone must have been listening. In 2010, after a series of new studies that demonstrated strong evidence of positive health outcomes for breastfed HIV-exposed babies, WHO and UNAIDS reversed their earlier recommendations.  Now mothers are advised to exclusively breastfeed for six months in conjunction with antiretroviral treatment (ARV) for themselves and their babies.

The catch is that, in reality, this recommendation only applies to women living in resource-poor countries where formula feeding can be a death sentence because of the lack of access to clean water, and the long-term sustainability and cost of formula feeding. In most countries, while there are no laws prohibiting HIV+ mothers from breastfeeding, choosing to do so can result in a mother losing custody of her child. Marian refers to a recent study of mother-baby AIDS clinics in Chicago where nurses were asked in a questionnaire what to do if an HIV+ mother said she wanted to breastfeed. The unanimous response? Time to call the lawyers. 

In the podcast Marian talks about a few cases where this has happened, including the 1999 case of Kathleen Tyson, one of the mothers in This Child of Mine. In fact, Marian says that for a long time La Leche League counselors were afraid that supporting HIV+ mothers who wanted to breastfeed could land them in jail, and passed all calls of this nature on to Marian.  


She points out that even now, over ten years later, with new research and guidelines,  there are still very few resources for HIV+ moms who want to do something differently than they’re told. Many end up lying to their doctors, their neighbors, their friends -even going underground   to do so.

Pro-Life for Baby Joseph

Do hospitals have the right to remove a child's life-support against the family’s wishes? 

15-month-old Joseph Maraachli suffers from Leigh’s disease, a rare but fatal neurodegenerative disorder. Back in October his doctors concluded that that he was in a vegetative state from which he would never recover. Consequently, the government-run hospital in Canada where Joseph had spent most of his short life handed his parents an oxymoronic order to consent  to remove his life support. Joseph’s parents requested that the hospital perform a tracheotomy instead so that he could breathe on his own long enough for them to bring their son home to die.

The hospital refused, stating that a tracheotomy was indicated only for patients who needed it for long-term care. Joseph didn’t. So they wouldn’t. As if trying to provide your child with a dignified way to die isn’t bad enough, now you have to go to court to do it.  But the Ontario Superior Court, too, rejected the family’s appeal.

Enter Priests for Life, a Catholic group that funded Joseph’s trip to a hospital in St. Louis, Missouri where he finally got his tracheotomy. In April, Joseph returned home to Canada with his family. They, along with their 15,000+ Save Baby Joseph Facebook friends are all praying for a miracle. Meanwhile, the Christian Broadcast Network has hailed Joseph’s plight as a “Pro-life victory”. Capital P.

Well, maybe it is, and maybe it isn’t.  I’ll give credit where credit is due but mere moments after the hospital’s decision came down, Joseph became a crucible for another agenda: the case against ObamaCare.

AHA!,  roared the critics with palpable glee. THIS is what you’ll get with a government-run health care plan. No choice, no freedom of health care! Hmmm. So, using this logic, can I assume that the current “freedom-based” private healthcare system would consent to an arguably futile, expensive procedure like the one Joseph got?

Well, okay, maybe not.  But with ObamaCare, get ready for death panels like the one that wanted to pull the plug on that poor baby.

But wait a minute, haven’t you heard the good news?? If you’re on life-support and you live in Texas you don’t even need a universal health care plan to set up a death panel ‘cause they already have a law for that.

Yup. The Futile Care Health Law, as it’s politely named in Texas, basically states that a hospital, in consultation with an Ethics Committee, can opt to discontinue life support when a patient is in an irreversible vegetative state.

Oh. So that’s what this is about? Ethics?

But hang on, it gets better. If the family objects, they get ten days to find another hospital. Now that’s ethical. Although, most states mandate longer notice for apartment evictions. And the best part of all?  This bill was signed into law in 1999 not by President Obama or some hippie-freak politician on the fast track to socialism, but  by one good-ole-boy-cum-Governor, George W. Bush. And other states now have similar laws but without the creepy deadline.

Look, I’m not trying to make a case for ObamaCare. But I do find it chilling that this family’s tragedy can be used so disingenuously, so sloppily, for a political agenda.  Would ObamaCare kill baby Joseph? No. Leigh’s Disease will. If his parents had insisted that the hospital keep Joseph alive indefinitely, at any cost- financial or ethical, that might have been different. But they didn’t. They accepted his imminent death; they just wanted it happen in the quiet comfort and grace of his own home.  

Ranting aside, it’s easy to espouse platitudes about the dangers of putting price tags on human lives. Someone still has to pay for it, and health care plans – government or private  - are universally dispassionate in making expensive decisions.  And nobody wants say it’s okay and even necessary to let a child die even when all efforts to support life will most certainly fail. Nevertheless, in my own pro-life way, I believe that even dying people should be able to choose quality of life and death, no matter the quantity. 

What do you think? Should the hospital have granted the Maraachli family’s request? Was it the ethical responsibility of the hospital to do so despite the clear futility of such a procedure in prolonging his life?  Please post your thoughts……