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Taking Action to Ensure Breastfeeding as a Human rights Issue and Explore Informed Choice in the Context of HIV and AIDS

La Leche League 18th International Conference
Strength through Diversity - Creating One Breastfeeding World
San Francisco, California, USA
July 3-6, 2003

Saturday, July 5 - Session #229
Global Issues - Taking Action to Ensure Breastfeeding as a Human Rights Issue and Explore Informed Choice in the Context of HIV and AIDS

Presenters: Elisabet Helsing
Facilitators: Anna Coutsoudis, Marian Tompson and Selma James

Elisabet Helsing explored the issue of breastfeeding as a human right, particularly in the context of HIV and AIDS. Breastfeeding is the natural way of child feeding, however there are situations when the costs exceed the benefits. There are individuals and organizations that state that in these situations it is a woman's right to choose not to breastfeed. Helsing discussed the possibility of viewing this particular situation through a different perspective. Infants have a human right to be breastfed, and women have the right to be empowered to fulfill this duty. A woman's right not to breastfeed should not be an issue. When a baby is born, there is only one gland that can provide the baby with the highest attainable status of health, which all infants have a right to receive.

Governments and international bodies have the obligation to respect, protect and fulfill an infant's right to be breastfed and a mother's right to be supported during breastfeeding. Having said this, not everything can function as expected. There are situations when what is natural is not attainable, for example in the context of HIV and AIDS, and mothers are faced with a very difficult decision. However, this should not keep states from protecting and fulfilling the rights of all citizens.

Following are the actions presented during the session:

A. A Fact Sheet on the Transmission of HIV from Mothers to Babies
Facilitated by Anna Coutsoudis

The following is a 1/2-page, simple fact sheet to use in orienting anyone to the very complex issues of transmission of HIV from mothers to babies. This could be used on posters, half sheet inserts, as part of other materials, etc. The point is that it is simple, straightforward, short and to the point, specifically designed to counter the tremendous amount of misinformation, confusion and ignorance that exists at all levels on this topic.

Not all Babies born to HIV Positive Mothers will be Infected!
Only 20 out of 100 babies born to HIV positive mothers will be born infected.

The Risk of Infection through Breastfeeding is Small!
Did you know that the risk of HIV infection through breastfeeding is quite small (at most 5 of every 100) in the first six months? This is the rate of infection if nothing is done to make breastfeeding as safe as possible.

The Idea of Balancing Risks:
In many situations, the risks of not breastfeeding far outweigh the risk of possible transmission of HIV to the baby. Even in situations with relatively low infant mortality, the risk of dying from HIV is about equal to that of dying of diseases related to not breastfeeding during the first six months. Indeed, in countries with higher infant mortality rates (e.g., 80/1,000) twice the number of children would die from not breastfeeding as would die from HIV. When thinking of balancing risks, do not forget morbidity, economic issues, etc.

How to Make Breastfeeding as Safe as Possible:
Exclusive breastfeeding (only breastmilk, day and night) for six months ensures that the infant gets full protection from illness benefits and minimal openings/breaks in the "gut", reducing the risk of infection.

B. Informing and Collaborating
Facilitated by Selma James

List of actions:
1) Commit ourselves to stay informed on this issue and to share what we learn with at least four people.
2) Inform people about the controversy over HIV/AIDS in light of unbiased scientific evidence/lack of scientific evidence with respect to breastfeeding with a view to encouraging breastfeeding.
3) Approach AnotherLook about ways to gather, help analyze, and disseminate information to HIV+ women and their health care providers to help them make informed choices about breastfeeding.

C. Changing the Term Mother-to-Child Transmission
Facilitated by Marian Tompson

The following is a proposal to not continue to use the term Mother-to-Child Transmission.

For many years almost all agencies and organizations working to control HIV/AIDS have stated that no policy or actions may contribute to the stigmatization of women with HIV. But then, as Stephen Lewis at the UN has stated, "We have this monstrous hypocrisy- we call the disease MTCT- Mother-to-Child- Transmission. We lay the blame on the mother, she becomes the vector of HIV." Like mosquitoes are the vectors of malaria or of West Nile Virus. If we were to trace the route of infection it would usually be more correct to say "Father-to-Mother-to-Child Transmission of HIV". All the publications, all the documents, all the power point presentations, etc. follow this convention of MTCT. Why not say young child HIV, or HIV in children? Many of us believe that this terminology must be changed- it has to do with women, and their dignity.

We recommend that the term "prevention of HIV in infants and children" be used. An acronym such as PIC could be suggested.

The term MTCT and PMCT should not continue to be used.

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