One of the most difficult dilemmas faced by women with HIV is the
decision whether or not to breastfeed their babies. Even if children
are born without the virus, they can acquire it through breast milk.
But in resource-poor countries, feeding a child with formula can also
create a health threat. Researchers are working on ways to make breast
milk from HIV-positive mothers safe.
In the beginning of the AIDS crisis, HIV-positive women in poor countries were told not to breast feed. So those women's babies didn't receive the many benefits that breast feeding provides. In addition, many of them died of diarrheal diseases.
Researcher Sera Young from the University of California at Davis has been working with about 100 women in Tanzania, teaching them to pasteurize their milk at home using a technique called flash heating.
"What the mother does is she expresses the milk into a glass jar. It could be an old peanut butter jar; it could be a jam jar. And then she puts that glass jar into a pan of water and puts the jar in that pan onto a fire. It could be any kind of fire.
And as soon as the water boils, the milk has reached a hot enough temperature - about 70 degrees Celsius - to kill all of the HIV but maintain most of the integrity of the nutrients and the immunological properties. It's a double-boiling technique."
Young says she wanted to know if the women would be willing and able to do everything needed to treat the milk.
"… and then, could they actually follow a protocol which includes washing your hands before you express the milk, expressing regularly throughout the day and then heating it with utensils that had been properly cleaned? And what we found is that, heck yes, women can do this!"
The protocol did prove to be a problem for some women, in particular, those who wanted to keep their HIV status secret.
"Onlookers are extremely curious about why they are heating their breast milk," Young says.
She says the World Health Organization actually recommends that HIV-positive women self-pasteurize their milk. But, ironically, no one knew whether it was feasible or acceptable to do so. She says her research shows that women can and will do what they need to do to protect their babies.
The next question is: What effect does this technique have on babies?
"Right now, we are in the planning stages of a large clinical study that will look at hundreds and hundreds of women, and then we will have the statistical power to look at the differences between those children who received flash-heated milk and those who haven't."
Young says these women - and their children - desperately need to know the answer to this question.