Ayanna Robinson | SisterLove, Inc. - MPH Intern
Ayanna Robinson was born and raised in Cincinnati, Ohio. She moved to Atlanta in 2003 to attend Spelman College. As a Biology major, she enjoyed learning about the different systems in the body, including the reproductive system. She combined her passion for biomedical research with her desire to serve her community and decided to attend Morehouse School of Medicine. At Morehouse School of Medicine, Ayanna is enrolled as a first year Master of Public Health (MPH) student with a concentration in Health Education and Health Promotion. A vegetarian for twelve years, her public health interests revolve around chronic disease and diet/nutrition. With an upbeat outlook on life, her motto is “All that we are is the result of what we have thought. The mind is everything. What we think is what we become.”
While I am open to embarking on all new, positive, and enlightening experiences, in this lifetime I can honestly say that I never imagined myself blogging for reproductive justice. And actually, before coming on board with SisterLove, I wasn’t exactly sure what reproductive justice was or even all the topics that it includes. So this will be an interesting journey. I will forewarn that as a mother of a beautiful baby girl, barely past her first year of life, and as a graduate student in the field of Public Health, 86% of my thoughts naturally turn to motherhood or school. It work likes this -- someone says “blog about reproductive justice”. I immediately think “breastfeeding”. Then from a public health stand point I think of promoting breastfeeding because of its benefits to mommies and babies. And because of my work with SisterLove I realize it is important to recognize the tie between “breastfeeding” and “HIV/AIDS”. And so, the plot, along with my mission, thickens.
Considering the many benefits of breastfeeding, I’ve always wondered why many minority women, especially African American women, opt not to breastfeed. With the proper information and a strong support network, I’m sure more women would choose to breastfeed. That’s my public health side coming out. But then I remember another group of women who, despite their personal preferences, would never get the chance to -- or have a reasonable option to -- breastfeed at all.
Until now, I never questioned or gave a second thought to the CDC, World Health Organization, and other medical experts’ advice that mothers living with HIV or AIDS should not breastfeed and should seek alternative/”safer” methods for feeding their babies. So for me and the rest of American society, women living with HIV and AIDS do not have the choice, or right, to breastfeed. Some recent studies, however, question the risk of mother to child transmission of HIV through nursing.
In many developing countries, infant formula is not readily available. Formula can’t be found ‘within the walking distance’ like it is in the U.S.. Or, better yet, formula isn’t affordable or culturally acceptable. And even when infant formula is available, it may not be a safe alternative because of the lack of water, or the lack of an uncontaminated water source. For these reasons there are many mothers with HIV and AIDS living in less industrialized nations who breastfeed their babies, despite medical warnings regarding HIV transmission. So the question remains, how risky is it for HIV-positive women to breastfeed?
Early research showed that breastfeeding increases the risk of mother-to-child transmission of HIV. The most often cited source for this conclusion, which is used to drive home the recommendation against breastfeeding for mothers with HIV or AIDS, is a study published by Dunn in 1992. However, in this study “breastfeeding” was not clearly defined. Other researchers have distinguished “exclusive breastfeeding” (defined as a diet consisting solely of breast milk) from a “mixed feedings” diet which is one that consists of breast milk and formula. Recent studies actually show that there is no additional risk of mother to child transmission of HIV if the baby is exclusively breastfed in comparison to not being breastfed at all (Coutsoudis et al, 1999). A study done in South Africa showed that by 6 months, babies who had been exclusively breastfed for 3 months still had lower rates of infection (18%) than never breastfed (19%) or mixed fed babies (26%) (Coutsoudis et al, 1999).
Some breastfeeding advocates now argue that exclusive breastfeeding should continue to be promoted for the first six months of life, despite the mothers’ HIV status. Breastfeeding gives the babies all necessary nutrients, builds a healthy immune system, and decreases the risk of developing certain disorders. But from a public health standpoint, prevention is definitely important when confronting HIV/AIDS and there is still a risk of transmitting HIV when breastfeeding. While I don’t believe that this newer research should cause HIV positive mothers to completely disregard warnings given by medical experts, I do believe that mothers should be properly educated on the risks and benefits of breastfeeding so that they can make the best decision for themselves and their babies. The inconsistencies in research, especially when it comes to clearly defining methods of “breastfeeding”, and the lack of available and accessible feeding options when alternative feeding methods are recommended, limit women’s right to make an informed choice.
Considering the many benefits of breastfeeding, I’ve always wondered why many minority women, especially African American women, opt not to breastfeed. With the proper information and a strong support network, I’m sure more women would choose to breastfeed. That’s my public health side coming out. But then I remember another group of women who, despite their personal preferences, would never get the chance to -- or have a reasonable option to -- breastfeed at all.
Until now, I never questioned or gave a second thought to the CDC, World Health Organization, and other medical experts’ advice that mothers living with HIV or AIDS should not breastfeed and should seek alternative/”safer” methods for feeding their babies. So for me and the rest of American society, women living with HIV and AIDS do not have the choice, or right, to breastfeed. Some recent studies, however, question the risk of mother to child transmission of HIV through nursing.
In many developing countries, infant formula is not readily available. Formula can’t be found ‘within the walking distance’ like it is in the U.S.. Or, better yet, formula isn’t affordable or culturally acceptable. And even when infant formula is available, it may not be a safe alternative because of the lack of water, or the lack of an uncontaminated water source. For these reasons there are many mothers with HIV and AIDS living in less industrialized nations who breastfeed their babies, despite medical warnings regarding HIV transmission. So the question remains, how risky is it for HIV-positive women to breastfeed?
Early research showed that breastfeeding increases the risk of mother-to-child transmission of HIV. The most often cited source for this conclusion, which is used to drive home the recommendation against breastfeeding for mothers with HIV or AIDS, is a study published by Dunn in 1992. However, in this study “breastfeeding” was not clearly defined. Other researchers have distinguished “exclusive breastfeeding” (defined as a diet consisting solely of breast milk) from a “mixed feedings” diet which is one that consists of breast milk and formula. Recent studies actually show that there is no additional risk of mother to child transmission of HIV if the baby is exclusively breastfed in comparison to not being breastfed at all (Coutsoudis et al, 1999). A study done in South Africa showed that by 6 months, babies who had been exclusively breastfed for 3 months still had lower rates of infection (18%) than never breastfed (19%) or mixed fed babies (26%) (Coutsoudis et al, 1999).
Some breastfeeding advocates now argue that exclusive breastfeeding should continue to be promoted for the first six months of life, despite the mothers’ HIV status. Breastfeeding gives the babies all necessary nutrients, builds a healthy immune system, and decreases the risk of developing certain disorders. But from a public health standpoint, prevention is definitely important when confronting HIV/AIDS and there is still a risk of transmitting HIV when breastfeeding. While I don’t believe that this newer research should cause HIV positive mothers to completely disregard warnings given by medical experts, I do believe that mothers should be properly educated on the risks and benefits of breastfeeding so that they can make the best decision for themselves and their babies. The inconsistencies in research, especially when it comes to clearly defining methods of “breastfeeding”, and the lack of available and accessible feeding options when alternative feeding methods are recommended, limit women’s right to make an informed choice.
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Sources:
Coutsoudis, et al, (1999) Influence of infant-feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South Africa: a prospective cohort study, The Lancet 354: 471-6. See also correspondence in The Lancet 354: 1901–4.
Dunn, et al (1992) Risk of human immunodeficiency virus type 1 transmission through breastfeeding The Lancet 340: 585-8.
Pamela Morrison, IBCLC. Mothers and Babies and HIV: What is the Risk of Breastfeeding? AnotherLook. http://www.anotherlook.org/papers/e/index.php
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