Research on HIV and breastfeeding: definitions can make all the difference

Abstract

Perhaps all fields feel under-appreciated and underfunded. But somehow breastfeeding seems to fall between more than the usual number of cracks. Paediatricians rarely receive more than cursory training in the field. Indeed even at my own “breastfeeding-enlightened” department eyebrows were initially raised when plans for a full-time 5-wk course on paediatrics were first raised—until the faculty saw the enormous list of topics that needed to be covered. Outside of the field of paediatrics (with the possible exception of midwifery) there is even less recognition of the very existence of a field of “breastfeeding expertise”. Thus it is hardly surprising if no less distressing that research and policy-making regarding the infant feeding component of mother to child transmission (MTCT) of HIV has taken place internationally with very little regard for the need for input from “breastfeeding experts”. This was true from the first WHO Expert Meeting on HIV and Breastfeeding in Geneva in June 1987 which I attended as an observer on behalf of the Swedish International Development Agency—the only other attendee I would have considered to be a breastfeeding expert was another observer sent by USAID. (excerpt)