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Laura A. Guay, MD; Andrea J. Ruff, MD

JAMA. 2001;286:2462-2464.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Recognition that human immunodeficiency virus type 1 (HIV-1) could be transmitted through breastfeeding precipitated a public health dilemma. Long promoted as a means of decreasing infant morbidity and mortality, particularly in resource-poor areas, breastfeeding now posed a potential health hazard. Differences in the risk-benefit ratio associated with breastfeeding ultimately led to 2 sets of public health recommendations. In settings with readily available safe breast milk substitutes and low background infant mortality rates, withholding breastfeeding was not expected to be associated with increased infant mortality rates and thus HIV-infected women were advised not to breastfeed.¹ In contrast, in resource-poor settings, withholding breastfeeding was known to significantly increase infant morbidity and mortality due to infectious diseases and malnutrition.^2-5 However, the risk-benefit ratio for an HIV-infected woman was not constant throughout resource-poor settings: some women in such settings might in fact be able to provide . . . [Full Text of this Article]

Author Affiliations: Departments of Pathology (Dr Guay) and Pediatrics (Drs Guay and Ruff), Johns Hopkins University School of Medicine and Department of International Health, Johns Hopkins University Bloomberg School of Public Health (Dr Ruff), Baltimore, Md.

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