Covid because of the way that it had been changing structures around work arrangements was actually something I thought about when it came to keeping like going through with the pregnancy because it actually felt like an opportune time just given that I’m like such a professionally orientated person so it’s maybe one of the few times in my life where I was like complete location flexibility which also would translate to feeding because the women that I talked to, a lot of women ended up giving up when they were working because it was just so difficult to do, breast feeding and work in a professional job were you had to be in an office, like 9 to 5.

Just like basic things like if you were breast feeding and trying to interact with like larger society would probably feel like pretty uncomfortable and/or embarrassing, so yeah. So, it’s like the working from home definitely makes it easier to capacitate breastfeeding.

In my opinion, the current triangle policy is not human-centered. To expect that HIV-positive moms – who are already under a great degree of pressure and scrutiny to ensure they do not pass the virus during pregnancy – exclusively breastfeed for 6 months without cracked nipples, mastitis, gastrointestinal issues for either mother or baby, supply failure, or other host of potential roadblocks for a reduction in risk that can't really be quantified and could be negligible, is not an ideal policy response. It piles on the mother, and only accounts for the costs of breastfeeding via transmission risks, without also factoring in benefits from a mental health or bonding, immunity, or financial standpoint. To give some last-mile perspective, according to the specialist in my hospital, of the 20 HIV positive mothers who have attempted to breastfeed, only 2 (or 10 percent) were able to get to the six month goal post with exclusive feeding. The guidelines as they currently stand do not really empower HIV positive women, they guilt and suffocate them.

So they’re quite supportive, like to me they have to say what current policy is which is that in the UK they recommend that women do not breastfeed if they are HIV positive and they’ve said that to me but they also say that if you chose to breastfeed we will support you in any way shape or form possible. So, I feel like to me it’s almost like they were like we have to say this policy thing because this is technically the policy but like we also really wanna support you so like if that’s not what you wanna do we can completely respect that and there is zero judgement and we wanna make like a medically feasible thing for you where you feel like you have support.

I am just worried that like, well I get scared that, you know, there will be the one case where like the undetectable mother passes the virus on to her new born infant and then what ends up happening is that every mother regardless of how negligible that risk is will then internalise the fact that like this choice could still somehow lead to that because we just don’t have the mountains of data that would make me feel like that I can still make a moral choice when it comes to like sexual activity versus breast. And I know that like I think from many, many mothers they would hold themselves to like such a high, like I feel like they’d be punishing themselves for the rest of their life if that happened, you know, so yeah…But I still think the policy is good I just think that it’s harder for mothers and to like collect this data because it, it does feel like there is just, the stakes are really high and so if there is even one case that flips by, you know, that could have like a really big psychological impact on the women as well.