We agree with Dr Murray that pediatricians have a strong obligation to protect their patients because they cannot protect themselves. However, we believe that it is essential to consider all of the risks to an infant's health and well-being before seeking a court order. In the third clinical scenario, the infant would be placed at risk of loss of housing, economic support, or even violence if the mother's HIV infection were discovered. Seeking a court order to require bottle-feeding would disclose the infection and place both the infant and mother at risk. The mother is cooperating with her physicians to reduce the medical risk of transmission as much as possible. Under these circumstances, we believe that it is more protective of the infant to honor the mother's decision to breastfeed.
Wolf LE, Lo B, Beckerman KP, Dorenbaum A, Weintrub PS, Kilpatrick SJ. The Choice by HIV-Positive Women to Exclusively Breastfeed Should Be Supported. Arch Pediatr Adolesc Med. 2002;156(1):88. doi: