Paper short abstract:

The paper focuses on the dramatic effects on subjectivities and sociality instigated by mother to child transmission of HIV programmes (PMTCT) that are currently launched globally. It explores the manner in which mother’s milk, through PMTCT, has been transformed from a prime symbol of nurture and love to a feared source of death.

Paper long abstract:

The paper focuses on the adverse effects on subjectivities and sociality instigated by 'mother to child transmission of HIV' (PMTCT) programmes that are currently being launched globally to prevent infants from becoming HIV infected during pregnancy, birth and breastfeeding. With the 'opt out' approach increasingly implemented in HIV testing, vast numbers of HIV positive mothers today live with a known HIV+ status without an experienced ability to prevent the virus from spreading to their babies. None of the infant feeding options promoted through the programs - exclusive breastfeeding and exclusive replacement feeding - emerge as realistic alternatives for the large majority of HIV positive women; only a small minority can afford infant formula products, and exclusive breastfeeding has in many PMTCT programs increasingly emerged as the feeding option of poor women who have to breastfeed and 'let their babies die', as informants put it. Cherished moments of nurture and warmth are transformed to scenarios where mothers who hate their bodies, sometimes to the point of throwing up, breastfeed their infants with a sense of feeding them a poisonous liquid. The paper discusses the frightful alterations in perceptions of body and self produced through PMTCT programs, transformations that generate inconceivable suffering in a most vulnerable group, and simultaneously threaten vital gains in global breastfeeding promotion. The material was collected through interviews with HIV positive mothers and nurse counsellors in Ethiopia and Tanzania between 2004-2006. The methodological backdrop is five years of ethnographic fieldwork in East Africa.