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I spent hours today (far more hours than I actually have available, but when has that stopped me?) tracking down evidence about that exclusive-breastfeeding-for-the-first-6-months recommendation we hear so much about. (![[livejournal.com profile]](https://www.dreamwidth.org/img/external/lj-userinfo.gif)
fairoriana, I thought of you!)
I was intrigued to discover that:
1. The evidence base for the WHO's recommendation consisted of a whopping 2 small controlled trials and 17 observational studies, used by a panel of experts to develop a consensus. In the consensus report, the section on recommendations for further research was actually longer than the recommendations for practice.
2. There seems to have been a substantial worry that pushing out the recommendation for exclusive breastfeeding from "4 to 6 months" to "6 months" might lead to poor growth in at least some babies.
3. The benefits actually seem to be pretty equivocal, especially in developed countries where babies don't tend to die of diarrhea. (3a. It's really hard to develop health recommendations that apply to all people everywhere in the world all the time. Surprise!) The Canadian Paediatric Society's statement on the subject is pretty lukewarm: "The Nutrition Committee recognizes that more research in infant feeding is needed. However, there is no evidence of harm in the new recommendation, and promoting exclusive breastfeeding to six months has the potential to improve health for infants who are economically and socially disadvantaged."
Having read all this, I'm still totally in favour of the recommendation, particularly for babies in developing countries. I'm less in favour of people beating themselves up, or beating up others, for introducing new foods slightly earlier than 6 months of age, assuming the baby's ready and there are no contraindications. Something I think gets lost when people focus on this particular recommendation is that any breastfeeding is far, far better than none at all.
fairoriana, I thought of you!)I was intrigued to discover that:
1. The evidence base for the WHO's recommendation consisted of a whopping 2 small controlled trials and 17 observational studies, used by a panel of experts to develop a consensus. In the consensus report, the section on recommendations for further research was actually longer than the recommendations for practice.
2. There seems to have been a substantial worry that pushing out the recommendation for exclusive breastfeeding from "4 to 6 months" to "6 months" might lead to poor growth in at least some babies.
3. The benefits actually seem to be pretty equivocal, especially in developed countries where babies don't tend to die of diarrhea. (3a. It's really hard to develop health recommendations that apply to all people everywhere in the world all the time. Surprise!) The Canadian Paediatric Society's statement on the subject is pretty lukewarm: "The Nutrition Committee recognizes that more research in infant feeding is needed. However, there is no evidence of harm in the new recommendation, and promoting exclusive breastfeeding to six months has the potential to improve health for infants who are economically and socially disadvantaged."
Having read all this, I'm still totally in favour of the recommendation, particularly for babies in developing countries. I'm less in favour of people beating themselves up, or beating up others, for introducing new foods slightly earlier than 6 months of age, assuming the baby's ready and there are no contraindications. Something I think gets lost when people focus on this particular recommendation is that any breastfeeding is far, far better than none at all.
