Breastfeeding From Months Four To Six

Ready for a bit of controversy? There's a breastfeeding debate that broke out in the UK this morning. Let's look at a Yahoo! article on it entitled Breastfeeding study raises doubts over guidelines:

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LONDON (AFP) – Breastfeeding exclusively for the first six months is not necessarily best for a baby's health, British researchers said Friday, calling into question advice given to new mothers.

The team led by a paediatrician from University College London said babies fed only breast milk could suffer iron deficiency and may be more prone to allergies.

The study says babies could start to be weaned on to solids as early as four months, although other experts advised sticking to the existing guidelines.

Ten years ago, the World Health Organisation (WHO) recommended that infants should be exclusively breastfed for six months.

"Many Western countries, including 65 percent of European member states and the United States, elected not to follow this recommendation fully, or at all," the authors said, although Britain did.

The WHO recommendation "rested largely" on a review of 16 studies, including seven from developing countries.

It concluded that babies given only breast milk for six months had fewer infections and experienced no growth problems.

But another review of 33 studies found "no compelling evidence" not to introduce solids at four to six months, the experts said.

Some studies have also shown that breastfeeding for six months fails to give babies all the nutrition they need.

One US study from 2007 found that babies exclusively breastfed for six months were more likely to develop anaemia than those introduced to solids at four to six months.

On the issue of allergies, the British study said researchers in Sweden found that the incidence of early onset coeliac disease increased after a recommendation to delay introduction of gluten until age six months, "and it fell to previous levels after the recommendation reverted to four months".

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Although a storm has broken over this story from breastfeeding advocates and nay-sayers, the article's crux is simply discussing whether to start a baby on solid foods at four months instead of six. The article does not attempt to say that exclusive breastfeeding for four months is bad. The key statement, buried in the article, is that "another review of 33 studies found 'no compelling evidence' not to introduce solids at four to six months". The article comes across, therefore, as more shocking than it really is, especially with the opening inflammatory statement.

The article still affirms the need to exclusively breastfeed infants for the first four months of life.

However, there are certainly competing interests at work here. The baby food industry has long claimed that their products of formula and solid baby food are "healthier" for the baby than natural breast milk. The original article from The Guardian also says that your baby may be "harmed" if not started on solid foods during a specific two month period of time. These statements are so... well... strong!

But what about the article's claim that the recent rise of coeliac disease is a direct result of not feeding babies gluten between ages four months and six months? If this were the case, then coeliac disease would have been absolutely rampant all throughout human history, when "primitive" peoples were exclusively breastfeeding their infants for at least the first year. Besides, the authors mention specifically that many Western countries did not follow the WHO guidelines for exclusive breastfeeding anyway: so how does one explain the rise of gluten intolerance in the West? There are certainly other environmental and chemical factors at work besides this rather miniscule two month window in infant digestive behavior. There is an almost willful lack of logic here that makes me skeptical as to the article's intent.

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The authors said however that exclusively breastfeeding for six months remains the best recommendation for developing countries, which have higher death rates from infection.

But in developed countries, it could lead to adverse health outcomes and may "reduce the window for introducing new tastes".

"Bitter tastes, in particular, may be important in the later acceptance of green leafy vegetables, which may potentially affect later food preferences with influence on health outcomes such as obesity."

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Really? Giving a four-month-old rice cereal will decrease the incidence of obesity? But giving a six-month-old rice cereal will increase obesity? This stretches my credulity, and again shows the article's too-eager willingness to assign causality to one small factor. It's clear by now, if anything is, that the recent obesity epidemic is a result of many complex variables. But it seems as though the article is pulling out every possible recent buzzword (coeliac disease! obesity!) in order to cement the case against exclusive breastfeeding.

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Experts in Britain challenged the findings of the new study.

Janet Fyle, professional policy adviser at the Royal College of Midwives, said: "I really must challenge the suggestion from the review that the UK should reconsider its current advice on exclusive breastfeeding for six months.

"I believe that this is a retrograde step and plays into the hands of the baby food industry which has failed to support the six-month exclusive breastfeeding policy in the UK."

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Young parents can make themselves dizzy by going round and round, seeking the advice of "baby experts" who always seem to contradict each other. The wisest advice, it seems to me, is still the simplest: your baby has been intelligent enough to grow from conception to 0 months to 4 months without any sudden food interferences, and your baby is probably intelligent enough to ask for food when his/her body is capable of properly handling and digesting it. Introducing foods before your baby's gut is ready to handle it? I just fail to see the wisdom in that. It seems to me that we often don't give babies enough credit for being able to grow.

When your baby lunges off your lap for a headfirst dive into your pasta, it's about the right time for early simple foods.

UPDATE: My original suspicions as to intent have been confirmed. Although Yahoo! neglected to report it, the original Guardian story contains the following quote: "The paper acknowledges that three of the four authors "have performed consultancy work and/or received research funding from companies manufacturing infant formulas and baby foods within the past three years.'" It's the old adage: follow the money.