Current guidance advising mothers in the UK to exclusively breast feed
for the first six months of their baby's life is being questioned by
child health experts on bmj.com today.
The authors, led by Dr
Mary Fewtrell, a consultant paediatrician at the UCL Institute of Child
Health in London, have reviewed the evidence behind the current guidance
and say the time is right to reappraise this recommendation.
The
researchers stress that while they fully back exclusive breast feeding
early in life, they are concerned that exclusively doing so for six
months and not introducing other foods may not always be in the child's
best interests.
In 2001 the World Health Organisation (WHO)
made its global recommendation that infants should be exclusively breast
fed for the first six months. Many western countries did not follow
this recommendation but in 2003 the UK health minister announced that
the UK would comply.
Fewtrell and colleagues support six months
exclusive breast feeding in less developed countries where access to
clean water and safe weaning foods is limited and there is a high risk
of infant death and illness. However they have reservations about
whether the WHO's guidance about when to introduce other foods is right
for the UK.
The WHO's recommendation that mothers should breast
feed exclusively for six months is largely based on a systematic review
undertaken in 2000 that considered existing research in this area, say
the authors. This review concluded that exclusively breast fed babies
have fewer infections and that the babies experience no growth problems.
Dr Fewtrell argues that the evidence that breast milk alone
provides sufficient nutrition for six months is questionable. She says
there is a higher risk of iron deficiency anaemia if babies are
exclusively breast fed and that there could also be a higher incidence
of celiac disease and food allergies if children are not introduced to
certain solid foods before six months.
The authors also fear
that prolonged exclusive breast feeding may reduce the window for
introducing new tastes, particularly bitter taste which may be important
in the later acceptance of green leafy vegetables. This could
encourage unhealthy eating in later life and lead to obesity, they say.
Fewtrell
and colleagues conclude that it is time to review the UK's guidance in
the light of the evidence that has built up on this issue over the last
ten years.
Contact information:
Authors can be contacted via UCL Institute of Child Health
& Great Ormond Street Hospital (GOSH) press office: tel +44 (0)20
7239 3126 or +44 (0)20 7239 3119 or email dodmah@gosh.nhs.uk
For genuine and urgent out of hours call speak to switchboard on 020 7405 9200
