BMJ 2010;341:c5955
The authors would like to clarify
some of the issues and misunderstandings that have arisen following
publication of their paper by BMJ online.
“Our aim was to
consider scientific data relevant to the UK recommendation that infants
should be exclusively breast-fed for six months. This recommendation
is now eight years old, and more recent data have emerged.
“This
paper was not a systematic review, but we considered all data relevant
to the nutritional adequacy and health effects of exclusive
breastfeeding for six months, versus shorter durations, for infants in
developed country settings.
“This scientific paper was not
directed at parents, and we did not seek to offer them new advice.
Rather we suggest there is sufficient evidence of both benefit and risk
associated with six month exclusive breastfeeding for infants in
developed countries to merit a review of the data and the original
recommendation.
“We are pleased that the Department of Health
has now asked the Scientific Advisory Committee on Nurtrition (SACN) to
review its policy on infant feeding, as part of which they will review this paper alongside other emerging evidence.
“We
fully support the promotion of breastfeeding as the optimal nutrition
for infants, and we are not suggesting that it should stop when other
foods are introduced. The key issue we are discussing is when mothers
should be advised that they can start introducing other foods, ideally
alongside continued breastfeeding.
“We are not suggesting that it
is ‘dangerous’ for infants to be exclusively breast-fed for 6 months,
but consider that the age at which infants need or want solid foods is
likely to vary from infant to infant, as with any other developmental
milestone.
“As a group of professionals we have a long track
record of scientific research in this field, and have published
numerous, widely cited, scientific papers demonstrating the health
benefits of breastfeeding, particularly for longer-term outcomes such as
reduced heart disease risk.
“Whilst unquestionably supportive of breastfeeding, we consider it important to conduct research on all
forms of infant nutrition used by parents, to ensure thorough
scientific analysis and scrutiny. We want to ensure that breast milk
substitutes, used by the majority of mothers at some point in their
baby’s first year, are the optimum ‘second best’ option they can be.
“We have, from time to time, carried out research with funding from the infant formula industry.
In these studies, the investigators retain full control of the data,
perform the analyses, and write the scientific papers without
interference from the industrial sponsors. We declare all of this
publicly according to University College London (UCL) and respective
journal policy.
“Such industrial collaboration is not relevant to
this BMJ paper, for which we received no additional funding beyond our
everyday academic salaries. We have worked with all the major
stakeholders in nutrition – including government departments,
professional medical bodies, academic departments and the general
public.
“The perception that we were commercially driven in
writing this paper is wrong, unfair and damaging. Our interest is,
first and always, in promoting child health. This is shown by the work
we have done in demonstrating the benefits of exclusive breastfeeding to
infants, and the adults they become.”
Dr Mary Fewtrell and Professor Alan Lucas, UCL Institute of Child Health
Contact information:
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