In 2001, WHO began recommending exclusive breastfeeding for six months and supplementation thereafter and for at least two years, after conducting an extensive review of various scientific studies. From that moment all the official organisms in terms of health were adhering to this recommendation and it was extended in all countries to the point that any person trained in breastfeeding is clear that the best thing for a baby is to breastfeed in a way exclusive until six months.
However, an article in England has appeared these days, specifically in the British Medical Journal, saying that breastfeeding a baby for six months could be counterproductive for them, for being too long taking only breast milk. Luckily, as they explain, few children have been affected by this practice because there are still few babies who reach six months of age drinking only breast milk.
The controversy is served
As a result of this article, a great stir has originated both at the institutional level and at the population level. Breastfeeding mothers begin to doubt, breastfeeding groups have come to the defense of exclusive breastfeeding and the professionals (Among those I find myself) they have given the article the credibility it deserves: very little. WHO and even UNICEF have obviously come out in defense of breastfeeding, to the point that it has been made public that Some authors of this study could have some kind of relationship with the infant feeding industry that, evidently, I would be very grateful to start feeding the babies at four months instead of at six, as currently recommended.
We will now summarize the study and also show what the response of WHO and UNICEF has been:
"Breastfeeding for six months could be dangerous for babies"
According to the authors of this study it is dangerous not to offer any food until six months because babies breastfed until that date have more risk of anemia due to iron deficiency, being dangerous if we consider that anemia can affect the mental, psychomotor and psychosocial development of children.
They also suggest that children who have not tried any food until six months have a increased risk of allergies and explain that “countries that use, for example, peanuts as a complementary food have lower rates of peanut allergy than the rest“.
The third potential problem is that of the Celiac Disease. Apparently cases of celiac disease have increased in Sweden since mothers breastfeed until six months and appear to have decreased where gluten is offered after four months.
As they comment, it is not that they disagree with WHO recommendations, but that they should be interpreted differently depending on the country, since breastfeeding in poor countries can save a baby's life, but in countries developed “only gastroenteritis rates decrease slightly“.
What has UNICEF said about this study?
Both WHO and UNICEF have come out in defense of the initial recommendations after analyzing this study. You might think that a recent study brings new conclusions because there are new data behind that could change the recommendations, however it has been observed that not based on new data and that, to make the study, old evidence has been used, many of which were used to conclude that the best for babies is 6 months of exclusive breastfeeding.
It has been stated, as a conflict of interest, that three of the four authors of the study have carried out work and / or received funding for research by infant formula and infant feeding companies in the last three years.
The benefits of breastfeeding have been discussed on multiple occasions and, as there are no new data that modify those already known, these benefits still exist: even in industrialized countries, breast milk can be used to save lives and protect both health. in the short and long term of both the baby and the mother. It also decreases the risk of diabetes and childhood obesity and breast cancer in mothers and is associated with a better ability to raise children by women with low incomes (breast milk is still free) and a lower incidence of postpartum depression.
With respect to iron deficiency anemia Emphasis has been placed on something we have talked about on several occasions: the iron levels of a child at six months depend heavily on the iron reserves at birth and the early cutting of the cord (which can reduce the reserves by up to 33%)
To avoid anemia in babies the solution is, therefore, to make sure that the mother does not have anemia during pregnancy and cause the cord cut to be delayed. In this way the baby's reserves will be greater and he will be able to have the iron insured for at least six months.
It should also be borne in mind that the foods that are usually offered in the first months, such as fruit and cereals, are low in iron and, far from preventing iron deficiency anemia, could be the cause of it, since displace breast milk that contains iron in a very bioavailable form (it is absorbed very well).
On the second of the arguments commented on in the study, the Celiac Disease, it has been commented that the Scientific Advisory Committee on Nutrition and the Committee on Toxicity of Chemicals in Food, Consumer Products and Environment of the English Government has stated in this regard that studies are being done to try to determine what is the best time to offer gluten to children, without having enough data to express a specific moment as a recommendation.
What they do affirm is that if gluten is introduced into the diet when the baby is still breastfed, the risk of developing celiac disease is considerably reduced.
Finally, regarding allergiesIt has been commented that there seems to be some data that suggest that when there is a history of allergy in the baby's family, the early introduction of certain foods could be beneficial. This is currently being studied and therefore there is no clear evidence. In any case, even if it were true, the recommendation would be offered only to high-risk families individually and not to an entire population.
What did WHO say about it?
WHO has stated, in addition to what UNICEF has commented, that the recommendations that began to be given in 2001 are still in force because in the same way that an exhaustive review of the bibliography was then made, these recommendations have been reevaluated with the new data received after each quality study performed and no reason has yet appeared to change his mind.
The article published in the British Medical Journal, which might seem like a systematic review of the evidence is not really. The last systematic review carried out dates from 2009 and is available at the Cochrane Library. This review included studies conducted in industrialized countries and others conducted in underdeveloped countries and it concludes that Breastfeeding for 6 months has several advantages over exclusive breastfeeding for 3-4 months followed by mixed breastfeeding, such as lower risk of gastrointestinal infections, faster maternal weight loss and delay in the return of menstruation (beneficial for the mother's iron deposits).
This review did show that babies in underdeveloped countries did seem to have a lower level of iron.
Summarizing
Summarizing and answering the question of the title of this post: no, it is not harmful for a baby to drink exclusive breast milk until six months. The problem is that breastfeeding does not benefit anyone economically beyond the baby's own family (and in a global way to health, it could be said, for the lower number of hospital admissions in breastfed babies) and of course, that a Person spend six months of his life without consuming industrial food is too much. For this reason it is very easy to find for sale a wide catalog of baby food “from 4 months” and that is why studies like the one mentioned appear, trying to convince mothers and professionals that meals could be advanced a couple of months ” for the sake of the child. "
Photos | Lars Plougmann, diluted on Flickr
In Babies and more | Exclusive breastfeeding up to six months, the best for the baby, Why exclusive breastfeeding is advised up to six months (I) and (II), Why breastfeeding is advised up to two years or more
