Messing with the Six Months Exclusive Breastfeeding Recommendation: Hidden Boobytrap

By now you may have read the latest sensationalist headline suggesting that six months of exclusive breastfeeding “could harm babies,”  according to the U.K.’s Guardian, which reported on a study in the British Medical Journal.   The point of the study in the BMJ was to question the timing for the introduction of solid foods, and argue against the widely recommended 6 months of exclusive breastfeeding with no other solids or liquids.  Fortunately, the Unicef  UK was on the ball, and issued an excellent rebuttal, which is well worth reading. 

You would think that Unicef’s response should put the issue to rest.   Sadly, this won’t be the case, because the number of articles that are spinning off the Guardian’s sensationalist headline will far outnumber any visibility or publicity that Unicef’s response can get.   The media has figured out that breastfeeding is a hotter-than-lava issue and gleefully jumps on the opportunity to stir up controversy and strike more fear into the hearts of moms, all in the interest of hits and comments.   What is unfortunate is that many people won’t even read the full article, they will just interpret these headlines as proof that breastfeeding isn’t all that it is cracked up to be, and that it is okay to wean babies completely off breastmilk before 6 months.  Most people will miss that even the authors of the BMJ study were NOT recommending early weaning, because to the average mother-in-law, expecting mom or physician not trained in the basics of lactation management, the breastfeeding recommendations get a little fuzzy.    So that’s the first big booby trap here:  sensationalist headings do tremendous damage to breastfeeding continuation.

The second booby trap has been entirely missed as far as I can tell.   One of the best reasons for following the WHO / Unicef guidelines as they stand now is that the early introduction of solids can mask breastfeeding problems.    Suppose a baby is going through a growth spurt, or it’s the holidays and mothers are rushing around, and accidentally missing a feeding here and there without realizing the ramifications.   Suppose there is an underlying condition where the mother’s milk supply has dropped, and she tells her friends or mother-in-law that her baby is always hungry.   Suppose she asks for help from her pediatrician, who is not required to undergo continuing education for breastfeeding.   He or she may weigh the baby and rebuke the new mother that “she is starving her baby” and demand that she begin supplementing.   Soon she is on a slippery slope of too much supplementation and her milk has dried up altogether, and since no one uncovered the root of the drop in her milk supply, or solved the breastfeeding issue, she thinks that she just didn’t make enough milk or that it wasn’t enough for her baby.    That’s how one of the biggest booby traps, the myth of not having enough milk, has taken hold and been perpetuated. 

Breastfeeding experts know that each baby is different, and that mothers have finely honed instincts of when their baby is ready for solid food.   This is not about adhering to some arbitrary rule.   It’s about making sure that breastfeeding is going well FIRST, and fixing any breastfeeding problems or issues before recommending solids.  

Finally, Unicef, WHO and IBCLCs know that there is another good reason for recommending a minimum of 6 months:  they know from vast experience in working with moms that if you set the bar at 6 months, you’ll get a lot of moms who breastfeed until 5 months.   If on the other hand, you set the bar at 4 -6 months for the introduction of solid foods, you will get a lot of moms and some pediatricians who will think it’s okay to introduce cereal at 3 months, and that will REALLY harm a lot more babies. Cereal too early can not only increase the risk of infection and allergies (as per Unicef), but it can also interfere with milk supply. Unfortunately, there are no sexy headlines to be made out of that…though it would be fun to try and think of some!

1/19/2011 Update:  We wanted to share this quote from Marsha Walker, RN, IBCLC of the National Alliance of Breastfeeding Advocacy with you:

I find it very interesting that this article has gotten so much press and is coming out at the same time as the US Surgeon General’s Call to Action on Breastfeeding. The BMJ article has no new  information and is not even a study. Just a rehash of articles that are weaker than the ones they are criticising from WHO. Most of the BMJ articles are observational and do not clearly point to a need to change current recommendations. Then factor in the new book that was just published titled: “Is Breast Best: Taking on the Breastfeeding Experts and the New High Stakes of Motherhood” by Joan B. Wolf ( 2011,  New York University Press). The conclusion of the book mentions the “Call to Action”  whose launch is scheduled for Thursday, January 20, 2011 as follows:

 “For the time being, the “Call to Action” to increase breastfeeding that the Disease Control and Prevention and the U.S. Department of Health and Human Services’ Office on Women’s Health were to issue in 2010, a project they defined as “an urgent public health priority,” seems as least slightly overwrought. In the overshelming majority of cases, either breastfeeding or formula feeding is a healthy option.”

One wonders about the cluster of bad press for breastfeeding that just happens to being coming out at the same time!!!



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11 Comments | Last revised on 01/17/2011


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