Study: Breast Milk May Not Be Enough for Babies
Are you doing your baby a disservice by not introducing sustenance other than breast milk in the first six months of life?
In what is sure to cause a bit of a stir in the breastfeeding community, the British Medical Journal has published a report that indicates babies may not exactly benefit from a steady diet of breast milk alone in the first six months of life.
Researchers found that delaying the introduction of solid foods and waiting to wean from the breast could increase the occurrences of food allergies and iron deficiency. While most experts have always recommending starting babies on solid foods at six months, this new study is saying four months might be even more beneficial. Furthermore, waiting until six months to introduce solids to a baby could mean the window for introducing new tastes like substance-rich leafy greens is too narrow, thereby leading to increased risks for problems such as obesity later in life.
The current guidelines, issued by the World Health Organization, have been in place for about a decade, and the study says they should remain in place for mothers in developing nations, as their access to clean water and proper baby food can be limited.
But there’s another side to the study, of course. Gillian Smith from the U.K.’s Royal College of Midwives told Sky News in Britain that digestion problems could occur as a result of early feeding because a baby’s stomach isn’t developed enough, according to MSNBC.com.
There are also those who believe that this study will “play into the hands of the baby-food industry,” and argue that some babies in developed countries die from inappropriate young child feeding, namely, the introduction of solid foods at too young an age.
Hopefully the debate that is likely to ensue will take into consideration the fact that food allergies have become a bigger issue in the past few decades — with solid researching showing that the introduction of key foods can help eliminate some allergy risks — and iron deficiency is not something to be taken lightly. I remember introducing rice cereal followed by certain fruits and vegetables to my daughter when she hit the four-month mark without an issue, but I know there are plenty of women who believe strongly that nothing but breast milk is appropriate in the first year of life. I don’t think there’s a single right answer for everyone; it’s certainly not a one-size-fits-all issue, and hopefully those who are strong breast milk advocates will at least take into consideration the scientific findings before deciding what’s best in the short and long terms for their babies.
Does this study change your opinion on when babies should be weaned from the breast and/or introduced to solids?
Image: Wikipedia
You mean other than to wonder who funded the study? (I wonder this about any given study…)
Not really changing my views. Babe the Elder was actually tested for iron at 4ish months because his pediatrician and I had differing views on the vitamin drops – I felt that if I was giving him the drops, he should need them, you know? Iron was toward the high end of normal. No formula, breast only.
I wish that breastfeeding wasn’t such a charged issue, that it was one that we could discuss rationally. This study seems like it should be taken into consideration. I don’t know anything about its validity or methodology or how widely its results should be applied, however.
But in another article on this study, I read this:
Janet Fyle, professional policy adviser at the Royal College of Midwives, said:
“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.”
If a study is factual, how can it be retrograde? If facts “play into the hands” of an industry we don’t like, should we ignore them? Again, I don’t have specific knowledge about this study, though it WAS in the British Medical Journal, presumably not the equivalent of the National Enquirer.
Strident reactions like that just make breastfeeding advocates look paranoid and silly. I think the proper reaction would be “wow, that’s interesting, let’s look into this further.”
My first two started solids (bananas), both around 4 months of age, which was recommended by their pediatrician at that time. (They are currently 9 and 7 y/o). My youngest is almost 3: his ped. recommended 6 months. However, at about 5 months, the kid literally lunged from his father’s arms to get to a dish of pineapple…which began his foray into solid foods.
This NHS page tells alot more:
http://www.nhs.uk/news/2011/01January/Pages/call-for-breastfeeding-advice-to-be-re-examined.aspx
The “study” sounds a little murky to me. But, I don’t think it matters a whole lot if you start a kid on solids at 4 months or 6 months, it’s more of a matter of if they’re interested and what you choose to feed them. I would be careful not to mistake different meanings of “weaning” when the say to “wean” before six months in press coverage. I would think that just means to not EXCLUSIVELY give breast milk, but to give other foods along with breastmilk. I think that breastmilk probably provides higher-quality and safer nutrients than most solids a baby would sample and so a mother would want to continue breastfeeding, really, as long as possible (within the general social expectations/comforts she has). For me, that was about 33 months, with my kids trying out solids around 6 months. I would never act based on the results of a single study. Uhm, especially not a BMJ study (autism hoax, anyone?)
I started my breastfeeding babies on cereal at 4 months old. Not really for the nutritional side but to ease the transition from breastfeeding and bottlefeeding to the exercise of eating at the table with a spoon or a fork. They both are great eaters (they will eat anything I cook for them) and my son started eating with fork by himself before he turned 2 years old.
@Rosana — My daughter used to be a good eater, and now we’re down to peanut butter and jelly, fruit, and macaroni and cheese. Oh well.
@Gretchen — Hard to discount an entire medical journal for the fraud of one doctor who was thought to be credible by nearly the entirely medical community for years.
@Jenny From Austin — I agree — I wish this weren’t such a charged issued.
@Plumblucky — Like I said, it’s not a one-size-fits-all topic.
OK, point taken, but the larger point of not changing one’s practices because of one study stays. The authors themselves are cautious…parents are probably going to keep doing whatever they want anyway. Among my parenting peers, many gave solids, on doc’s suggestion at 4 months. Meh. I let the kid take the lead.
The “authors acknowledge that the new evidence they discuss is observational, so caution is needed in interpreting the results. They call for a more vigorous evidence-based system of policy-making in this area. Until then, they cannot say whether the current policy should be changed or not. They suggest that it is time to revisit the evidence again and report that a survey suggests that less than 1% of British women breastfeed exclusively to six months anyway.”
@Gretchen — I agree that unless the results are definitive and literally a matter of life or death, we shouldn’t drive ourselves crazy every time a new study is released. However, when I gave birth to my daughter, I had no experience to go on and relied very much on my doctor’s advice on guidelines for what and when to feed my baby, and I think it’s important not to discount new research if there’s an upside to the health of our children.
Yeah, I guess that’s up to individual interpretation. I’m not buying that there’s an upside here. That’s my interpretation.
@Gretchen — And my only opinion on it is that it’s something to take into consideration, particularly considering the issue of food allergies. I hear a doctor from National Jewish in Denver speak last year about what other countries do in terms of peanuts, for example. Some give peanuts (or products with peanuts) as close as possible after birth, and they experience little to no peanut allergies. I think he was talking about Israel, but I can’t remember 100%. I just think there’s a lot to consider.
re: food allergies. I am interested in hearing more on the whole “avoid = fewer allergies vs. give = fewer allergies”. I really am, since I have what I define as “wicked nasty food allergies that could in all likelihood kill me if I’m not careful” that the only saving grace is that they aren’t airborne in nature so far, knock on wood.
I actively ate the worst offender (can’t even kiss hubby if he’s had it now or my mouth and tongue swell) til I was 12. Literally overnight my body decided it was not only done with it, but it was going to go into full on anaphylaxis over my consumption of the food.
Because of how sudden (and severe, it shocked doctors that saw me in the ER that I was having such an awful reaction with NO prior known food allergies and no different foods consumed in the past 48 hours much less the previous hour) mine came on, my kids pediatrician is of the opinion that they should be verbal before we give this a whirl with them. I’m quite all right with that; its scary enough when its me, the idea of my kids….that is the definition of terrifying to me.
@Plumblucky — That’s so scary. I discovered a few months ago after a lifetime of eating mangoes that I’m allergic to mango juice. Throat closed up, tongue swollen, the whole nine yards. Just awful. I had 9-1-1 on speed dial the first time I gave my daughter peanut butter (not to mention strawberrie, and every other allergy-prone food). So far, so good . . . but I’m also curious about the theories of starting the same foods earlier.
My baby is 7.5 months old, and I just converted to baby-led weaning after reading the book by Gill Rapley, a public-health nurse in the UK who has made this her area of study. BLW advocates no purees of any kind, but rather just letting the baby handle food in large pieces from as early as 4 months. They will eventually put it in their mouths, but won’t eat it for the first while; however, they will gum it, taste it, and swallow some, and this will increase as time goes on. For us, this has meant a much greater variety in my son’s diet. Instead of just pureeing things a couple times a week and freezing, I usually give him whatever we’re having. He’s had cabbage, sweet potato oven fries, broccoli, cantaloupe slices, pork chops and more. Some of it does get eaten, because it comes out the other end. His manual dexterity and ability to move food around his mouth have both improved in only two weeks. It’s hard initially not to stress about your baby getting “enough,” but I just feed him breast milk on demand, and he’s perfectly satisfied. The author says that breast milk and infant formula are both more nutrient dense, and usually more calorie-dense, than whatever pureed mush you offer at this stage anyway.
According to UNICEF UK, “When considering this analysis it should be noted that three of the four authors have declared an association with the baby feeding industry.”
http://www.babyfriendly.org.uk/items/item_detail.asp?item=680
I have a problem with the way “wean” has been reported. In the study, it means to add solid foods. Period. Besides, the study really was a meta analysis of the data and suggested that the policy adopted by the British Government should be reviewed periodically in light of continuing scientific advancements. Attacking the researchers for their funding is a logical fallacy and does nothing to prove or disprove anything.
Furthermore, maybe some children are ready at four months and others aren’t. Considering how differently children develop at that stage why the fuss? These reactions of vitriol are a bit much. Read the actual study. Most science journalists just aren’t very good and they rile people up to sell papers or generate clicks.
http://statgirlskewer.blogspot.com/2011/01/breastfeeding-paranoia-feed-my-child.html
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the story only had legs because everything goes viral.
It’s an invented controversy stirred up by a couple of nutritions and MD affiliated with formula companies. Read their conflict of interest and past affiliations statements it say infant formula companies.
FYI: Anemia in infants has more to do with the birth practices.
Delayed cord cutting and you cut down on infant anemia. The answer is not food or iron added to formula, the birth practices!!!
I don’t think anyone should get up in arms about this study. Like someone else has mentioned, the authors of the study themselves are careful to state that more studies are needed. I do think, though, that more studies should be done and people should support them because of the recent surge in food allergies and the like. It’s very serious when such a large number of kids are popping up with life-threatening allergies like this. When I was a kid in school in the late ’80s/early ’90s, no one I met had such severe allergies. In fact I was the kid in class with the worse ones, and that was just severe hay fever. Even in a high school of 3000 students in the late ’90s there was maybe one or two people with serious allergies. So why is it so common nowadays to meet kids that react so severely to food?
I strongly belief this avenue for potential answers into that question should be further explored, and not so people can start getting defensive about when and how to feed a baby, but to gain a better understanding of how a baby’s digestive system develops so we can hopefully avoid any serious allergies from forming.
According to the disclosure at the end of the British Medical Journal article, 3 of the authors “have performed consultancy work and/or received research funding from companies manufacturing infant formulas and baby foods within the past 3 years.”
I am not sure if that means we should discount their professional opinions, but I am skeptical.
There’s a fairly strong study from Colorado a few years ago of children known to be at risk of Type 1 diabetes genetically that showed increases in the risk of actually getting Type 1 if solid foods are introduced at 3 months or before, or if solid foods are delayed after 7 months. Type 1 Diabetes is known to have about a dozen genetic risk factors, but there’s a major environmental component. Part of the environmental component is vitamin D (incidence of Type 1 increases with direct proportion to latitude, and D supplements have shown up to 80% reduction in Finland), and another part of the environmental effect seems to be related to proteins that may ‘leak’ from an under-developed gut into the bloodstream, causing an immune reaction.
There’s also a study from the UK of children of specific ethnic heritage that showed that early exposure (1 year or less) to peanut butter (which pediatricians had been telling people to delay to 3 or 4 years) dramatically reduced peanut allergy rates (4x difference or more). They had suspected this because of comparisons to the country of origin where children were exposed early had much lower incidences, and because as parents had been heeding the warnings and avoiding peanut butter the allergy rate had increased, not decreased. They’re doing a followup study where they offer a wide range of parents the choice and then track the results.
Perhaps the problem is not breastmilk, but undernourished mothers? You can only give what you’ve got and most
i have a 9 month old daughter. at four months my daughter didnt even open her mouth to a spoon. i gave a rice cereal every once in a while when she was five months but didnt start feeding her solids everyday until six months which was perfect because she actually got excited about food and opened her mouth for the spoon. she also got her first tooth at six months. i breastfeed my child and take vitamins every day. i dont believe my daughter is going to have a iron deficiency or have trouble adjusting to food because i waiting a few months until i thought she was ready. she em brasses any type of food i give her and loves green veggies. in fact i only feed her solids once a day until she was 8 months old. now i feed her lunch at 1pm and dinner at 6pm. she is smart, healthy, and develops very well. my daughter has created a feeding schedule on her own and has great eating habits.