From Suite 101
Jan 31, 2011 Kerri TYLER
The year started with a media frenzy over a new UK report on breastfeeding. But what’s the truth behind the headlines?
New parents have enough to cope with in terms of information overload, so breastfeeding mothers in the UK must be tearing their hair out. In January 2011, newspapers ran headlines such as ‘Six months of breast milk…could harm babies’ and, in the best-selling Sun, ‘Breast is not best’.
World Health Organisation (WHO) guidelines advise women to exclusively breastfeed to six months. But new research seems to suggest that babies breastfed to six months may be losing out on essential nutrients, especially iron. Such children may also be more susceptible to food allergies and even obesity.
Take a look behind the headlines, though, and the story is far from conclusive. NHS Choices, the information provider of the UK’s National Health Service, deflates the hyperbole by explaining how the researchers (from London’s Institute of Child Health, the University of Edinburgh and the Institute of Child Health at the University of Birmingham; printed in the British Medical Journal or BMJ) reached their conclusions.
Far from being new research, the report which triggered the media frenzy was a narrative review of existing evidence; or, as Rosie Dodds, Senior Policy Advisor with the National Childbirth Trust (NCT), the UK’s leading parenting charity puts it, “an opinion piece which raised questions and did not provide any new evidence, alter policy or recommendations.”
Based on the studies they considered, the researchers conclude that the existing advice should be reconsidered. They do not detail how many studies they reviewed, nor how they selected them. They confirm that the studies they reviewed were observational, so cannot conclusively prove cause and effect, and they say their results should be approached with caution.
So what are the facts?
The new report cites a 2007 study that suggests babies breastfed to six months are at greater risk from anaemia and had lower levels of iron.
However, there is disagreement over just how much iron a baby needs. La Leche League, a charity that supports breastfeeding mothers, says, “[Iron in] breast milk is more completely absorbed than the kind in formula, baby cereal or supplements. Breastmilk contains a protein that binds to any extra iron baby doesn’t use because too much iron can end up feeding the wrong kind of bacteria in his intestines, and this can result in diarrhoea/constipation or even microscopic bleeding. Formula-fed babies can have too much iron in their intestines, which causes these problems and ends up reducing their overall iron.” Rosie Dodds of the NCT adds, “The authors mention early cord clamping, which is almost universal in this country, but do not reference the recent Cochrane review which concludes that physiological or ‘late cord clamping can be advantageous for the infant by improving iron status’.”
There is little debate over this: evidence clearly indicates that exclusive breastfeeding to six months reduces a baby’s chances of pneumonia, gastroenteritis and ear and respiratory infections.
It’s complicated. The British Medical Journal report suggests there’s an increased risk of food allergies if solids are introduced before three to four months. However, allergies may be increased if the foodstuffs that trigger them are introduced too late. So how can parents get it right? More research is needed. “Trials are being undertaken to test if babies with a family history of true allergy might be helped by earlier introduction of certain foods,” says La Leche League. “But, as a rule, the majority of babies are less likely to have an allergic reaction to foods by around six months.”
The jury’s still out. One study in Belarus found that children who were exclusively breastfed to six months were more likely to be overweight than those who were breastfed to three months. However, earlier evidence from Denmark showed that introduction of solids before six months was linked with a greater risk of being overweight by the age of 42.
So what’s the best thing to do?
Until conclusive, results-based evidence is published, trust your instincts regarding your own baby‘s nutritional needs. Don’t let friends, family members or news providers make you feel bad about your choices. As far as introducing solids is concerned, La Leche League suggests you watch for cues that baby’s ready, such as being able to sit up, taking an interest in food, putting it in his or her mouth and chewing without choking – and that often happens around six months.
Copyright Kerri TYLER. Contact the author to obtain permission for republication.