Prolonged Breastfeeding ‘May Harm Babies’ Health’
Breastfeeding exclusively for six months may put babies off some foods and increase their risk of allergies, obesity and iron deficiency, an expert report reveals today. The highly controversial study, published in the British Medical Journal, raises serious questions about the Government’s advice to hold off giving babies any solid food until they are six months old. The authors – who include Professor Alan Lucas, director of the largest child and nutrition research centre in Europe, and Professor Ian Booth, an expert in paediatrics and child health at Edinburgh University – are now calling for a review of the guidance. They said the decision to adopt the six months goal, after a World Health Organisation (WHO) recommendation in 2001, underwent “surprisingly little scrutiny” in the UK. They added that 65% of European countries and the United States did not fully adopt the advice, if at all. Dr Mary Fewtrell, consultant paediatrician at University College London’s Institute of Child Health and lead author on the report, said: “To make mothers feel they have failed because they have not reached this six-month target, particularly when it is not solidly evidence-based, is simply wrong. “I think we should be more honest with parents as to what evidence we have. At any other developmental stage of a baby’s life we do not expect them to achieve it at the same time. Why this should be seen in a different way, I do not know.” The authors stress they are not disputing the benefits of breastfeeding, but wholeheartedly support it alongside the timely introduction of other food. According to their research, the Who recommendation “rested largely” on a review of 16 studies, including seven from developing countries, where infants are at much higher risk of infection. While this concluded babies just given breast milk for six months had fewer illnesses and experienced no growth problems, the experts say a review of another 33 studies found “no compelling evidence” against starting solids from four months onwards. In fact, they say some research has shown purely breastfeeding for so long does not give infants all the nutrition they need. One US study found it leaves children at greater risk of anemia, which can permanently damage their development. There is also mixed evidence on whether children who live on breastmilk for six months are at greater risk of allergies. Researchers in Sweden found the incidence of early onset coeliac disease increased after a recommendation to delay introduction of gluten until six months, “and it fell to previous levels after the recommendation reverted to four months,” say the authors. They later add: “There are also relatively unexplored concerns about the potential for prolonged exclusive breastfeeding to reduce the window for introducing new tastes. Bitter tastes, in particular, may be important in the later acceptance of green leafy vegetables, which may potentially affect later food preferences with influence on health outcomes such as obesity.” They note most parents already make a judgement on the right time to wean their children based on their behaviour, with a UK survey in 2005 showing just 1% limit their diet to breastmilk for six months. Scotland has poor breastfeeding rates overall, with almost three-quarters of babies drinking infant formula by eight weeks. Gillian Smith, director of the Scotland board for the Royal College of Midwives, agreed there was a need to review the evidence. She added: “With this report coming out I think health professionals advising mothers are going to need more information on what guidance they should be giving.” A Scottish Government spokeswoman said: “We want every child to get the best possible start in life and we know breastfeeding has many major health benefits for mum and baby – both short and long-term. “That’s why we fully endorse the World Health Organisation’s guidance, recommending exclusive breastfeeding until a baby is six months old, when solids should be introduced.” She said this followed the consensus of international opinion, but they would continue to monitor emerging evidence. A new framework on maternal and infant nutrition will be published by the Scottish Government later this month.