Pat, you say:  >Since I read the article I have been asking some of my
clients (from the
past year) if they would classify themselves as having exclusively
breastfed their babies.  Most of them have said "yes."  However, my notes
indicate that very few--actually only 3--have avoided some artificial baby
milk.<

Have you asked about water, teas, fruit juices, etc?  If a baby has any of
these, he or she is not exclusively breastfed, under the WHO definition.  I
don't know what is usual in the US, but in the UK, most babies who escape
milks other than that from their own species [the definitions are silent
about banked milk or wet nursing] probably have one of these fluids.  Any
semi-solids are out, too.

There is a great article in the december issue of the Internation Journal of
Epidemiology by Clara Aarts et al: How Exclusive is Exclusive Breastfeeding?
A Comparison of Data since Birth with Current Status Data.  This compares
the 24 hour recall of the official Swedish stats with more regular detailed
questionaries of the women's feeding practice.

"Results A wide discrepancy between the results obtained from the two
analyses was  found. The difference in the exclusive breastfeeding rate was
over 40  percentage points at both 2 and 4 months of age, (92% versus 51% at
2 months  and 73% versus 30% at 4 months) and 9 percentage points at 6
months (11%  versus 1.8%).
Conclusions Current status indicators based on a 24-hour period may be
inadequate and       even misleading for many purposes. We propose that in
many studies an indicator called “exclusive breastfeeding since birth“ could
be added."

Magda Sachs
Breastfeeding Supporter, BfN, UK

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