Karleen

Thank you for alerting us to the discrepancies between breastfeeding
recommendations between different regions and countries.  And thank you to
those who have replied.  I've just read the WHO European recommendations
with much interest.  Who could have known that they would be different from
the global recommendations.???

Karleen, what you have found is indeed very strange.  The phraseology in
some of these policy documents is so intriguing.  Altering a word or two
can completely change the meaning and intent, to affect, either positively
or negatively, the health and well-being of hundreds of thousands, if not
millions, of babies/young children/future adults.  It is one thing to
suggest that continued breastfeeding well into the second year of life and
beyond is a recommendation for all babies (as in the global guideline) and
quite another to suggest that the risks of not breastfeeding for this
length of time will have greater negative consequences for those children
in resource-poor settings than it will for those born in comparatively
affluent societies.    The effect of the slight change in the wording of
the recommendation suggests that breastfeeding for the first year is only
necessary for poor countries, or poor children in rich countries.   Why
would European or Australian or AAP policy need to differ from Global
policy?  Why would international health agencies suggest that national
policy should differ from international policy?  Babies are babies, and
there are likely to be negative health consequences for *any* child weaned
too early no matter where they are.

I do find this strange.  If we consider that breastfeeding is a very basic
healthful practice which provides optimal nutrition/health for all babies
no matter where they are born,  costs nothing and saves millions, then
there is no logical justification for different places to adopt different
policies.  Where policy guidelines use the same research base to arrive at
different conclusions, or selectively exclude research to arrive at
seemingly inexplicable conclusions, then perhaps a small investigation of
the political affiliation and/or degree of influence of individual
committee members might be in order.   That's not to imply that all the
good people listed in the front of the WHO Regional European Guideline have
not done their best, I can see that we had some really good friends on the
panel.  But discrepancy hints at political influence, rather than
oversight, that's all ....

Lovely to see you at the ALCA Conference last weekend.

Pamela Morrison IBCLC, Australia


At 03:42 AM 27/09/04, you wrote:
>Date:    Sun, 26 Sep 2004 15:50:11 +1000
>From:    Karleen Gribble <[log in to unmask]>
>Subject: Re: WHO European recommendations on duration of breastfeeding
>
>Kathleen, Thankyou very much for passing on the link (I did look but =
>couldn't find it, I love Lactnet!).
>
>
>
>Anyway, checking the document has underlined how important it is to look =
>at the primary source.=20
>
>=20
>
>The NHMRC Dietary Guidelines for Children and Adolescents in Australia, =
>2003 states "It is recommended that breastfeeding continue until 12 =
>months of age and thereafter as long as mutually desired." and cites =
>Michaelsen KF, Weaver L, Branca F, Robertson A. Feeding and nutrition of =
>infants and young children: guidelines for the WHO European region, with =
>emphasis on the former Soviet countries. Copenhagen: WHO Regional Office =
>for Europe, 2000.=20
>
>
>
>However, this document says something quite different
>
>
>"For the WHO European Region it is therefore recommended that =
>breastfeeding should preferably continue beyond the first year of life, =
>and in populations with high rates of infection continued breastfeeding =
>through the second year of life and longer will benefit the infant."
>
>However, the AAP statement says  "It is recommended that breastfeeding =
>continue for at least 12 months, and thereafter for as long as mutually =
>desired"=20
>
>
>
>It is very strange indeed. The statement in the NHMRC document does not =
>say anything like what is in the WHO Europe document but in fact says =
>something that is close to (but certainly not the same) as the AAP =
>position statement. I wonder if this is deliberate or accidental, who =
>did they mean to quote? Did they just add in a reference to back up what =
>they thought the recommendation should be.
>=20
>
>Moral to the story, never believe any quoted position statement, always =
>check the primary source!
>
>=20
>
>Karleen Gribble
>
>Australia

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