Kristeen

So interesting!!! I heard a slightly different version from someone 
who moves in the right circles at the international meetings.  The 
story goes that the 4 or 6 months thing was entirely a political 
decision - four months being an initial compromise (is it in the 
Innocenti Declaration and in the WHO Global Strategy?)   Finally 
sanity prevailed, and the recommendation was changed to 6 months, 
reflecting the actual research.

Far from developing-country mothers' milk being weak or inadequate, 
it's just as good as the milk produced by mothers in industrialized 
countries.  Young child malnutrition usually starts around the time 
of weaning, not during full breastfeeding.   I think it was Ann 
Prentice who studied the "quality" of the milk of Gambian mothers who 
experienced seasonal food variation and found that it was 
normal.  What did happen is that prolactin levels were raised, 
however, so that mothers stopped ovulating during lean times and 
birth intervals were longer.  Nature knows best!   One of my 
Zimbabwean nutritionist friends explained to me that the mother would 
have to be very severely malnourished herself for her milk supply to 
be affected, eg you see loss of muscle as well as loss of fat, and 
then the quantity rather than the quality would fail first.  In 
addition, if you think about it, if food is in such short supply that 
adults would starve, then babies would be even worse off.  In fact, 
when you see newsclips of starving babies and young children in 
Ethiopia and Niger and Darfur, you'll often notice that the mothers 
are quite well-covered (ordinarily plump fingers holding the babies, 
pretty faces) - it is only the babies who are so distressingly 
emaciated.  Clearly, what has gone wrong is that mothers have 
sufficient access to food, but they have insufficient access to good 
information and support for breastfeeding.  The remedy in such a 
situation would always be to feed the mother to feed the baby.

Pamela Morrison IBCLC

At 23:15 24/02/2008, you wrote:

>Hi,
>   I have been waiting to see if anyone with more expertise on this 
> subject would add this thought to this thread, but haven't seen it, 
> so I'll chime in.  I know that I read "somewhere" that the reason 4 
> - 6 months was first proposed for beginning solids is because in 
> developing worlds, the mother's diet may be so deficient, both 
> during breastfeeding as well as during the pregnancy, that those 
> babies may need to start solids earlier in order to get all their 
> nutrients, than the babies of mother's in more affluent, well fed 
> countries.  That's not to say that "Watch the baby, not the 
> calendar" isn't valid, but I was under the impression that was the 
> main "clinical" reason for suggesting starting solids before 6 
> months.  Of course, I can't remember where I first heard or read 
> this, so have no references, but maybe someone else remembers it, too.
>   Kristeen Rogers, RN, IBCLC

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