Andrea says:  I want to know what exclusive bf is according to thoes who ask
questions =
on the IBCBC exam.  I ran into some questions in the Linda Smith review =
book which made me wonder.  i read Riordan and Aerobachs defenition and =
i hear a lot of different answers when i ask this question, so i guess I =
wnat to knw which would give me the correct answer onthe test, or are =
they not that specific?

Andrea, I don't know what the exam-setters define as ebf, but there are two
international sets of breastfeeding definitions.  These were developed for
use in research.  They are reiterated in the LLLI Breastfeeding Abstracts of
Feb 2000 (19(3) 19-20), by Miriam Labbok.

The first set, from the Interagency Group for Action on Breastfeeding (IGAB)
came from a meeting in 1988.  "The parameters agreed upon for a definition
include:
* A definition only applies to a single point in time, perhaps a 24-hour
recall
*It defined only breastfeeding and does not define other forms of feeding.
* It differentiates breastfeeding from breast-milk feeding
* It encourages further description when the basic definitions are used

In this schema 'exclusive breastfeeding: No other liquid or solid from any
other source enters the infant's mouth'  whereas 'almost exclusive allows
occasional tastes of other liquids' and these together constitute 'full
breastfeeding'.  there is also 'full breast-milk feeding' and other
definitions.

The second set of definitions is the set done in 1989 by WHO/UNICEF.  This
is the definition used in some recent research (e.g. Coutsoudis study).  In
this, breastfeeding is defined as 'the child has received breastmilk direct
from the breast or expressed'.  Exclusive breastfeeding  is defined as 'The
infant has received only breast milk from the mother or a wet nurse, or
expressed breast milk, and no other liquids or solids with the exception of
drops or syrups consisting of vitamins, mineral supplements, or medicines'.

For more discussion see Labbok.

Note that neither of these definitions is 'dynamic' -- i.e. over a child's
life so far.  The Coutsoudis research used this definition and applied it
over the course of the baby's life from birth.  The Hormell paper I cited a
day or so ago and a paper by Aarts in Dec 2000 International Journal of
Epidemiology consider in detail how the lived experience of babies and
mothers over time contrasts with 24 hour sampling (which is how official
govt stats are done -- at least here in the UK and in Sweden and also, I
believe in Africa -- these are the stats I am familiar with).

Labbok finishes her review in Breastfeeding Abstracts :  "So, what is the
'exclusive breastfeeding' that so may organisations recommend for the first
six months?  Do they know?  Do you?"

Magda Sachs
Breastfeeding Supporter, BfN, UK

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