Katherine said:

>There are a few colleagues who omit these key references from their
>discussions of the timing of complementary feeding, and insist on
>recommending complementary foods from 4 months or using the outdated
>terminology of "4-6 months."

I would hardly call the World Health Organization "a few colleagues."

When I read this I understood it to mean that the authors were remarking on
colleagues working in UN agencies or within WHO.  I assume that there is
bound to be debate and differing opinion among the fellow-colleagues working
in these agencies.  When a debate is happening within an organsation it is
not always easy, as outsiders, to see what is happening -- I guess we all
have experience of that.  I am not sayin gthere shoudl be uniform agreement
on the part of those involved in the policy-making organisation, by the way,
merely indicating that what we may be seeing is as a result of these.

I would, in fact, be astounded if any change to the recommendations were to
come about without disagreement of some level of intensity.  Has anyone ever
know this to happen anywhere else?

You went on to say:

. " So it isn't at all clear how exclusively BREASTFED babies grow
when they are fed on demand and throughout the night and cosleep with their
mothers.  We do not in fact know whether their growth patterns are similar
to the NCHS standards, whether as a group they start to falter between 3-6
months relative to the NCHS standards, or if, in fact, they grow faster
than the NCHS standards.

Even the new and improved WHO standards due out in 2003 based on babies fed
according to current WHO guidelines of exclusive bf for 4-6 months followed
by appropriate and safe solids are not taking into account how often babies
are breastfed, where they sleep at night, or whether they are encouraged
not to breastfeed at night.  Thus, we may NEVER know what the normal growth
patterns are like of co-sleeping babies fed on demand."

Yeah, I can see this is an issue in some ways, however, lets be honest about
our practice at the moment.  Some of us are sometimes wanting to know what
growth we should can expect is within normal limits for exclusively
breastfed babies, but so many of the babies we see are not exclusively
breastfed ad lib, so why would applying those standards to them be helpful?
The whole thing comes down to how useful a notion one thinks growth charts
and growth monitoring are.  As I previously posted, there is debate in the
ADC this year and the Cochrane review of Dec 1999 came down to questioning
any usefulness in growth monitoring through routine weighing. (Panpanich and
Garner).  You can probalby guess my general feeling  on the subject, and I
know that this is not in congruence with most Lactnetters.  However, we did
not discuss what kinds of charts -- if we use them -- would be most useful.
Why would we want to measure the growth of mixed fed babies against that of
exclusively breast fed ones?  We really need a bezillion different charts
taking individual circumstance into account.

Magda Sachs, wondering who would make money if there *were* a bezillion
different charts to sell.
Breastfeeding Supporter, BfN, UK

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