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Date: | Sun, 16 Jan 2011 12:05:37 +0000 |
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Dear friends
Jim Akre sent me the following text from Randa Saadeh at WHO. Randa
said it isn't up on the Internet as yet given all the clearances
required, but she says it can be distributed under her name without
restriction. It's certainly good to have such an expert, prompt response.
************
WHO's global public health recommendation is for infants to be
exclusively breastfed for the first 6 months of life to achieve
optimal growth, development and health. Thereafter, infants should be
given nutritious complementary foods and continue breastfeeding up to
the age of 2 years or beyond.
WHO closely follows new research findings in this area and has a
process for periodically re-examining recommendations. Systematic
reviews accompanied by an assessment of the quality of evidence are
used to review guidelines in a process that is designed to ensure
that the recommendations are based on the best available evidence and
free from conflicts of interest.
The paper in this week's BMJ is not the result of a systematic
review. The latest systematic review on this issue available in the
Cochrane Library was published in 2009 ("Optimal duration of
exclusive breastfeeding (Review)", Kramer MS, Kakuma R. The Cochrane
Library 2009, Issue 4). It included studies in developed and
developing countries and its findings are supportive of the current
WHO recommendations. It found that the results of two controlled
trials and 18 other studies suggest that exclusive breastfeeding
(which means that the infant should have only breast milk, and no
other foods or liquids) for 6 months has several advantages over
exclusive breastfeeding for 3-4 months followed by mixed
breastfeeding. These advantages include a lower risk of
gastrointestinal infection for the baby, more rapid maternal weight
loss after birth, and delayed return of menstrual periods. No reduced
risks of other infections or of allergic diseases have been
demonstrated. No adverse effects on growth have been documented with
exclusive breastfeeding for 6 months, but a reduced level of iron has
been observed in developing-country settings.
Randa Saadeh
**************
Pamela Morrison IBCLC
Rustington, England
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