Sarah Vaughn writes that the idea of recommending six months exclusive bf
originated with the 2001 Kramer and Kakuma article, but I suspect that
article was prompted by the industry-driven recommendations for 4-6 months
of exclusive bf in most of the western world, which had replaced previous
advice to wait until 6 months to introduce complementary foods. I know that
when I was feeding my first child in 1981, I did so in accordance with what
the professor in my maternal and child nutrition course said the evidence
supported at the time, which was exclusive bf for six months. My health
care provider, a GP in a large HMO, as well as the professional midwives
who cared for me in the beginning, were all in agreement and my
contemporaries had all been given the same advice. It was the
recommendation in Norway before I moved here in 1984, but was changed to
4-6 months when the industry lackeys on the working committee responsible
for revising the guidelines won the power struggle over it. In 2000 the
guidelines were revised again, to support exclusive breastfeeding for six
months, and the industry has been fighting it in really dishonest and
underhanded ways ever since. The revision involved a comprehensive review
of the current evidence at the time and the Kramer article had not yet been
published.

I would be happy indeed if our health visitors could be more relaxed about
the six month exclusive bf recommendation, but in the other direction! Most
seem to be recommending 'tastes' of solids from 4 months, and they refer to
the mythical window for accepting new tastes as justification: unless you
start offering taste samples by 4 months, you won't be able to escalate to
the required amount by 6 months, if ever.

When a baby is thriving on breastfeeding, and I mean thriving - growing
beautifully, passing developmental milestones as expected and just
generally bouncing around pleased as punch, but has reached the magical age
of 182.5 days on breastmilk alone, 'hammering' barely begins to describe
the combination of threats, scaremongering, and cluckings of concern about
malnutrition and even child neglect mothers are subjected to if the baby is
not devouring at least two large helpings of iron-enriched commercial
infant cereal plus 'dinner' daily. The number one suggestion for how to get
the baby to take 'enough' other foods (enough for what? never elucidated
upon) is to restrict access to the breast or wean altogether. I wish I were
joking but this is in fact commonplace all over the country. The pressure
to start weaning is massive, far greater than the purported pressure to
breastfeed here. And it is applied as though 100% of babies are ready to
cease breastfeeding more than 2-3 times in 24 hours by exactly 6 months of
age, to the minute.

As you can see, this really winds me up. I don't hammer on mothers, and
especially not about feeding. Would dearly love to have a mallet in a room
filled with policy makers and health visitors where I could keep them
penned in until I'd tapped them all on the head as many times as it took to
get this point through their heads, though.

Rachel Myr, haranguing away in Kristiansand, Norway

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