Thanks are due Sandy Arnold for alerting us to the article,
which we in Geneva have not yet seen. Judgement and action
are reserved until we do. However, this is perhaps a good
opportunity for you to have access to WHO's infant-feeding
recommendation and not what someone else says it is. The
reference is: Weekly Epidemiological Record 1995;17:119-120.
<The World Health Organization recommends that infants
should be fed exclusively on breast milk from birth to 4 to
6 months of age; that is, they should be given no other
liquids or solids than breast milk, not even water, during
this period. Given the worldwide variation in growth
velocity, an age range is an essential element of this
feeding recommendation. Mean growth Z-scores are indeed
observed to begin falling at different points within this
4-to-6-month range in breast-fed infants from different
populations worldwide. WHO and its partners are in the
process of refining the definition of "optimal" growth, as
measured by accepted functional indicators of infant health
and well-being.
<After this initial 4-to-6-month period of exclusive
breast-feeding, children should continue to be breast-fed
for up to 2 years of age or beyond, while receiving
nutritionally adequate and safe complementary foods.
Starting complementary feeding too early or too late are
*both* undesirable. Ideally, the decision when precisely to
begin will be made by a mother, in consultation with her
health worker, based on her infant's specific growth and
development needs.
<WHO's current infant-feeding recommendation was based
initially on the technical review and discussion undertaken
in 1979 in connection with a joint WHO/UNICEF meeting on
infant and young child feeding. The meeting's statement and
recommendations were subsequently endorsed in their entirety
by the World Health Assembly. Important additional
scientific evidence including, most recently, from the WHO
Expert Committee on the use and interpretation of
anthropometry, underscores the reliability of the 1979
review.
<Although future scientific information and better
understanding of the variable impact of individual and
population circumstances may well warrant a change one day,
present scientific evidence confirms the suitability of
WHO's long-standing infant-feeding recommendation.>
If anyone has a copy of the WP article, my fax number is
(41-22) 791-4156. Also, fax no. and e-mail address for WP
would be appreciated. TIA. Jim Akre, Nutrition unit, WHO
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