>Alison Hazelbaker writes:

>Babies show signs of readiness for solids. Solids given in the first year
>appear to be more of a social event rather than a nutritional one, generally
>speaking. Now, there are babies who need solids. I question the former WHO
>guidelines of 4-6 months in any country.
>

Jumping back in, and trying *not* to start a huge debate, I will try to be
clearer on the WHO guidelines than I was before.

In countries where many women have marginal nutrition themselves and poor
health/lack of access to health care, breastfed babies AS A GROUP grow well
until 4 months of life.  After that time, if not supplemented with safe and
appropriate solid foods, their growth AS A GROUP deviates below the NCHS
standards.  We can debate the appropriateness of the standards, and how they
were developed, until the cows come home, but there is already abundant
research documenting that children who grow poorly in childhood have
lifelong functional consequences including: lower IQ and poorer school
performance, more sickness and earlier death, less ability to do sustained
hard physical labor, and for the females lower reproductive fitness in terms
of more miscarriages, more stillbirths, higher child mortality.

In countries where women generally have good nutrition and good health,
breastfed babies AS A GROUP grow well until 6 months of life.  After that
time, if not supplemented with safe and appropriate solid foods, their
growth AS A GROUP deviates below the NCHS standards.  Thus, the WHO
guidelines that breast milk is sufficient by itself for 4-6 months,
regardless of the country.

Of course there are children in both situations who can survive and grow
well on breast milk alone for the first year or longer.  Of course there are
children in both situations who do not survive or do not grow well on breast
milk alone for the entire 4 months.  WHO guidelines are supposed to be "one
size fits all".  It's akin to the RDA guidelines for how many calories, how
much protein, vitamins, minerals, etc. people need each day.  They are set
at what satisfies the needs of 80% of the population.  So some people can
ingest the RDA and be getting less than they need, while more than 3/4 of
the populations can ingest the RDA and be getting more than they need.

Children generally start showing an interest in food during the second half
of the first year, and I feel, as I said before, that we should listen to
them and follow their cues.  If the five month old belly crawls across the
floor in pursuit of a croissant, don't be a slave to the calendar and say he
can't have it because he isn't six months old yet.  I *don't* think that
food is *just* or even *mostly* a social event at this age, though the
social aspect of eating is an important factor in every culture.  End of
soapbox.

 P.S.  I'm confused by the use of the term "former" in Alison's post.  These
are STILL the WHO guidelines, despite UNICEF's attempts to tell the world
that the WHO had changed the guidelines to say "6 months."  Is this what you
are referring to, Alison?  UNICEF was mistaken in saying that the WHO had
changed their guidelines from "4 to 6" to "at 6" -- they did not.  And I
have that from James Akre's mouth, personally, less than two weeks ago, and
he is the one who writes the WHO recommendations.
Kathy Dettwyler
e-mail to [log in to unmask]
Associate Professor of Anthropology
Specialist in infant feeding and growth