First, let me say that I have not read the article in Scientific American
about malnutrition and development. The study being referenced sounds like
one done by Ray Martorell, Jere Haas, J.P. Habicht and several others in
Guatemala over the last twenty years or so. If so, I also happen to know
these authors (a couple of them quite well) and I have visited the study
sites in Eastern Guatemala. The study began in the mid-1960's back when
people thought that dietary protein was the be-all-end-all of curing
malnutrition. The artificial dietary supplement (called "atole" and
"fresco"
in the study) was created from locally available foodstuffs as a means to
increase dietary protein and, thereby, increase growth of children. Well,
it
turns out that it wasn't so much the protein, but, when you feed kids more,
they grow better (I think the difference was like 2-3 cm in height). It may
sound obvious now, but this study helped us define stunting and better
understand that people in economically-developing countries weren't just
short because of genetics, thus giving us the concept of moderate or mild
malnutrition. Since the late 60's, these scientists have been following up
the children who received supplements (atole/fresco) to see how they
developed into adults and to see if the benefits could be seen in the next
generation. A lot of fascinating things have been discovered in this study,
but they really have little to do with lactation or breastfeeding. When the
study began, that region of Guatemala was relatively remote and impoverished
with essentially no ABM in the communities. Even today, the standard in
that
region is breastfeeding with ABM being truly rare.
While we would love every study to have a breastfeeding component, it is not
mandatory in many very good research projects. Also, the scientists
involved
are quite pro-BF - J.P. Habicht is even a member of the executive committee
of the International Society for Research on Human Milk and Lactation (of
which I too am a member). Before you write those letters to the editors of
Scientific American, think about how your letter might be read and what
effect you are trying to have.
Paul Zimmer, Ph.D.
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