>But, if the conditions are that adverse that mothers' milk is not sufficient
>(which means maternal food status is really, really bad), where do they get the
>good foods to complement?
>Just wondering how to put two pieces of knowledge together.

You don't have to have starving mothers (at all!) to see slower growth in
populations of babies living under adverse environmental conditions.  Growth
is not just about nutrition -- it is also about disease.  Children coping
with many diseases need more calories and nutrients than children living in
basically disease-free circumstances (most in the US).  The mother may be
quite healthy herself and quite adequately nourished, but the child has
greater-than-normal nutritional needs.

And, no one says that safe and appropriate complementary foods are readily
available in developing countries.  This is one of the big problems.

Really, folks, I'm going to stop commenting on this, as most of the
discussion is silly -- you cannot conflate what mothers do in industrialized
countries with circumstances such as Mali.

The original post that got this started was the newcomer (whom we probably
scared off) who posted that she couldn't convince her pediatrician that all
babies were fine on exclusive breastfeeding until 6 months of age or longer.
She wanted to say that no babies ever needed anything other than mother's
milk until at least 6 months, and the data simply do not support this claim.

Whether or not solids undermine breastfeeding depends on when they are added
(see Sara Quandt's work on this, summarized in Fishman and Dettwyler 1992,
Annual Review of Anthropology article "Infant Feeding and Growth"), and in
what quantities.

Imagine for a moment a "typical" baby -- these are made-up numbers for the
purpose of the explanation.

Birth to 6 months: 100% of nutrition from breast milk, say starting out with
one UNIT of breast milk per day and increasing as he grows to 10 UNITS of
breast milk per day at six months.

6 to 12 months: he continues to ingest 10 UNITS of breast milk per day,
gradually increasing up to 12 UNITS of breast milk per day, plus he starts
getting solids.  So he no longer gets 100% of his nutrition from breast
milk, even though he continues to ingest as much or more breast milk as he
did at 6 months of age.  By 12 months he is getting 75% of his nutrition
from breast milk and 25% from solids.

at 24 months: he is now getting only 6 UNITS of breast milk per day, which
represent 50% of his nutrition, and the other 50% from solids (he needs less
than he did as an infant because his growth rate has slowed way down).

at 36 months: he is now getting only 4 UNITS of breast milk per day, which
represents 25% of his nutrition, and the other 75% from solids.

at 48 months: he is now getting only 2 UNITS of breast milk per day, which
represents 15% of his nutrition, and the other 85% from solids.

at 60 months: he is now getting only 1/2 a UNIT of breast milk per day,
which represents 5% of his nutrition, and the other 95% from solids.
However, whenever he gets sick, he is still being helped to recover by the
immune factors in breast milk, and he also gets great emotional comfort out
of breastfeeding.

The point of this exercise is to point out that the addition of solids does
not NECESSARILY lead to an immediate reduction in the amount of breast milk
the child is getting, and it does not necessarily mean the imminent end of
breastfeeding.  Most children in the world nurse for several years beyond
the addition of solids in the second half of the first year.

Kathy Dettwyler

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