Below are the current (and unchanged since 1979) WHO recommendations, which
I just this second pulled off their web site.  You can verify this for
yourself by going to the WHO web page at http://www.who.int/

Click first on "Health Topics" and then "Lifestyle" and then "Food and
Nutrition" and then down at the bottom right on "NHD Activities and Outputs"
and then on "WHO's Infant-Feeding Recommendation in English" (it is also
available in French).

In an email to me on 22 December 1999, Mr. Akre wrote, in part:

>Also, researchers in England have just completed a thorough review, based
on stringent >criteria, of the last 40 or so years of research on the
subject of when complementary >feeding should begin. Based on the studies
retained and analyzed, they conclude that >the evidence is currently
insufficient to justify any change from the 4-6 month >recommendation.


World Health Organization's Infant-Feeding Recommendation

    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 in 1995, from the
WHO Expert Committee on the use and interpretation of
anthropometry, underscores the reliability of the earlier 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.

    * The World Health Organization's Infant-Feeding Recommendation
is also available online in French.

    * A list of references is available on request from the Division of
Nutrition for Health and Development, WHO, 1211 Geneva 27,
Switzerland.

On another part of the WHO web pages, they mention major problems they are
currently working on, including:

>Other important nutrition issues affecting large population groups:
>Only 34% of infants ever exclusively breastfeed between 0-4 months of age;

Just one more indicator that 4 months is the lower cutoff they are worried
about.


Katherine A. Dettwyler, Ph.D.
Associate Professor of Anthropology and Nutrition
Texas A&M University
Defender of the WHO

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