I think that the brain-storming that has followed on the Lactnet postings about recommendations to start solid foods at 4 months is fantastic.  Everybody has contributed valuable pieces of information.  At last I got through the 32 pages of Hebrew text, the revised guidelines on infant feeding recommendations of the Israeli Ministry of Health.
I might get more sympathy if I explain that while most of us speak the language fluently, the Hebrew alphabet is completely different from any Latin language,  we read from right to left and in printed text no vowels are used.  
Tht mns tht y hv t b fmlr wth th rt cnsnnts t mk sns f t txt
If you found that sentence incomprehensible it is because there are no vowels and it should read:
That means that you have to be familiar with the root consonents to make sense of the text.

At first glance I was impressed by the numerous references from respected organizations such as WHO and the Cochrane Database.  The documents deal with every aspect of infant nutrition, so the numerous references to WHO documents refer to the established facts that reinforce that breastfeeding is best for babies and for mothers too.  The basic recommendation remains that exclusive breastfeeding should be encouraged until age 6 months and then breastfeeding continued until at least one year of age with the introduction of suitable foods.

The new concerns dealt with in this document are:
1)prevention of allergies by introducing "tastings" of small amounts of solid food from 4 months
2) prevention of iron deficiency.

Tje problem is that there is no attempt to differentiate between babies who are exclusively breastfed from birth and those who are only partially breastfed or entirely formula fed.  While advising mothers not to restrict their diet unless a baby suffers from severe intolerance to dairy foods, it acknowledges that babies are exposed to allergens in their mothers milk.  There is also reference to cultural norms in diet and in Israel this is very varied.
So using this parameter, the recommendation to expose the baby to allergens by giving small amounts at 4 months should apply only to formula-fed babies.
The foods recommended to be given in these small amounts are ones that previously would not have been considered suitable for a baby under 6 months and in some cases even under one year, i.e. fish, eggs, meat, chicken.
Has anyone considered the assault on those little tummies even if it is just a couple of spoonfuls twice a day?   Also all these foods have potential for contamination.
When I worked in a kibbutz nursery after we arrived here in the 70`s, babies were given chopped liver and chicken soup, cottage cheese and scrambled eggs from 4 months and although the food was prepared under extremely hygienic conditions we had to cope daily with tummy upsets - or if babies got constipated they were given drinks of tomato juice!!  There were also lots of ear infections and respiratory infections which suggested they were not handling these allergens as well as exclusively breast-fed babies.

 Esther Grunis has alerted us to the correlation between the list of consultants who wrote these recommendations and the list of "experts" who are participating in a "scientific conference" run by Materna, the local manufacturer of artificial baby foods (owned by Nestles)
Contrary to everything written in the WHO Code, this company is using their name to donate to hospitals, to sponsor research and study events.

It is true that the new document continues to recommend breastfeeding and nowhere does it suggest that any of the recommended supplements at 4 months should include formula. But this causes sufficient confusion and anxiety so that mothers  will not get consistently correct information from their professional caregivers.

When there is confusion, this reinforces all the fears and concerns that many mothers have that their milk is not adequate, not good enough.

While these formula manufacturers can use their enormous profits to invest in marketing strategies, breastfeeding organizations get no public funding for promotion or for our counsellors to reach a wider public.


 Let`s continue to network on this issue.
Wendy Blumfield
Israel Childbirth Education Centre




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