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From:
Nutrition <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 27 Feb 1999 08:09:33 -0800
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I have been following the discussion on solids and appreciated everyone's
comments.

Perhaps it should be mentioned that there is a good resource now available
titled "Complementary Feeding of Young Children in Developing Countries:  a
review of current scientific knowledge", World Health Organization, 1998.
,
There is a special section 2.2 on Age of introduction of complementary
feeding including Current recommendations and Theoretical considerations,
with full discussion on energy needs, infant growth, observational studies
in both developed and developing countries, and a discussion on results of
experimental studies and risk of nutritional deficiencies during exclusive
breast-feeding.

The summary is very helpful and points out that energy needs cannot be used
as the basis for deciding when to introduce solids, that growth rates of
fully breast-fed infants in developing countries are similar to those of
their counterparts in more affluent countries in the first six months of
life.   The risk of diarrhoeal morbidity in poor populations is 2-fold to
13-fold higher when breast-fed infants are given complementary foods
between 4 and 6 months than when they are exclusively breast-fed, based on
2 observational studies.

The authors of the report take the viewpoint that it is safer to recommend
exclusive breast-feeding until about six months, and that there are
advantages to this recommendation rather than stating an age range.  They
point out that an age range is vulnerable to misinterpretation by health
care workers and food companies with a vested interest in earlier
introduction of solids.  Health care workers may encourage earlier
introduction "just to be safe", and parents may provide "tastes" of foods
before four months thinking that the infant should be eating solids well by
that time.

As to the issue of risk of iron deficiency, it points out that low birth
weight infants are at greatest risk, and that supplemental iron drops are
recommended, and may also be more effective than the introduction of foods
for normal birth weight infants who are iron deficient.

It  also points out that complementary foods may or may not reduce the risk
of micronutrient dieficiencies, the nutrients of most concern being iron,
vitamins A, D, B12, riboflavin and possibly zinc.

Lois Englberger, MNS, Federated States of Micronesia.

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