>There is also no growth
>advantage in the complementary feeding of breastfed infants in developing
>countries prior to six months.

I must disagree.  The WHO reports that serve as the background for their
feeding recommendations do show better growth in breastfed infants (at the
population level) in developing countries from 4-6 months when *appropriate*
solids are added to the diet.

We must remember to distinguish between the addition of solids in western
contexts and the addition of solids in traditional societies and developing
country contexts.  They can be radically different.

In the west, people often begin with commercial cereals, followed by
commerical fruit mush and vegetable mush.  They often start right off with
offering solids several times a day, consistently and in ever increasing
amounts from the first time they offer.  Often within just a few weeks, the
child is eating a whole bunch of solid food and breastfeeding less and less
and less, so that the end of breastfeeding is hastened by the addition of
solids.

In Mali, just as one example with which I am very familiar, children start
solids around 8 months, and they start often with things like fried potatoes
(French fries) and fried whole fish (LOTS of fat and protein) and fruit
(mangoes in season, bananas, etc.), and peanuts.  They may get a small fish
at 7.5 months, and nothing more for 3 weeks, then a mango and some peanuts,
then nothing for 1.5 weeks, then some breakfast porridge (cereal) one day
and a piece of mango the next and then nothing for two more weeks.  It is
much more haphazard, and it doesn't seem to affect their breastfeeding
habits at all.  Children continue to nurse many times a day and at night for
several years after the addition of solids.

Western and Malian nutritionists and crop specialists collaborate to develop
better solid foods for infants -- ones with more protein in particular, and
more vitamin A and more vitamin C.  For example, they work to develop seed
varieties that have more protein, plus they do studies on the naturally
occuring levels of protein, A, C, and zinc in wild plants that local
populations use.  When they found trees with extraordinarily high levels of
these nutrients, they planted orchards of grafted trees to try to provide
every village with their own source.  When carrots are added to the diet of
young children so their Vitamin A levels are better -- the kids grow better
because they get sick less often.  There is plenty of evidence that adding
solids to the diet between 4 and 6 months helps kids grow better under
certain circumstances.  This doesn't mean they don't still need their
mothers' breast milk -- they obviously do.  But it may not be enough after 4
months under adverse conditions.

Kathy Dettwyler

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html