>A study done by Pisacane in 1995 concluded that babies who were
>exclusively breastfed for 7 months (and were not give iron supplements
>or iron-fortified cereals) had significantly higher hemoglobin levels at
>one year than breastfed babies who received solid foods earler than
>seven months.

OK, I'll accept this.  But I also want to know -- where were these infants
from?  What part of the world?  What sorts of diseases?  What is the sample
size?  How much earlier than 7 months are we talking for the "early solids"
group?  If this a controlled comparison of 6 vs. 7 months of exclusive
breastfeeding, or is this a division into 7 months of exclusive
breastfeeding vs. less than 7 months of exclusive breastfeeding?  If the
latter, you could have children in the sample who started solids at 1 month
or 2 months or 3 months.  They might pull the average hemoglobin levels down
in their group.  There may be no difference in 6 vs. 7 months of exclusive
breastfeeding.

I also want to know how their growth was?  I wouldn't necessarily want to
trade-off better iron status for poorer physical growth.

>The researchers found no cases of anemia within the first
>year in babies breastfed exclusively for seven months and concluded that
>breastfeeding exclusively for seven months reduces the risk of anemia
>and should be recommended in parts of the world where breastfeeding is
>common and iron supplementation is not available or culturally
>acceptable.

OK, so this would mean only in places like Mali and other 3rd and 4th world
countries?

I suspect that the early addition of solids in these places leads to poorer
iron status because:
(1) the solids are contaminated with bacteria, leading to GI infections and
blood loss
(2) the solids are contaminated with parasites, leading to GI colonization
and blood loss
(3) the solids contain something which binds to iron and pulls it out of the
body (I know that phytates in some grain crops like millet and sorghum pull
zinc out of the body, for example)

So Pisacane's conclusion would then be that it is perfectly fine to give
solids to 4-6 month old children in 1st and 2nd world countries where
breastfeeding is uncommon and where iron supplementation is readily
available and culturally acceptable.  Right?

Kathy Dettwyler

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