I just wanted to add my two cents regarding the age at which solid foods are
added to the breastfeeding baby's diet. Looking at the literature we find
that in affluent populations, introducing solid foods before six months has
little impact on the total energy intake or growth. There is also no growth
advantage in the complementary feeding of breastfed infants in developing
countries prior to six months. However, at about 6 months is when the
infant's liver iron stores show signs of needing assistance in providing the
amount of iron required for the next 6 months. Complicating this is the fact
that exclusive breastfeeding is not practiced by very many mothers, even in
developing countries. When the baby is given other foods a toll is exacted on
iron stores, and iron absorption can be reduced which can lead to anemia.

Another problem that occurs with the recommendation of starting solids or
other complementary foods at 4 months is that the formula companies now jump
in with their "follow-on" formula, designed to be used at "four months of age
when baby is taking other foods." This gives an extra two months to buy more
formula than would have happened with exclusive breastfeeding. One of the
problems with some of this follow-on formula is the drastic reduction in fat
that they provide. 40-50% fat is provided by breast milk and standard
formulas. Some follow-on formula provides as little as 37% fat. Restricting
fat at this stage in brain development is not recommended and can have
lifelong consequences. The other baby foods, like rice cereal, fruits and
vegetables provide none of the fat required by the brain. That's why it is so
important to keep breast milk in the diet during the second six months and
beyond while the brain is still growing and developing.

Marsha Walker, RN, IBCLC
Weston, MA

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