RESEARCH Breast is best for 6 months A study in Honduras has found that exclusive breastfeeding for the first 6 months of life should be recommended in low-income populations. There was no advantage indicated in introducing complementary foods before 6 months, whereas there were disadvantages in exposure to contaminated weaning foods. (Lancet 1994; 343: 288-93) Commercial baby foods in sealed jars are not expected to be contaminated, provided they are thrown away after the first use. They are, however, very expensive. Cheaper commercial weaning foods (such as Nestle's Cerelac or Gerber's baby cereals), which are rehydrated with water in a similar manner to baby milks, are more likely to present a contamination danger. Breastfeeding protects US children Health and feeding information drawn from a large representative sample of US children shows that breastfeeding protects against pneumonia in 1-2 year-olds and that early introduction of solid foods increases the likelihood of pneumonia. Breastfeeding was found to protect against ear infections in children under one year old. A slight protective effect against asthma was also shown. Ford K, Labbok M, Breastfeeding and child health in the United States, Journal of Biosocial Science 1993; 25: 187-194 Breastfeeding protects LBW babies A study of 118 low-birth-weight babies showed that those fed on infant formula were 13 times more likely to suffer necrotising enterocolitis (a potentially fatal condition) than the breastfed babies. The artificially-fed babies were 5 times more likely to contract urinary infections, 9 times more likely to suffer diarrhoea and 2.3 times more likely to need blood transfusions. Contreras-Lemus J et al., Boletin Medico del Hospital Infantil de Mexico 1992; 49: 671-677. Breast cancer Studies showing the protective effect of breastfeeding against breast cancer (see Update 12) have been confirmed by a US study. The cumulative period of breastfeeding was studied - women who lactated for longer periods were the least likely to suffer breast cancer. The younger a woman is when she first breastfeeds, the lower the risk of cancer. Newcomb PA et al., Lactation and a reduced risk of premenopausal breast cancer, N. Engl J Med 1994; 33: 81-7. Educate the fathers A survey of 115 UK mothers has shown that the partner's attitude to breastfeeding is the biggest factor influencing their feeding decision. If the father approved of breastfeeding, three quarters of infants were totally breastfed; if the father was indifferent or disapproving, the proportion fell to less than 10%. Clinical Paediatrics 1994; 33: 214-9. Multiple sclerosis An Italian study has found that patients with multiple sclerosis are less likely than a control group to have been breastfed for a prolonged period of time. Pisacane et al, Breastfeeding and multiple sclerosis, BMJ 1994; 308: 1411-1412. Gaps in health workers' knowledge A survey to assess whether parents would be likely to receive the same sound and clear infant feeding advice from different community health professionals shows that further training and initiatives are required. A confidential questionnaire was distributed to all clinical medical officers (CMOs), health visitors and every second GP in south Derbyshire. Of 200 respondents, 34 were in favour of complementary bottle feeding in the establishment of breastfeeding and 75% of CMOs agreed with the statement that infant formula is as good as breastmilk (74% of GPs and 78% of HVs disagreed). However, follow-on milks were not considered to play an important role. Health visitors said that professional journals and company information were the main sources of information. GPs said that health visitors were their main source. Hyde L, Knowledge of basic infant nutrition amongst community health professionals, Maternal and Child Health 1994; 1: 27-32. Breastfeeding literature compared An evaluation of all breastfeeding literature distributed to mothers in Ontario, Canada, has shown noticeable differences between materials produced by non-profit sources and those given out by infant food manufacturers. 12 company pamphlets and 10 non-profit pamphlets were compared against several criteria. The non-profit sources scored higher in positive attitude, accuracy and Code compliance, although one government pamphlet violated the Code with its presentation of bottle feeding. The reading levels were considered to be too high in both sources, particularly in view of the 1.5 million Canadian women with limited reading skills. The baby food company pamphlets, which are abundant and often remain in circulation for long periods, generally gave negative impressions of breastfeeding. Health professionals are reminded of their responsibility to check the information they distribute. Valaitis RK and Shea E. Canadian Journal of Public Health 1993; 84: 24-27. [log in to unmask] (Arly Helm, LC)