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>Date: Mon, 6 Apr 1998 10:01:34 +0100
>Subject: Further precision
>To: DETTWYLER Kathy <[log in to unmask]>
>Content-Description: cc:Mail note part
>
> Kathy,
>
> Calling into question, then redefining, WHO's current infant-feeding
> recommendation began in a big way after the Forty-seventh World Health
> Assembly in May 1994 and the adoption of resolution WHA47.5. The
> following paragraphs should help you through the thicket on this one.
>
> Jim
>
> ***
>
> May I suggest that you read World Health Assembly resolution WHA45.34
> (1992), which dealt with WHO's entire infant-feeding recommendation,
> and compare it with resolution WHA47.5 (1994), which focused on
> complementary feeding. You will see that the relevant wording in
> resolution WHA47.5 -- "fostering appropriate complementary feeding
> practices from the age of about six months, emphasizing continued
> breast-feeding and frequent feeding with ... local foods" -- is
> virtually identical to the wording in resolution WHA45.34 --
> "Reaffirming that during the first four to six months of life no food
> or liquid other than breast milk, not even water, is required to meet
> the normal infant's nutritional requirements, and that from the age of
> about six months infants should begin to receive ... locally available
> foods ... in addition to breast milk."
>
> I would also like to draw your attention to the boxed text on pages 3
> and 4 of the offprint from WHO's Weekly Epidemiological Record (No.
> 17, April 1995), which is a concise statement of WHO's current
> infant-feeding recommendation:
>
> "The World Health Organization recommends that infants should be fed
> exclusively on breast milk from birth to 4 to 6 months of age; that
> is, they should be given no others liquids or solids than breast milk,
> not even water, during this period. Given the worldwide variation in
> growth velocity, an age range is an essential element of this feeding
> recommendation.
>
> "After this initial 4-to-6-month period of exclusive breast-feeding,
> children should continue to be breast-fed for up to 2 years of age or
> beyond, while receiving nutritionally adequate and safe complementary
> foods. Starting complementary feeding too early or too late are both
> undesirable. Ideally, the decision when precisely to begin will be
> made by a mother, in consultation with her health worker, based on her
> infant's specific growth and development needs.
>
> "WHO's current infant-feeding recommendation was based initially on
> the technical review and discussion undertaken in 1979 in connection
> with a joint WHO/UNICEF meeting on infant and young child feeding.
> The meeting's statement and recommendations were subsequently endorsed
> in their entirety by the World Health Assembly. Important additional
> scientific evidence including, most recently (1993), from the WHO
> Expert Committee on the use and interpretation of anthropometry,
> underscores the reliability of the 1979 review."
>
> Consistent with this recommendation, three essential principles govern
> complementary feeding:
>
> * It is undesirable for complementary feeding to start either too
> early or too late.
>
> * Ideally, the decision when *precisely* to begin complementary
> feeding should be made by a mother, in consultation with her health
> worker, based on her infant's specific growth and development needs.
>
> * Breast-feeding should continue.
>
>
>
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