And don't forget the research study reviewing accuracy of mother's recall where they compared real-time data with mother's later recall and found big discrepancies. Remember that the mind is a funny thing - it takes related experience and puts it in the same banks as real experience - and calls it, it's own. Think about some of the articles about "repressed memories" where it was later found that the psychologist actually implanted the memories! What is memory anyhow? Is it physical imprints or is it ethereal? As lactation consultants, we encourage mothers to modify baby's latch and be consistent in order that the baby learns, neural pathways are created and reinforced. That's why we care about supplementation devices and methods - we want things to be consistent for the baby. That's why we care about such research as is being done using ultrasounds to "see" what's going on in the baby's mouth and breast with various issues, techniques, etc. It is really SOOO complex and not nearly as simplistic as say, getting the right bits and bytes working in my computer! No wonder people are daunted!
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of Pamela Morrison
Sent: Saturday, December 05, 2009 2:31 AM
Subject: Definition of "exclusive breastfeeding"
Jacquie picked up that a recent media article about the new WHO HIV and infant feeding guidelines mistakenly suggested that exclusive breastfeeding should be maintained for 12 months. Christine asks why we should be surprised at this, when we can't agree on the definition of exclusive breastfeeding even between ourselves, citing the example of feeding a baby probiotics. Then she goes on to say, "Exclusive breastfeeding means that the only things to go into baby's mouth are mom's breast .... Any giving of a vitamin or supplement means baby is not exclusively breastfed."
You would think so, wouldn't you? And I happen to agree with you. But actually WHO gives this definition of exclusive breastfeeding:
"Exclusive breastfeeding means giving a child no other food or drink, including no water, in addition to breastfeeding with the exception of medicines, vitamin drops or syrups, and mineral supplements "
(Ref: World Health Organization, Division of Child Health and Development. Indicators for assessing breastfeeding practices:
reprinted report of an informal meeting 11-12 June, 1991. Geneva:
WHO, 1991. Available at
http://www.who.int/child-adolescent-health/new_publications/NUTRITION/WHO_CDD_SER_91.14.pdf
There's also the possibility that even in research papers when babies are described as "exclusively breastfed" there may have been a "lapse", or two or three, in this definition. This is especially confusing and frustrating in the HIV and infant feeding story, where exclusive breastfeeding is so important. But "allowable lapses" are described in a 2004 WHO document entitled, HIV and infant feeding data analysis, Geneva, 12-14 November 2003, Workshop Report.
So it's as well to read the fine print in the methodology section to ascertain exactly what the authors mean when they say "exclusive breastfeeding", and we could all be forgiven for becoming confused, and perhaps continue to advocate for a tightening up of the definition!
Pamela Morrison IBCLC
Rustington, England
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