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WHO Assails New Report on Breast-Feeding

SomaliNet Forum (Archive): Health - Caafimaadka: WHO Assails New Report on Breast-Feeding
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Mulkia

Saturday, August 05, 2000 - 04:46 am
NEW DELHI (Reuters Health) - While supporters of World Breast-feeding Week (August 1 - 7) exhort women to exclusively breast-feed their babies for at least 4 to 6 months, a new study that recommends supplemental feedings of some very young infants has drawn criticism from the World Health Organization (WHO) and UNICEF.

The report, prepared by Ravilla Anandaiah, who is the state demographer of Tamil Nadu in southern India, and Minja Kim Choe, a senior fellow at the East-West Center in Hawaii, asserts that exclusive breast-feeding can, in some cases, be dangerous to the mother and infant. This stand has significant policy implications for India and other developing countries.

Breast milk is considered ideal for infants as it suits the metabolic structure of the baby and contains an optimal combination of nutrients, and allows the mother to pass on important antibodies to the child.

Several studies have underscored the positive value of breast milk in preventing diseases in breast-fed children ranging from infections and allergies to cardiovascular disease and even tooth decay.

Using data from the National Family Health Survey-I, conducted in 1992-1993 under the aegis of International Institute of Population Studies, Bombay and the US Agency for International Development (USAID), the researchers analyzed the effect of breast-feeding on mortality at each month of infancy.

The results, Anandaiah and Choe report, indicate that the effect of breast-feeding in lowering infant mortality is smaller, the higher the level of infant mortality is in a particular region. The beneficial effects of both exclusive and non-exclusive breast-feeding are weakest in states where infant mortality is high.

It appears that mother's breast milk is more likely to be inadequate in states with high infant mortality than elsewhere in India, the authors note. Anandaiah and Choe assert that breast-feeding with supplements is more beneficial than exclusive breast-feeding, even for children younger than 4 months of age in areas with high infant mortality.

The authors state that exclusive breast-feeding by mothers who are poorly nourished and in poor health themselves may not provide adequate breast milk for their growing infants.

Their findings indicate that supplemental food should be introduced at earlier ages in high-risk mothers and infants.

WHO guidelines state that, ``infants should be exclusively breast-fed for the first 4 to 6 months and thereafter. To meet their evolving nutritional requirements, infants should begin to receive nutritionally adequate and safe complementary foods while breast-feeding continues for up to 2 years of age or beyond.''

In a joint statement, Dr. Sultana Khanum of the WHO Regional Office in Delhi and Dr. Patrice Engle of UNICEF India Office have attacked the conclusions of Anandaiah and Choe. Most disturbing, they add, is the interpretation that in the poorest states, infants of mothers who begin supplements early grow better than those who continue breast-feeding exclusively.

That infants would grow better if they begin to get supplemental food apart from breast milk at 2 to 3 months of age is in conflict with most scientific research on the physiology of the developing infants and the benefits of exclusive breast-feeding for around the first 6 months of life, Khanum and Engle continue.

Research in India and Bangladesh shows, Khanum and Engle say, that women have enough breast milk for their babies regardless of whether or not the women are malnourished, as long as the child suckles often. Referring to the potentially dangerous implications of the study, the two add that ``we cannot risk the lives of millions of children with such misleading interpretations.''

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