Literature review for - Flourish Paediatrics

Breastfeeding is natural and normal and gives your baby the best start. The Department of Health
recommends exclusive breastfeeding for the first 6 months of life and can continue to benefit your
baby along with solid foods for many months after. Every day you breastfeed makes a difference to
your baby’s health now and in the future. http://www.breastfeeding.nhs.uk/ Accessed 9 October 2010
After reviewing the introduction of solids, including allergenic foods such as peanuts, the UK Food
Standards Authority reached the following conclusion (Thompson, Miles et al. 2008);
“In common with the advice given for all children, infants with a parent or sibling with an atopic
disease should be breastfed exclusively for around 6 months;”
Statements on exclusive Breastfeeding 4-6 months
USA - Centers for Disease Control
“Exclusive breastfeeding is recommended for the first 4–6 months of life, and breastfeeding together
with the age-appropriate introduction of complementary foods is encouraged for the first year of
life.” (Centers for Disease Control and Prevention 2009)
ESPGHAN (European Society for Pediatric Gastroenterology, Hepatology, and Nutrition
On the basis of available data, the Committee considers that exclusive or full breastfeeding for
around 6 months is a desirable goal (ESPGHAN Committee on Nutrition, in preparation). In all
infants, in consideration of their nutritional needs, developmental abilities, and reported associations
between the timing of introduction of complementary feeding and later health, which are discussed
later, the introduction of complementary foods should not be before 17 weeks but should not be
delayed beyond 26 weeks (Agostoni, Decsi et al. 2008).
History of the changes in breastfeeding duration recommendations (Agostoni, Decsi et al. 2008)
“In early 2000 a WHO-commissioned systematic review of the optimal duration of exclusive
breastfeeding (Kramer and Kakuma 2002; Kramer and Kakuma 2002; Kramer, Guo et al. 2003;
Kramer and Kakuma 2004) compared mother and infant outcomes with exclusive breastfeeding for 6
months versus 3 to 4 months. Of 20 eligible studies identified, only 2 were randomized intervention
trials of different exclusive breastfeeding recommendations, both conducted in a developing world
setting (Honduras). All of the studies from the developed world were observational. The review
concluded that there were no differences in growth between infants exclusively breastfed for 3 to 4
months versus 6 months. An analysis of observational data from a trial of breastfeeding promotion in
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