Early Life Nutrition and Lifelong Health - Derbyshire Local Medical ...

BMA Board of ScienceDeveloping country perspective on complementary feedingPoor-quality complementary feeds are the norm for infants in disadvantaged families and amajor cause of infant stunting. Programmes to support breastfeeding, promote bettercomplementary feeding and supply micronutrient supplements, are some of the most effectivemeasures that could be taken to reduce undernutrition in these countries. 123Guidelines on infant feedingBreastfeeding guidelinesIn 2003, the World Health Organisation (WHO) recommended that all babies should be exclusivelybreastfed for the first six months of life (the previous recommendation was four to six months).Thereafter complementary feeding should be introduced, with breastfeeding continuing as long aspossible up to two years. The evidence underlying the advice to extend exclusive breastfeedingfrom four to six months is persuasive in developing countries, but less so for high-incomecountries. 143-145 Breastfed babies, even in high-income countries, experience significantly fewerepisodes of gastro-intestinal and respiratory infection. 146 Benefits to the mother of breastfeedinginclude convenience, less expense, a faster return to pre-pregnant weight, delayed onset ofovulation, and possibly long-term protection against breast and ovarian cancer. 147Key messageBreastfed babies, even in high-income countries, experience significantly fewer episodes ofgastro-intestinal and respiratory infection compared with formula-fed babies.The National Service Framework for Children, Young People and Maternity Services highlights theimportance of breastfeeding, and recognises that it is a skill that needs to be taught andsupported. The DH produces a booklet for health professionals on how best to do this entitledGood practice and innovation in breastfeeding. 148More recently NICE 149 have produced guidance on improving the nutrition of pregnant andlactating mothers from lower socio-economic groups as a way of targeting those most in need ofadvice and support.Maternal diet during lactation guidelinesFor most women in the UK, a normal healthy diet is adequate to support breastfeeding. The FoodStandards Agency (FSA) provides specific dietary advice for lactating mothers. 150 Vitamin Dsupplements (10 micrograms daily) are recommended. Mothers are advised that fish is good fortheir own health and for the development of the baby, but to limit the intake of oily fish to twoportions per week because of mercury levels. If there is a family history of peanut allergy, womenare advised to avoid eating peanuts during lactation. 15034Early life nutrition and lifelong health