Editorial

Breastfeeding is natural and therefore best. Mothers are usually advised to stick to breastfeeding in the first six months of their infant’s life and to start solids only once babies are six months and not earlier unless there are specific problems. This is because breast milk is less likely to induce obesity, is a complete and natural feed and may also give additional benefits such as a reduction in allergies and helping the infant’s developing immune system.

A major advantage, particularly in developing countries, is enhanced protection against gastroenteritis and respiratory infections and there is no doubt that breast milk is superior to formula milk in this regard.

Breastfeeding may also enhance the response to vaccinations, reduce the risk of middle ear infection and sudden infant death. In premature babies, breast milk feeds are less likely to provoke severe bowel infections than preterm formula feeds and mothers of preterm babies are actively encouraged to express breast milk for their babies.

In Malta, the World Health Organisation recommendations have been adopted. The benefits listed above do not make big differences to health outcomes in developed countries and, indeed, the world body’s recommendations were deliberately not followed in 65 per cent of European member states and in the United States. However, despite the relatively minor medical advantages, breastfeeding remains a crucial issue because there is substantial evidence to show that early nutrition has definite implications for long-term health as habits acquired in early infancy programme the individual’s dietary inclinations, for life, and this may affect eventual cognitive function, obesity, cardiovascular disease, cancer and risk of developing allergies and, possibly, even other diseases that may be influenced by breastfeeding.

A recent medical publication – the British Medical Journal – suggests it could be beneficial to introduce solids in infants’ diets before six months. The benefits cited include a lower risk of developing iron deficiency anaemia, coeliac disease (intolerance to wheat, rye, oats and barley) and food allergies. Moreover, the study suggests, the earlier introduction of new tastes could increase the rate of acceptance of green leafy vegetables and this might help in the global fight against the ubiquitous problem of obesity. This recommendation stems from the European Food Safety Authority and concludes that, for infants in developed countries, complementary foods could be safely introduced between four and six months.

However, the study is not based on 100 per cent solid data, which led the United Nations Children’s Fund in the UK to immediately accuse the journal of excessively inflating a single statement in a single paper that led to sensational headlines the UK organisation feels could mislead parents and, ultimately, perhaps causing a deleterious effect on infant health.

Clearly, more studies are needed to reveal the ideal age at which solids should be commenced but there is no doubt breast remains best and, up to six months, infants should ideally be breastfed. Whether solids should be started at four or at six months will, ultimately, not make a huge difference.

In the wake of the British Medical Journal study, the Health Department in Malta rightly advised health professionals to continue to support mothers with accurate information based on national and WHO guidance, thereby helping them to recognise the signs when their baby is ready to try new foods while continuing to breastfeed. The guidelines in place for the introduction of solid foods remain set at six months, regardless of whether the baby is breastfed or formula-fed.