Mothers are being advised to stick to breastfeeding exclusively for six months in the light of an international study that has led to a review of World Health Organisation guidelines.

The highly regarded British Medical Journal last week published an analysis questioning evidence behind the WHO recommendation that infants should be exclusively breastfed for the first six months.

A series of studies analysed by a team of experts from London, Edinburgh and Birmingham suggest present advice not to give children solid foods before six months could lead to long-term harm.

The study authors argued that delaying the introduction of solid food could increase the risk of iron deficiency anaemia, coeliac disease and food allergies and that introducing new tastes could increase acceptance of green leafy vegetables.

However, Mater Dei Hospital’s Paediatric Department chairman, Simon Attard Montalto, believes more research was required because the evidence was based on studies that were less than robust. In spite of this, Prof. Attard Montalto said the towel should not be thrown in on the conclusions of the analysis as more studies were needed to reveal the best age to introduce solid foods.

“Certainly, the jury is still out and, hopefully, current, well-designed ongoing research will determine the best age to wean once and for all,” he said.

Either way, the differences would be small, Prof. Attard Montalto said, advising mothers not to worry that what they were doing, or had done, with regard to weaning their infants had serious harmful effects.

In Malta, WHO recommendations are followed and this advises mothers to breastfeed exclusively for the first six months. The major advantage was enhanced protection against gastroenteritis and respiratory infections in breastfed babies, the chairman said, adding there was never any doubt breast milk was superior to formula milk in this regard.

Breastfeeding Clinic head Helen Borg also agreed mothers should continue breastfeeding for six months but pointed out WHO guidelines were some 10 years old and merited a review. At the same time, she criticised the BMJ article for not having a strong evidence base and being founded mainly on the authors’ opinions.

“You do have to individualise every case and it is hard to go by a hard and fast rule to breastfeed for six months because some babies are ready earlier and some later,” she said, pointing out this was the advice she gave to mothers attending the clinic.

The Health Department said health professionals should continue to support the mother with accurate information based on national and WHO guidance, helping them to recognise the signs when their baby would be ready to try new foods, while continuing to breastfeed.

Current guidelines for the introduction of solid foods were set at six months regardless of whether the baby was breastfed or formula-fed, adding that babies’ individual development varied and this was acknowledged by health professionals.

Health Promotion director Charmaine Gauci referred to the reaction of the UN Children’s Fund in the UK, which immediately criticised the BMJ press office and the media for focusing on “a single piece of comment which has resulted in sensational headlines and risks misleading parents and damaging infant health”.

Dr Gauci pointed out that three of the four authors had declared an association with the baby feeding industry, which she said should be noted when considering the analysis.

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