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Scientific Advisory Committee on Nutrition (SACN) and the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) Join Statement, March 2011

Background
In 2010, the Department of Health and Food Standards Agency asked the Scientific Advisory Committee on Nutrition (SACN) and the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) to assess the evidence on timing of introduction of gluten into the infant diet and subsequent risk of developing coeliac disease or type 1 diabetes mellitus (T1DM). The request was made in response to the publication of a European Food Safety Authority (EFSA) Panel on Dietetic Products, Nutrition and Allergies (NDA) Scientific Opinion on the appropriate age for the introduction of complementary food into infant diets in the EU; this included conclusions that were inconsistent with UK infant feeding advice.

A La Leche Liga angliai szervezetének válasza a British Medical Journal című orvosi szaklapban 2011 januárjában megjelent cikkre, amely megkérdőjelezi a hozzátáplálás nem korábban, mint 6 hónapos korban való elkezdésére vonatkozó eddigi ajánlásokat

A La Leche Liga már több mint 50 éve nyújt információt és támogatást azoknak a szülőknek, akik szoptatni szeretnék gyermeküket. Munkája során osztja a WHO, az Egészségügyi Minisztérium és más mértékadó szervezetek azon nézeteit, miszerint a csecsemők optimális növekedését, fejlődését és egészségét az szolgálja legjobban, ha életük első 6 hónapjában kizárólag szopnak. Ezután pedig a szoptatást kiegészítve kapjanak a kisbabák megfelelő minőségű ételeket, hogy növekvő, változó táplálékigényüket kielégíthessék.

New Rochelle, NY, January 20, 2011 —A recent challenge to the well-established World Health Organization (WHO) breastfeeding guidelines is not supported by current research findings and unnecessarily questions the clear benefits of exclusive breastfeeding for at least the first 6 months of life. The Academy of Breastfeeding Medicine (ABM), a global physicians’ organization, supports the 2001 WHO recommendation for exclusive breastfeeding (not supplemented by formula or solid food) for six months after birth and emphasizes the proven health benefits of breastfeeding for both infants and mothers. ABM cautions against unsubstantiated, contradictory messages that create unnecessary confusion.

Háttér

Az elmúlt hónapokban az egészségügyi dolgozók (gyermekorvosok, védőnők) körében elter­jedt az a nézet, hogy a gluténtartalmú élelmiszereket 4 hónapos korban be kell vezetni a csecsemők étrendjébe, mert a glutén későbbi bevezetése fokozza a cöliákia kialakulásának kockázatát. Ez a javaslat a kutatási eredmények félreértelmezésén alapul, ellentmond az Egészségügyi Világszervezet és az európai egészségügyi szervezetek ajánlásának, és – a szilárd táplálékok túl korai bevezetése miatt – egészségügyi kockázatokat hordoz mind a szoptató anyákra, mind a szoptatott csecsemőkre nézve.

Press release 23 December 2009

Health advocates predict a decline in breastfeeding if a new opinion of the European Food Safety Authority (EFSA) which is at variance with that of the World Health Organisation is translated into european legislation. The opinion which was issued on the 21st December (1) is a backward step and plays into the hands of the baby food industry which is trying to undermine moves to improve the 1996 EU baby food Directive. (2) It flies in the face of the global recommendation of the World Health Assembly, which was arrived at after a systematic review of over 3000 studies and is now policy in over 70 countries, including the UK. (3)

A discussion paper developed for the International Baby Food Action Network (IBFAN) by Gabrielle Palmer

The IBFAN network has a 30-year experience of campaigns on breastfeeding and the regulation of marketing of breastmilk substitutes.

Relatively recently, generated to some extent by the concerns over the promotion of market-led approaches to solve nutritional problems related to inappropriate complementary feeding, a broad ranging debate has started within and outside the network.

Joint statement based on a workshop of the World Alliance for Breastfeeding Action (WABA) Global Breastfeeding Partners Meeting (GBPM) VII in Penang, Malaysia, October 2008.
The Joint Statement on Continued Breastfeeding was produced following the WABA GBPM in October 2008 in response to shared concerns that breastfeeding after 6 months has slipped off the policy and programme agenda. Action and investment in improving complementary feeding or providing foods supplements seems to be taking place with little consideration for supporting or improving breastfeeding amongst 6 - 24+ month old children, despite estimates that 20% of deaths in 12 < 24 month age group in developing countries are due to lack of breastfeeding. The statement calls upon everyone involved in improving the health and development of infants and young children to take steps to ensure that continued breastfeeding 6-24+ months is protected, promoted and supported as the precondition for, and foundation of, appropriate complementary feeding.

Nancy F. Krebs

J. Nutr. 137:511S-517S, February 2007

The primary focus of this review is considerations for complementary feedings to meet micronutrient needs of infants aged 6–24 mo who are continuing with breast-feeding and minimal or no formula. The World Health Organization recommends initiation of complementary feeding to breast-fed infants at ~6 mo of age. Whether complementary foods will meet nutrient needs will depend on the types of food selected. One criterion for the selection of complementary foods is that they be rich sources of zinc and iron because both of these essential micronutrients are critical for normal growth and development, and requirements are not met by exclusive breast-feeding after ~6 mo.

KramerMS, Kakuma R.

Cochrane Database of Systematic Reviews - 2007. Update

Plain Language Summary

Exclusive breastfeeding for six months (versus three to four months) reduces gastrointestinal infection, does not impair growth, and helps the mother lose weight.

Caroline J. Chantry, MD, Cynthia R. Howard, MD, MPH and Peggy Auinger, MS

PEDIATRICS Vol. 117 No. 2 February 2006, pp. 425-432

OBJECTIVE. The American Academy of Pediatrics recommends exclusive breastfeeding for an infant's first 6 months of life. When compared with exclusive breastfeeding for 4 months, greater protection against gastrointestinal infection, but not respiratory tract infection, has been demonstrated for the 6-month duration. The objective of this study was to ascertain if full breastfeeding of ≥6 months compared with 4 to < 6 months in the United States provides greater protection against respiratory tract infection.

A K Akobeng, A V Ramanan, I Buchan and R F Heller

Archives of Disease in Childhood 2006;91:39-43

Background: Coeliac disease (CD) is a disorder that may depend on genetic, immunological, and environmental factors. Recent observational studies suggest that breast feeding may prevent the development of CD.

Ivarsson A.

Best Pract Res Clin Gastroenterol. 2005 Jun;19(3):425-40.

Sweden has experienced an epidemic of symptomatic coeliac disease that has no likeness anywhere else in the world. This is quite unique for a disease that is genetically dependent, immune-mediated and chronic, and suggests an abrupt increase and decrease, respectively, of one or a few causal factors influencing a large proportion of Swedish infants during the period in question.

World Health Organization, 2005

According to current UN recommendations, infants should be exclusively breastfed for the first six months of life, and thereafter should receive appropriate complementary feeding with continued breastfeeding up to two years or beyond. However, there are a number of infants who will not be able to enjoy the benefits of breastfeeding in the early months of life or for whom breastfeeding will stop before the recommended duration of two years or beyond.

Graciete O. Vieira , Luciana R. Silva , Tatiana de O. Vieira , João Aprígio G. de Almeida , Vilma A. Cabral

J Pediatr (Rio J). 2004;80(5):411-16

Introduction

Human milk offers the nutrients that a child needs to begin a healthy life and represents the essential food for infants until their sixth month of life, as an exclusive food, and from then onwards should be complemented with other sources of nutrition until at least 2 years of age (1,2).

Earlier World Health Organization (WHO) documents recommended exclusive breastfeeding for 4-6 months (3). Based on scientific evidence of the benefits of exclusive breastfeeding, many countries, including Brazil, officially adopted the recommendation of complementary foods at 6 months of age (4,5). Nowadays the WHO and domestic policy concur on the recommendation of exclusive breastfeeding for the first 6 months of life (1,5).

Complementary feeding is defined as the process starting when breast milk alone is no longer sufficient to meet the nutritional requirements of infants, and therefore other foods and liquids are needed, along with breast milk. The target age range for complementary feeding is generally taken to be 6 to 24 months of age, even though breastfeeding may continue beyond two years. A review of feeding guidelines promoted by various national and international organizations has shown that there are inconsistencies in the specific recommendations for feeding infants and young children (Dewey, in press).