There’s a bit of a rumpus going on at the moment in the world of Midwifery. It seems that some brave doctors, paediatrician Dr Mary Fewtrell, of University College London and her colleagues, have published a paper challenging the WHO dogma of six months of breast feeding. The Midwives are all frothing at the mouth already:
Britain’s College of Midwives challenged the suggestion the country should reconsider its official advice on breastfeeding.
“I believe this is a retrograde step and plays into the hands of the baby food industry,” said the college’s professional policy adviser, Janet Fyle.
She said that if earlier introduction of solids was encouraged, many parents would offer sugar-based foods to their babies, potentially nurturing a sweet tooth.
Help, help! It’s the evil baby food industry behind this! Except that none of the authors of the paper nor any of the numerous studies they cite have any connection to the baby food industry. It would have been nice to have some sort of counter-argument citing dissenting studies, but I guess that is too much to expect from the dogma-ridden UK college of midwives (and I doubt ours will be any different)
At least the Ministry will take the time to study the evidence. Essentially, the authors have pointed out that the WHO dogma of 6 months of exclusive breast feeding is based on epidemiological evidence mostly from third-world countries. There is no doubt that, in third world situations, this is a good policy. Unfortunately, its extrapolation to first world situations is essentially pure supposition. Fewtrell, and her colleagues, point out that there is evidence that children not placed on solids between the ages of 4 and 6 months may develop iron deficiency anaemia, food sensitivities and coeliac disease. The evidence for these things is also quite weak, as the authors observe, but there is sufficient evidence to question the dogma of WHO and of the college of Midwives. At the very least we should be looking urgently at whether there are disadvantages to late weaning in first-world communities.
Interestingly, the paper mentions the possibility that late introduction of solids predisposes children to dislike bitter things like green leafy vegetables when they are older. This is interesting because the Midwives response above says almost the opposite; that babies may develop a sweet tooth. I note that the paper merely suggests this as an area of further research, whilst the Midwives state their theory (for which there is no evidence) as a gospel truth. Therein is the problem in a nutshell.
It is about time that the dogma surrounding breast feeding is dispelled. There is no doubt that breastfeeding is the best way to start feeding a baby, but mothers should not be made to feel like they are inadequate when they choose to use formula milks. There is no reason at all that babies should come to any harm if they are weaned off the breast starting at four months instead of six. There is also no reason why mothers should not use mashed vegetables and similar foods, rather than expensive baby preparations. On the other hand, those preparations are extremely handy when going out to visit friends and there is no reason why mums should be made to feel guilty if they want to use them.
Where there is no hard evidence there should be latitude. Where there is doubt, there should be grace and humility. Medicine should always be based on evidence and reason rather than supposition and dogma.