The WHO systematic review found no evidence that infant health might be compromised by six months exclusive breastfeeding. The review found that such feeding reduced the risk to the infant of gastro intestinal infection. There is also evidence that many of the health effects of breastfeeding are dose responsive, i.e. the more breastfeeding a baby has the more positive the effect (Raisler et al, 2000). Thus, the increased frequency and volume of breastfeeds experienced by babies breastfed exclusively for six months are likely to be beneficial to health.
The ability to safely chew, swallow and digest foods other than breastmilk is an important part of infant development. This ability can be encouraged by exclusive breastfeeding for six months. Oral/facial development of the baby is dependent on effective breastfeeding since this provides a frequent ‘workout’ of the muscles required (Westover et al, 1989). This will then enable the six month old to actively take food from a spoon, to chew the food (regardless of whether teeth are yet present) and to swallow foods safely. In practice, six month old babies may begin with foods of some texture, e.g. mashed fruits or vegetables rather than purees or sloppy baby rice as previously recommended for three or four month old babies.
Exclusive breastfeeding for six months can enhance maternal health. Lactational amennorhoea (absence of ovulation/menstruation while breastfeeding) is likely to continue during exclusive breastfeeding, especially when baby is breastfed during the night. This may optimise iron status. Frequent and exclusive breastfeeding helps maximise postpartum weight loss in the mother, contributing to health by reducing the risk of obesity.
It is sometimes suggested that exclusive breastfeeding for six months may not be practical for families in our society. However, there are many positive aspects to such a course of action. Exclusive breastfeeding for six months maximises the time for which baby feeding is free, involves no preparation or clearing up and is completely portable. The convenience of exclusive breastfeeding may be important to some families. Delaying weaning until six months reduces the need to prepare, store, transport and feed special foods for baby and keeps mum and baby easily mobile for longer.
The obligation to return to work outside the home is sometimes cited as a reason why families choose to introduce foods other than breastmilk or to stop breastfeeding altogether, prior to six months. It is important to recognise that although providing expressed breast milk to meet the needs of a baby younger than six months presents an obstacle to exclusive breastmilk feeding, this is not insurmountable. Health professionals may provide timely advice to mothers about expressing technique, frequency of expressing and storage of breastmilk. Health professionals may also provide support and advice with regards to mother’s employment rights to ensure that working mothers have access to appropriate facilities in which to express and store their milk and have adequate opportunity to do so.
– Raisler J, Alexander C, O’Campo P (2000)
Breastfeeding and infant illness; a dose – response relationship?
American Journal of Public Health 2000 Sept;90(9) 1478-9
– Westover KM, Dilorato MK, Shearer TR (1989)
The relationship of breastfeeding to oral development and dental concerns.
Journal of Dentistry for Children 1989;56 140-3
– World Health Organization (2002)
Infant and young child nutrition – Global strategy on infant and young child feeding
World Health Organization April 2002
This information has been compiled by Cornwall and Isles of Scilly Infant Feeding Co-ordinators’s as part of the UNICEF Baby Friendly training pack for health professionals. Thank you to them for allowing Real Baby Milk to use them on www.realbabymilk.org
Date: January 2009