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Breastfeeding Bubble Burst?

Posted Jan 15 2011 7:36pm
Pediatricians challenging exclusive breastfeeding.

What next? Gisele Bundchen turning to formula. Gwyneth Paltrow forgoing her kids'  daily dose of lemon-flavored flax oil (yes, read about her hectic day at HuffPo).

A group of British pediatricians bring to the table some evidence exclusive breastfeeding for 6 months (i.e. not introducing solids or any formula or other liquids such as soymilk, cow's milks, etc. until 6 months) may have, eek, several downsides - like higher risks of allergies, iron deficiency anemia, and celiac disease.  They speculate further about possible limited food preferences and nutritional deficiencies.

Remarkable  article in the British Medical Journal.  Refreshing, someone has done their homework.  I particularly appreciate their reasonable tone. 

Not only do the docs question exclusive breastfeeding, and thus the American Academy of Pediatrics  and the behemoth breastfeeding-is-best lobby but also provide a glimpse at the faulty foundation beneath the exclusive breastfeeding recommendations set down by the World Health Organization in 2001.  According to these daring docs out of University College London, "the evidence base supporting a major, population-wide change in public health policy underwent surprisingly little scrutiny."

Hmm.  How faulty was the evidence? 

The WHO edict rested largely on one published review of international studies authored by Kramer and Kakuma, the former who published one of the most methodologically-messed up pseudo scientific hatchet jobs (on breast-feeding and IQ!) I've laid eyes on outside of undergraduate pysch courses.  Here's how the London baby doctors see it
The review included 16 eligible studies, seven of which were from developing countries. Apart from two randomised trials in Honduras, the studies were observational, precluding proof of causation for the outcomes examined, since residual or unidentified confounding may remain even after adjusting for potential confounders. The study’s conclusions (box 1) included evidence for the efficacy of six months’ exclusive breast feeding (notably reduced infection rate) but also potential risk (iron deficiency anaemia, with its associated adverse neurodevelopmental outcomes).
Okay, so what about the "developed" countries, you know, like the US? There must have been lots of evidence, right?
"One study from Belarus showing a lower risk of gastroenteritis. "
In other words, stomach flu.  The WHO seemed to ignore another large review of 33 studies that basically concluded there was no basis for the 6 months-clause.

So there you have it.  By the way, the British peds are very much pro breast-feeding and would readily agree to exclusive breast-feeding for 4 not 6 months.  The evidence for 4 months is slightly less suspect.
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