Rapid Responses to:

EDITORIALS: Maria A Quigley Increasing exclusive breast feeding BMJ 2007; 335: 574-575 [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

WHO's global feeding recommendation is unqualified

James E. Akre   (24 September 2007)

WHO's global feeding recommendation is unqualified 24 September 2007
James E. Akre, Author, Public Member, Board of Directors, International Board of Lactation Consultant Examiners 1232 Confignon, Geneva, Switzerland Send response to journal: Re: WHO's global feeding recommendation is unqualified	Maria Quigley makes a number of helpful observations about culture- specific strategies to improve the rate of exclusive breastfeeding and the need for research to evaluate the cost effectiveness of related hospital- based interventions in various settings. But I'm concerned by her insertion of the words "wherever possible" to qualify the World Health Organization's feeding recommendation, which is population based and not intended as an unbending management tool for the individual baby. It's difficult to see why the universal nutritional norm for mothers and babies should be presented in a qualified way when every other public health recommendation is straightforward and categorical, e.g. have your baby vaccinated against the major childhood diseases, use an approved car seat, or even hold firmly your young child's hand while crossing the street. The global public health recommendation is that babies should be exclusively breastfed for the first six months of life and that, thereafter, they should continue to be breastfed for up to two years of age or beyond while receiving appropriate complementary foods (1). Granted, not every last baby and mother will make it to six completed months, but that's hardly the point. The exceptions to this default position are a matter for the individual mother to decide, in consultation with her health worker, in the light of her baby’s specific requirements. When purporting to present the relevant global public health recommendation the words "wherever possible" are simply out of place. James Akre, Geneva, Switzerland, akrej@yahoo.com (1) Global Strategy for Infant and Young Child Feeding, paragraph 10. Geneva, World Health Organization, 2003. http://www.who.int/nutrition/publications/gs_infant_feeding_text_eng.pdf Competing interests: None declared