Intended for healthcare professionals

Observations Out of Hours

Lactation wars

BMJ 2011; 342 doi: (Published 09 February 2011) Cite this as: BMJ 2011;342:d835
  1. Christopher Martyn, associate editor, BMJ
  1. cmartyn{at}

An internet storm sparked by a recent BMJ paper shows that there’s no substitute for prepublication peer review

“A common mistake people make when trying to design something completely foolproof is to underestimate the ingenuity of complete fools” was a witty bit of advice from Douglas Adams, author of The Hitchhiker’s Guide to the Galaxy. Adapted for authors of medical papers it might read: “A common mistake when trying to reach a provisional and nuanced conclusion is to underestimate the ability of readers to find an unintended meaning.”

Mary Fewtrell and her colleagues probably thought that they had been careful in the way that they phrased their analysis article published in the BMJ a fortnight ago (BMJ 2011;342:c5955, doi:10.1136/bmj.c5955). They had reviewed recent evidence on infant nutrition and asked whether it might be better to abandon the current recommendation to breast feed exclusively for six months in favour of introducing solids earlier. They reckoned that, among other things, there might be benefits in reducing the risk of iron deficiency and food allergies. In the hope of forestalling any misunderstanding they had put in …

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