Study questions breastfeeding alone for first 6 months

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As if new moms don’t have enough to worry about, the debate rages on about the best way to feed newborns. The World Health Organization recommends exclusively feeding your child breast milk for the first six months of life. But a new review by pediatric researchers at the University College London raises doubts about the standards, and suggests they could lead to iron deficiency or trigger allergies during development.

Should moms following the WHO guidelines worry? Not really, says Dr. Lori Feldman-Winter, member of the Executive Committee of the American Academy of Pediatrics' Section on Breastfeeding.  “First of all, breastfeeding isn’t being called into question—it’s still the healthiest way to feed your baby,” she says. “The only issue raised is when to add solid foods.” While the WHO sets the standard of six months, they’re taking into account developing nations, which may have additional health factors in play. The new review, published in the British Medical Journal, suggests babies in developed nations like the United States, could benefit from introducing solid foods earlier than six months. But it all depends on your child’s needs.

If your baby has immune disorders or a genetic predisposition to allergies, waiting six months to introduce solids may be risky, according to this new report. “We knew giving your child solid foods before four months puts them at risk for food allergies, but now starting them later could leave them vulnerable too, so it’s not as clear cut,” says Dr. David Greene, Professor of Pediatrics at Stanford University. Iron deficiency is the other concern for an all-breast-milk diet, especially for children born premature, or those whose moms are anemic and don’t produce enough iron in their milk. “Iron is a big concern because it affects brain development,” says Dr. Greene.

But don’t panic. If your child needs more iron-rich nutrients before six months, he’s likely to tell you. “Babies will let you know what they need. If they're making a fuss over the food you’re eating, they’re letting you know it's time to sample some solid foods,” says Dr. Greene. “Another sign is if your baby isn’t producing three to five wet diapers a day.” That’s could mean he’s lacking nourishment and ready for a more rounded diet. 

The best way to tell if your child’s feeding plan is working is simply by charting his growth patterns with your pediatrician every two months. “There are new WHO guidelines for growth adopted by the Centers for Disease Control that are more normative with the guidelines for breastfeeding,” says Dr. Feldman-Winter, who serves as Professor of Pediatrics at Cooper University Hospital. If your child’s on track with these standards, he’s likely getting all the nutrients he needs.

Now for moms: how to parse all the conflicting information about breastfeeding without going nuts?  Trust your gut. “It may well be that our Stone Age ancestors combined breast milk with other foods before six months—certainly they didn’t have government guidelines telling them not to” says Dr. David Katz of Yale University's Prevention Center. He adds that, based on the latest study, it's still inconclusive whether four or six months is a better time to start your child on solids. 

Dr. Feldman Winter agrees, pointing to flaws in the British Medical Journal review: “The problem is all of the studies they look at are done differently with different subjects so it’s difficult to draw a solid conclusion.”

The one thing doctors agree on across the board is that breast milk is better for your baby than formula. “If a parent can breastfeed their child as opposed to giving them formula, they should,” says Dr. Feldman-Winter.

“Breastfeeding is the best human food for human babies, and this is pretty consistent,” agrees Dr. Greene. “The minute formula is introduced in babies, infection rates go up.” As far as solid food, wholesome, minimally processed foods are best for development, overall health, and future food tastes. 

 “To a certain extent it’s about common sense and following your baby's cues rather than a calendar,” says Greene. In other words, mother still knows best.