UNICEF Clarifies Recommended Length of Exclusive Breastfeeding

Despite WHO Resolutions on the introduction of complementary foods of "at about six months", the complementary foods industries continue to recommend rigid feeding schedules starting at 4 months of age. In order to ease the confusion caused by this, as well as WHO's lack of definition, UNICEF's Nutrition Cluster has released a statement clarifying the recommended time of complementary feeding.

UNICEF's position on infant feeding:

"Babies should be exclusively breastfed _ meaning that they receive nothing but breastmilk, not even water _ for about six months of life. Except in the rarest cases, no additional foods or fluids are necessary, and they can be harmful _ introducing germs, triggering allergies, and filling the stomach so that the infant takes less breastmilk. Breastfeeding should be sustained until the baby is at least two years old, but beginning at about six months breastmilk should be complemented with appropriate solid foods."

Firstly the clarification notes, "it is important to make a distinction between public policy and "individual case management."

UNICEF, the World Health Assembly, and many governments maintain that the infant feeding recommendations in general are for breastfeeding to be exclusive for about six months. Public health policies communicate what will produce the highest attainable health for the majority of infants. Exceptions are made only when medically necessary.

In cases where growth is less than optimal, the first approach would be to correct the breastfeeding pattern; getting rid of other feeds such as water or juices; ensuring that breastfeeding is exclusive and frequent; observing the effectiveness of suckling and who terminates the feed _ mother or baby; eliminating any bottles and pacifiers. It is only after a week or two of well-supported exclusive breastfeeding, in the optimal pattern, that one would consider complementary feeding if the infant is over four months of age but not yet six months.

There are three signals for a possible need for early complementation after four and prior to six months: shows interest in semisolid foods; appears hungry after breastfeeds; is not gaining weight adequately.

For more information contact Nutrition Section, UNICEF New York, TA-24A, Room 2438, 3 UN Plaza, New York, NY 10017.