We continue with the topic started yesterday in which I explain for what reasons exclusive breastfeeding is advised up to six months based on the conclusions drawn at the Meeting of Experts on the Optimum Duration of Exclusive Breastfeeding held in 2001.
Maintaining an exclusive feeding with breast milk for six months had always caused doubts related to child growth, however, at the Meeting of Experts it was concluded that there were no alterations in population terms.
In reference to the nutritional needs of normal full-term children, it was observed that they are covered by breast milk during the first six months.
In premature children the composition of milk is different because the needs of these babies are not the same as those born at term. This difference implies an adaptation to real needs and therefore it is recommended that premature infants be breastfed as soon as possible (and the better). There are some situations in which there may be a problem with a specific micronutrient. In children born with very low weight there may be some iron deficiency and the administration of iron drops from 2 or 3 months of age may be recommended. Advancing complementary feeding to alleviate this possible deficit could alter the bioavailability of iron and zinc in breast milk.
A preventive measure would be to promote late clamping of the umbilical cord at birth so that babies have a greater blood volume and therefore largest iron reserves.
Before 6 months there may also be a limitation of other nutrients such as zinc and some vitamins, however there is little information to support that zinc deficiency limits the growth of children in any way.
Vitamin D deficiency can occur in children who do not receive a lot of sunlight or dark skin, but giving the child drops of vitamin D generally prevents this deficiency. On this subject we talked in Babies and more a while ago.
Contrary to what many people think of offering complementary feeding to babies before six months does not improve growth and causes breast milk to be displaced by other foods or liquids of inferior quality that may not be nutritious enough or have enough energy to meet the needs of the child.
After the six month barrier, it is more difficult (than not impossible) for breastfeeding to cover the nutritional needs of babies alone and therefore it is recommended to supplement it with another diet.
Taking a look at the most disadvantaged countries and in environments where health conditions are poor, waiting beyond six months can be beneficial for babies as it means delaying feeding that could expose babies to foodborne pathogens. However, the six months coincide more or less with the age at which they begin to actively explore their surroundings, so they are also exposed to microbes through the ground and all the objects that are brought to the mouth.
Therefore, the current consensus is that the appropriate age to introduce complementary foods is six months of age and therefore the recommendation regarding breastfeeding is to be given to children the chest exclusively for six months.
