Why is the 6-month recommendation on complementary feeding under attack?

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The following is adapted from a comment I posted to the article: Dr Miriam Stoppard’s breastfeeding article is factually inaccurate and irresponsible, which appeared on The Independent blog, 21 August 2012.

Dr. Miriam Stoppard questioned the recommendation in the Global Strategy for Infant and Young Child Feeding regarding exclusive breastfeeding for the first 6 months of life. Dr. Miriam Stoppard is known to us from her being called in by Nestlé in 2008 to help push its anti-boycott strategy - see campaign blog.

We are at an interesting time with regard regulating the baby food industry and ensuring pregnant women, mothers, health workers and the wider public have access to accurate, objective information. Baby Milk Action monitors the baby food industry around the world with our partners in the International Baby Food Action Network (IBFAN). As Campaigns and Networking Coordinator at Baby Milk Action I have noticed some interesting trends in recent years.

After many years resisting the World Health Organisation position that complementary feeding should be fostered from 6 months (adopted under Resolution 47.5 of the World Health Assembly in 1994) companies have been forced to accept it in many countries. The World Health Assembly is the world's highest health policy setting body made up of the world's health ministries. Even Nestlé finally agreed to stop promoting complementary foods before this age (in selected countries) in 2003 during nationwide demonstrations at its sites in the UK

The Global Strategy for Infant and Young Child Feeding sets out the public health recommendations, as given in the Independent article, of exclusive breastfeeding for 6 months followed by continued breastfeeding and introduction of complementary foods (with a particular emphasis on promoting use of indigenous, local foods) into the second of year of life and beyond. This has been adopted as government policy by many countries.

Monitoring the industry around the world, we see that there is a move in company public statements and advertising to accept breastfeeding (though not exclusive breastfeeding) until 6 months of age. This is a measure of the success of the Global Strategy and the campaigning of health advocates. In some countries, this is reflected by an increase in breastfeeding initiation rates and longer duration of breastfeeding.

The acknowledgement of breastfeeding is also twisted into a product endorsement to suggest the formula is almost the same as breastmilk. So in the UK we have advertisements along the lines of: "Breastmilk is best for your baby. Our formula is based on breastmilk, so when moving on from breastfeeding, choose our formula."

At the same time, companies try to negate the impact on their sales from increased breastfeeding in the first month by pushing formulas for use beyond 6 months, such  as follow-on formula and growing up milks, for which there is no medical or nutritional need. Indeed, the World Health Assembly said in Resolution 39.28 of 1986 that follow-on milks are "not necessary". Any additional nutrients will be available from appropriate complementary foods introduced from 6 months. It is sad to see how companies push unnecessary products at mothers in the UK and elsewhere with claims about iron etc. to persuade them to buy these milks. 

Companies label these milks for older babies almost identically to the infant formula for use from birth to make them cross promotional to try to circumvent the prohibition on infant formula promotion (The UK Infant Formula and Follow-on Formula Regulations actually prohibit similar labelling of infant formula and follow-on formula, but companies currently ignore these provisions with impunity - Article 19 of the Regulations, Article 50 - 53 of the associated Guidance Notes that show how the Regulations should be interpreted).

As a further strategy, companies try to muscle in on promoting breastfeeding for the first 6 months, setting themselves up as the go-to health experts, while harvesting contact details and promoting their company and formula brand names (see the monitoring reports on the Baby Feeding Law Group website).

The progress that has been made in protecting health has to be defended, however, as companies continue to try to turn the clock back.

Why companies resisted the recommendation on 6 months so strongly in the first place and are trying to undermine it now raises the question of why it is so important to them to promote the introduction of complementary food from 4 months.

My theory is that as experiences from baby-led weaning shows, when given food to play with from 4 months, babies will experiment putting it in their mouths, but only start to actually eat after about 6 months. Advocates of baby-led weaning point out how their children become much happier eaters, while at the same time the stage of eating purées is bypassed as after 6 months babies can handle solids. 

Introducing foods from 4 months probably means many more parents are likely to buy processed foods rather than purée food themselves. If parents wait until the child is ready for complementary foods at six months, when they can be fed on family foods (with some care over salt etc), processed foods may be bypassed altogether. That is the last thing companies want.

Prior to the change to the 6 months recommendation for complementary foods in the UK, the Sales Director of Cow & Gate set out retailing strategy: "We suggest milk is merchandised on the left hand side of the fixture, followed closely by an early weaning block – jars and packet foods from 4 months – to stop mums drifting into home-made foods." (Quoted in Checks and Balances in the Global Economy: Using international tools to stop corporate malpractice - does it work?)

So there is a financial incentive for companies to challenge the 6 month recommendation on complementary foods, even if the recommendation is founded on solid scientific evidence.



Great article

There's a massive financial incentive in keeping parents feeling that they cannot adequately take care of their children by themselves, that's across the board... but the 'problem' with BLW in business terms is that there just aren't that many products to flog, so it's a huge opportunity for parents to break away from the brand loyalties that they've built up in the first few months of their child's life. Which is really bad news for companies that expect to have us by the goolies for at least five years... :D