Rethinking Current Recommendations to Introduce Solid Food between Four and Six Months to Exclusively Breastfeeding Infants

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Abstract
The World Health Organization and UNICEF currently recommend to start weaning between four and six months and no later than six months with the gradual introduction of solid food. However, some studies show that voluntary exclusive breastfeeding for about nine months is feasible and can sustain adequate weight gain and iron status in infants. It is therefore appropriate to review and evaluate the evidence presently used to set feeding policy. It appears that the alleged insufficiency of breast milk volume after four to six months is most likely due to management errors such as introducing supplements and spacing nursing bouts at wide intervals, both of which reduce milk yield. Women in developed countries who wish to breastfeed exclusively beyond four to six months should therefore not be discouraged from doing so. In developing countries, health authorities and non-governmental organisations should actively endorse exclusive breastfeeding for eight to nine months to protect infants against malnutrition and infections.