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a) Yes, with possible rare exceptions, exclusive breastfeeding is safe for the health of the mother. If the mother's nutritional status is very poor, it is generally preferable and less expensive to supplement the mother's diet, rather than the nursing infant's.
It is important to address the woman's health and nutritional status. Adequate child spacing and sufficient food will help protect women's health.
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a) Most women, even those who are moderately malnourished, are able to produce a sufficient quantity and quality of breastmilk to breastfeed exclusively for up to six months.
- Prentice AM, Goldberg GR, Prentice A. Body mass index and lactation performance. European Journal of Clinical Nutrition 1994;48 Suppl:S78-96.
- Krasovec K. The implications of poor maternal nutritional status during pregnancy for future lactational performance. Journal of Tropical Pediatrics 1991;37(Suppl):3-10.
- Huffman SL. Maternal malnutrition and breastfeeding: is there really a choice for policy makers? Journal of Tropical Pediatrics 1991;37(Suppl):19-22.
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b) Yes, exclusive breastfeeding for six months is safe for the health of the baby. Giving food or water supplements to the baby introduces a higher risk of disease and death, and has minimal nutritional benefits.
Note:
In some situations where a woman is known to be HIV-positive, WHO does not recommend breastfeeding. Breast-feeding women at risk for HIV should be advised that if they are HIV-positive, or acquire HIV during the course of lactation, there is a risk of transmitting the virus to their infants through their breastmilk. Where safe alternatives to breastmilk are not readily available, known HIV-positive women should still be advised to breastfeed; those women who are known HIV-positive and who can safely bottle-feed should be advised to do so.
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b) Supplements given to the baby before six months usually displace breastmilk without adding calories or important nutritional benefits. In addition, breastmilk is protective against infant illnesses and deaths due to diarrhea and infectious diseases.
- Cohen RJ, Brown KH, Canahuati J, Rivera LL, Dewey KG. Effects of age of introduction of complementary foods on infant breast milk intake, total energy intake, and growth: a randomized intervention study in Honduras. Lancet 1994;343:288-93.
- Victora CG, Smith PG, Vaughan JP, Nobre LC, Lombardi C, Teixeira AMB, et al. Infant feeding and deaths due to diarrhea: a case-control study. American Journal of Epidemiology 1989;129(5):1032-41.
- Howie PW, Forsyth JS, Ogston SA, Clark A, du V Florey C. Protective effect of breast feeding against infection. British Medical Journal 1990;300:11-6.
- Victora CG, Vaughan JP, Lombardi C, Fuchs SM, Gigante LP, Smith PG, et al. Evidence for protection by breast-feeding against infant deaths from infectious diseases in Brazil. Lancet 1987; 2(8554):319-22.
The growth pattern of breastfed infants differs from current reference standards, which are based on the growth pattern of bottlefed infants. This should not be interpreted as growth faltering as long as the infant continues to gain weight. All infants, however they are fed, should be monitored as a part of well-child care to be sure they are growing properly.
- Dewey KG, Peerson JM, Brown KH, Krebs NF, Michaelsen KF, Persson LA, et al. Growth of breast-fed infants deviates from current reference data: a pooled analysis of US, Canadian, and European data sets. Pediatrics 1995;96:495-503.
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