Breast may not be best for the first six months of life, some experts say

What could be healthier for a baby than feeding him nothing but breast milk for the first six months of his life?

Not relying exclusively on breast milk for the first six months of life, according to a small group of experts on pediatric health from the United Kingdom.

Writing online this week in the British Medical Journal, they question whether it makes sense for parents in developed countries to follow the World Health Organization’s advice to provide six months of exclusive breast feeding. In the decade since the WHO issued its global recommendation, evidence has emerged that babies who aren’t introduced to solid foods during the crucial window of four to six months of age may be at heightened risk of developing food allergies and celiac disease.

For example, the incidence of celiac disease in Sweden rose after parents were advised to wait until their babies were 6 months old before introducing them to gluten; when the advisory was changed and parents were told to wait only four months, the rate of celiac disease fell. The authors also note that while peanut allergies seem to be rising in much of the developed world, they are still low in Israel, where peanuts are a common weaning food.

In addition, a 2007 study from the United States raised questions about whether babies could get enough iron if their only source of nutrients for six months was breast milk.

On the plus side, there is clear evidence that breast milk reduces the rate of pneumonia, ear infections, gastroenteritis and other infections.

“Exclusive breast feeding for six months is readily defendable in resource-poor countries with high morbidity and mortality from infections,” the authors write.

But in the U.K. and other developed countries, other concerns can take precedence. Among them: Will babies who aren’t introduced to bitter-tasting foods before their six-month birthday develop a lifelong aversion to them?

“Bitter tastes, in particular, may be important in the later acceptance of green leafy vegetables, which may potentially affect later food preferences with influence on health outcomes such as obesity,” they write.

The article is available online at the British Medical Journal.