Large scale studies on the nutritional content of human milk? Pointers please!

[duchesse]

Had an weird conversation yesterday with a recently qualified, extended bfing GP friend who assured me that human milk is deficient in zinc and iron, that the WHO guidelines are designed for 3rd world countries without access to clean water and are in fact bolleaux for the developed world, and that most babies can start solids at 16 weeks.

I am left both confused and slightly upset as she may well be advising people to start solids than WHO advises. I'm working on the premise that she has been taught about breastfeeding using outdated information, and wondered if there were in fact any unbiased studies on the nutritional content of human milk that I could point her to?

it is true that human milk contains less iron than cows milk or formula

this led ltos of people to thijnk that BF babies needed supplements

in fact, the iron in breastmikl is more readily absorbed and so in fact a breastfed baby takes in just as much iron as a formula fed baby

and regardless of that,.. what early weaning foods are high in iron? baby rice certainly isn't, so even if breastmilk was deficient in zinc and iron then weaning early wouldn't help at all

kellymom might help? usually well referenced

actually it's this one

Most babies can start solids at 16 weeks without any ill effects but some of them (a very small number) could develop gut problems or allergies and it wouldn't be good if too much milk was removed from a small babies diet and replaced with less calorie rich, less nutricious solid food.

The guidelines are guides not some scientifically proven exact cutoff point and a certain amount of leeway is common sense and unlikely to do harm (excepting families with allergies etc.)

When the guidelines were 4 months quite a lot of people probably weaned 2-3 weeks earlier than that which probably was too early, so having the guidelines at 6 months is useful if it makes most people hang on till a bit later than 4/5 months.

What a strange thing for a GP to say. The zinc and iron in human milk is in precisely the quantities that the human infant requires, until said infant shows by his behaviour, physiology and ready acceptance of other foods that he is beginning to need a range of other nutrients. This is only very rarely as early as 16 weeks.

The studies - including large systematic reviews - that the WHO (and UK) guidelines are based on looked (among other things) specifically at zinc and iron and found that there is no evidence of deficiencies in babies offered solids at 6 mths. There may be a few babies born to very nutrient-deficient mothers (I think the reviews point to a study of chronically under-nourished mothers in Honduras) whose iron stores may need a boost before 6 mths, but in general, babies' nutritional needs are best served by breastfeeding alone to about 6 mths.

There have been no systematic reviews showing anything different from this in recent years

Why would it be anything other than this? Mammals have been in existence for several billion years, evolving the milk that matches the needs of each species. GPs generally get almost nil education on infant feeding. I suspect she may have been to a one-off lecture, or read an opinion piece in a journal? Ask her where she heard her info!

I must confess that my husband and I had a good laugh last night after that conversation, imagining the little cave babies who must have gnawed away at their raw meat with their little gums in order for our species to survive.

why does human milk has to prove it's viability in a lab when 4 million years of evolution has created it for erm, humans.

why is formula be considered as superiorly evolved when it is a processed food made from a mammal which is valued for it's muscle instead of it's brain.

ask her if that is why she is implying that formula is more suited for the first world babies. very big

Thing is I don't think she believes in formula- she seems to think that solids are going to supply things in a baby's diet that a nutritionally complete made to measure food like human milk doesn't. I just wonder if she's not just justifying to herself her own decision to start her daughter on solids at 4 months. A bit dangerous if she's bringing other people into it though. I did point out that DD3 is still exclusively bf at 8.5 months and showing no signs of deficiencies whatsoever.

Get her to read the Gill Rapley book Baby Led Weaning, and look at the studies it references.

That kellymom site is good- she ought to be able to access many of the referenced articles online as abstracts I should think.