DÄ internationalArchive4/2017Preventive Effect for Mother and Child

Correspondence

Preventive Effect for Mother and Child

Dtsch Arztebl Int 2017; 114: 61. DOI: 10.3238/arztebl.2017.0061a

von der Ohe, G

LNSLNS

This is an important topic. The meta-analyses published in December 2015 in Acta Paediatrica and in January 2016 in The Lancet confirmed the prophylactic effect of breastfeeding for both mother and child.

Human breast milk contains much less protein than the milk of many other mammals. It is therefore important that any product used as a substitute for breast milk also has a low protein content. The authors write that breast milk substitutes fulfilling this requirement are on the market. However, this is incorrect; in fact, human breast milk contains only 0.9 g/100 mL protein (1), not, as stated, 1.2 g/100 mL (2). Moreover, the protein is composed partly of immune substances that are not available for digestion.

With regard to allergy prevention, the first 4 months of life seem crucial. A recently published meta-analysis casts doubt on whether the various hypoallergenic (HA) formulae actually have a hypoallergenic effect.

Introduction of complementary feeding at the beginning of the 5th month of life is usually too early and unnecessary. Most infants first start showing interest in food after the age of 5 months (3), so—in contrast to the authors’ recommendation—there is no need to offer them supplements in the form of semisolid foods any earlier than that.

Owing to misinterpretation of the S3 guideline on allergy prevention, German pediatricians unfortunately often urge parents to start complementary feeding too early. More training courses not sponsored by producers of complementary foods would be desirable.

A postulated “window of opportunity” could not be confirmed. If babies continue to be breastfed on demand after introduction of complementary feeding, there are no nutritional/physiological objections to the complementary food being given in appropriately sized chunks (“baby-led weaning”) and the infants less frequently become overweight (4).

DOI: 10.3238/arztebl.2017.0061a

Gudrun von der Ohe, IBCLC

Hamburg, Germany

postfach@stillberatung.info

Conflict of interest statement

The author declares that no conflict of interest exists.

1.
Lawrence, R: Breastfeeding—A guide for the medical profession 8th edition, Maryland Heights, Missouri: Elsevier, Mosby, Inc. 2016.
2.
Prell C, Koletzko B: Breastfeeding and complementary feeding—
recommendations on infant nutrition. Dtsch Arztebl Int 2016; 113: 435–44 VOLLTEXT
3.
Cattaneo A, Williams C, Pallás-Alonso CR, et al.: ESPGHAN’s 2008 recommendation for early introduction of complementary foods: how good is the evidence?; Matern Child Nutr 2011; 7: 335–4 CrossRef MEDLINE
4.
Townsend E, Pitchford NJ: Baby knows best? The impact of weaning style on food preferences and body mass index in early childhood in a case–controlled sample. BMJ Open 2012; 2: e00029 CrossRef MEDLINE PubMed Central
1. Lawrence, R: Breastfeeding—A guide for the medical profession 8th edition, Maryland Heights, Missouri: Elsevier, Mosby, Inc. 2016.
2. Prell C, Koletzko B: Breastfeeding and complementary feeding—
recommendations on infant nutrition. Dtsch Arztebl Int 2016; 113: 435–44 VOLLTEXT
3.Cattaneo A, Williams C, Pallás-Alonso CR, et al.: ESPGHAN’s 2008 recommendation for early introduction of complementary foods: how good is the evidence?; Matern Child Nutr 2011; 7: 335–4 CrossRef MEDLINE
4.Townsend E, Pitchford NJ: Baby knows best? The impact of weaning style on food preferences and body mass index in early childhood in a case–controlled sample. BMJ Open 2012; 2: e00029 CrossRef MEDLINE PubMed Central

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