Institute of Child Health

BMJ 2010;341:c5955

The authors would like to clarify some of the issues and misunderstandings that have arisen following publication of their paper by BMJ online.

“Our aim was to consider scientific data relevant to the UK recommendation that infants should be exclusively breast-fed for six months.  This recommendation is now eight years old, and more recent data have emerged. 

“This paper was not a systematic review, but we considered all data relevant to the nutritional adequacy and health effects of exclusive breastfeeding for six months, versus shorter durations, for infants in developed country settings. 

“This scientific paper was not directed at parents, and we did not seek to offer them new advice.  Rather we suggest there is sufficient evidence of both benefit and risk associated with six month exclusive breastfeeding for infants in developed countries to merit a review of the data and the original recommendation. 

“We are pleased that the Department of Health has now asked the Scientific Advisory Committee on Nurtrition (SACN) to review its policy on infant feeding,as part of which they will review this paper alongside other emerging evidence.

“We fully support the promotion of breastfeeding as the optimal nutrition for infants, and we are not suggesting that it should stop when other foods are introduced.  The key issue we are discussing is when mothers should be advised that they can start introducing other foods, ideally alongside continued breastfeeding.

“We are not suggesting that it is ‘dangerous’ for infants to be exclusively breast-fed for 6 months, but consider that the age at which infants need or want solid foods is likely to vary from infant to infant, as with any other developmental milestone.

“As a group of professionals we have a long track record of scientific research in this field, and have published numerous, widely cited, scientific papers demonstrating the health benefits of breastfeeding, particularly for longer-term outcomes such as reduced heart disease risk.

“Whilst unquestionably supportive of breastfeeding, we consider it important to conduct research on all forms of infant nutrition used by parents, to ensure thorough scientific analysis and scrutiny. We want to ensure that breast milk substitutes, used by the majority of mothers at some point in their baby’s first year, are the optimum ‘second best’ option they can be.

“We have, from time to time, carried out research with funding from the infant formula industry. In these studies, the investigators retain full control of the data, perform the analyses, and write the scientific papers without interference from the industrial sponsors. We declare all of this publicly according to University College London (UCL) and respective journal policy.

“Such industrial collaboration is not relevant to this BMJ paper, for which we received no additional funding beyond our everyday academic salaries. We have worked with all the major stakeholders in nutrition – including government departments, professional medical bodies, academic departments and the general public.

“The perception that we were commercially driven in writing this paper is wrong, unfair and damaging.  Our interest is, first and always, in promoting child health.  This is shown by the work we have done in demonstrating the benefits of exclusive breastfeeding to infants, and the adults they become.”

Dr Mary Fewtrell and Professor Alan Lucas, UCL Institute of Child Health

Contact information:

For further information please contact Hayley Dodman, Great Ormond Street Hospital press office, on 0207 239 3126 or email dodmah@gosh.nhs.uk