New breastfeeding advice leaves mothers angry and confused

Mothers beseiged internet forums and radio phone-ins yesterday to express their frustration at the latest scientific controversy about breastfeeding.

In a review of existing evidence published yesterday, a team at the University of London's Childhood Nutrition Research Centre suggested that mothers should not follow official advice recomending that they exclusively breastfeed for the first six months.

Instead, the study claimed that mothers could increase their baby's protection from allergies and increase their chances of eating a healthier diet later by introducing solid food at the age of four months.

While maintaining its six-month advice, the Department of Health said a scientific study already investigating infant feeding would look into the research. The Royal College of Midwives, Royal College of Paediatrics and Child Health, and National Childbirth Trust criticised the new paper and backed the status quo.

Stuck in the middle, mothers debated the merits of both sides, with many airing their irritation at the confusion. "The thing is these things always change," complained one mother on Mumsnet. "I knew this six months thing would be discredited at some point. Then a new idea will come along and that will be discredited and so on and so forth."

Joanne Leaver-Cole, from London, emailed the BBC: "What should I do? I have an exclusively breastfed 21-week old baby who I want to do the best for. This is extremely stressful as the evidence is so polarised. I have even received mixed messages from healthcare professionals."

The Government introduced the guideline eight years ago after the World Health Organisation backed breastfeeding to six months following a review of 16 studies. Medical experts agree that breastfeeding is healthier than formula milk, but there is debate over when mothers should start weaning – introducing mashed up solid foodinto their child's diet.

The new study cited evidence that babies exclusively breastfed for six months were more likely to develop anaemia than those weaned from four to six months. It also referred to the European Food Safety Authority's finding last year that babies could be safely weaned from four months.

It urged the UK to reconsider its position, while recommending the six-month guideline remain in developing countries where the risk of infection is higher. Declarations in the paper revealed that three of the four authors had been paid by baby food companies for consultancy work or research in the past three years. However, they denied the paper – which was published in the British Medical Journal and was not funded by the baby food industry – was an attempt to promote commercial weaning foods. "Our view as authors is that the most sensible middle ground at present is four to six months," said Alan Lucas, director of the Childhood Nutrition Research Centre.

Janet Fyle, professional policy adviser at the Royal College of Midwives, said: "I believe that this is a retrograde step and plays into the hands of the baby food industry which has failed to support the six-month exclusive breastfeeding policy in the UK."

Advice varieas across Europe. The UK and Sweden back six months, but Ireland and Spain recommend four to six months and Germany five to seven months.

A study in 2005 found that although 76 per cent of UK mothers started out breastfeeding, fewer than half were still doing it at six weeks, while only one in 100 breastfed exclusively for six months.

Justine Roberts of Mumsnet said: "A lot of mums work quite hard, and it is hard work trying to exclusively breasfeed for six months without introducing solids. If that turns out not to be correct advice, we'd like to know as soon as possible."

Case Study

'It is obvious now that he was hungry'

Kate Morris, mother of two

There are many things that no one tells you about life with a baby. One is how physically demanding breastfeeding is. Putting aside its plus points (I breastfed my boys until 18 months), feeding every two hours round the clock is not for the faint-hearted.

I was very lucky with George, my first child. He fed every three hours, slept through the night and put on weight. But at four months he started waking four times a night, screaming lustily. Looking back, it is obvious that he was hungry but the mantra from health visitors was that breast milk alone should sustain him for another eight weeks. Too law-abiding to go against official advice, I ignored family who told me to start solids, and started losing weight and sleep.

It was only when I spoke to a retired health visitor, who assured me that it wouldn't damage his digestive system or condemn him to a life of allergies, that I caved in after two weeks. He practically bit the bowl of the spoon off. All babies have different needs, a fact that both the new report and the current guidance fail to recognise. First-time mothers need supportive, flexible advice, rather than scare-mongering that gives us yet another reason to feel guilty.