Hozzátáplálás, elválasztódás, elválasztás

Háttér

Az elmúlt hónapokban az egészségügyi dolgozók (gyermekorvosok, védőnők) körében elter­jedt az a nézet, hogy a gluténtartalmú élelmiszereket 4 hónapos korban be kell vezetni a csecsemők étrendjébe, mert a glutén későbbi bevezetése fokozza a cöliákia kialakulásának kockázatát. Ez a javaslat a kutatási eredmények félreértelmezésén alapul, ellentmond az Egészségügyi Világszervezet és az európai egészségügyi szervezetek ajánlásának, és – a szilárd táplálékok túl korai bevezetése miatt – egészségügyi kockázatokat hordoz mind a szoptató anyákra, mind a szoptatott csecsemőkre nézve.

Joint statement based on a workshop of the World Alliance for Breastfeeding Action (WABA) Global Breastfeeding Partners Meeting (GBPM) VII in Penang, Malaysia, October 2008.
The Joint Statement on Continued Breastfeeding was produced following the WABA GBPM in October 2008 in response to shared concerns that breastfeeding after 6 months has slipped off the policy and programme agenda. Action and investment in improving complementary feeding or providing foods supplements seems to be taking place with little consideration for supporting or improving breastfeeding amongst 6 - 24+ month old children, despite estimates that 20% of deaths in 12 < 24 month age group in developing countries are due to lack of breastfeeding. The statement calls upon everyone involved in improving the health and development of infants and young children to take steps to ensure that continued breastfeeding 6-24+ months is protected, promoted and supported as the precondition for, and foundation of, appropriate complementary feeding.

World Health Organization, 2005

According to current UN recommendations, infants should be exclusively breastfed for the first six months of life, and thereafter should receive appropriate complementary feeding with continued breastfeeding up to two years or beyond. However, there are a number of infants who will not be able to enjoy the benefits of breastfeeding in the early months of life or for whom breastfeeding will stop before the recommended duration of two years or beyond.

Kim Fleischer Michaelsen, Lawrence Weaver, Francesco Branca and Aileen Robertson
WHO Regional Publications, European Series, No. 87
World Health Organization 2000, updated reprint 2003

The guidelines are designed for the WHO European Region, with emphasis on the countries that resulted from the dissolution of the former Soviet Union. Nutrition and feeding practices vary throughout the Region and these recommendations should be applied flexibly and be adapted to local and national needs and circumstances. Despite the wide range of socioeconomic conditions found between and within the Member States of the Region, it is believed that many recommendations can be applied universally. They are especially applicable to the most vulnerable groups of infants and young children living in deprived conditions. These are mainly found in the eastern part of the Region, but are also common in ethnic minorities and children of low-income families in western Europe.

Introduction and Background

This review of the developmental readiness of normal full term infants to progress from exclusive breastfeeding to the introduction of complementary foods has been undertaken as a result of the international debate regarding the best age to introduce complementary (semi-solid and solid) foods into the diet of the breastfed human infant. Since 1979 the World Health Organization has recommended that normal full term infants should be exclusively breastfed for „four to six months.” Over the two decades since this recommendation was established further evidence regarding the benefits of breastmilk and breastfeeding has accumulated. In addition, there have been increasing reports suggesting an association between discontinuing exclusive breastfeeding prior to six months of age and an increase in infant morbidity and mortality. Throughout the world many professionals as well as a number of governments have concluded that there is sufficient evidence to recommend continuing exclusive breastfeeding for „about six months” Even within WHO, UNICEF and other international agencies, some documents continue to recommend exclusive breastfeeding for „four to six months” while others now use „about six months”. There is an urgent need to review this matter and determine whether or not there is sufficient scientific evidence to change in the global recommendation. WHO responded to this need and arranged for a review of the recent studies that relate duration of exclusive breastfeeding („four to six months versus six months”) to infant morbidity and mortality as well as growth and maternal health.