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Breastfeeding – realism and empathy

WHO guidance is in the best interests of the majority of infants worldwide

Sir, – In response to the recent article “It’s time for a little more realism and empathy on breastfeeding” (December 31st), I would like to commend Clare Moriarty for highlighting the the importance of the consideration of maternal mental health and the challenges that mothers who exclusively breast-feed may face. However, the World Health Organisation (WHO) advice to exclusively breast-feed infants for the first six months of life is of particular relevance to those living in low- and lower-middle income countries and conflict settings. In such settings, access to sanitation facilities and the safe preparation of formula is likely to be more challenging, and the cost of formula prohibitive. The potential for serious infection or malnutrition in infants who are receiving unsafely prepared or diluted formula can lead to increased infant morbidity and mortality. CG Victora et al (Lancet, 2016) found that optimising breastfeeding to a near-universal level could prevent over 820,000 annual deaths in children under five years of age.

While infant feeding choices in a well-resourced and safe country should be supported, the current WHO guidance to exclusively breast-feed is in the best interests of the majority of infants worldwide. – Yours, etc,

Dr DEIRDRE FOLEY,

Fellow in Global

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and Inclusion Child Health,

Children’s Health Ireland,

Dublin 12.

A chara, – I read Clare Moriarty’s piece on the WHO recommendations for breastfeeding with interest.

The first point I would take issue with is that breastfeeding a baby means removing yourself from any other siblings. This is simply not the case; breastfeeding a baby is easily done while spending time with the rest of your family.

Breastfeeding a baby for the first six months of its life is demanding on the mother, but I would argue that this can lay the foundations for a very strong bond.

New babies create many new challenges but we should not necessarily shy away from them.

Talk of division of labour in this context is misleading – feeding and caring for a baby in the first months is not a job that can be divided equally. Yes, of course a mother needs the support of their partner, but this can be given in many different ways.

At a time when there is much talk of good life-work balances I think that we should pay more attention to the role of nurturing our young. Rather than looking on the activity of breastfeeding a baby as an unduly onerous one, we could instead look upon this time spent with a new baby as a supremely rewarding one for the whole family. – Yours, etc,

KATE KELLY,

Bailieborough,

Co Cavan.