Why different reccomendations? - Mothering Forums

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Old 08-01-2003, 05:34 PM - Thread Starter
 
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APA says breastfeeding for at least 1 year. WHO says up to 2 years or longer. Why is there a disagreement? I've been wondering this for a while. Also what do other health authorities in other countries say?
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Old 08-01-2003, 05:57 PM
 
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Interesting you should mention this. Yesterday I was wondering the same thing and decided to look up what the Canadian Paediatric Society had to say about it. On their Caring for Kids site they say "Breast milk is the best food you can offer your infant. You can breastfeed until your child is two years of age and beyond." which seems to be inline with the WHO recomendations. (see their Breat feeding page for this and other interesting tidbits). I checked out the profesionals page and found a News Release about infant nutrition where they say essentialy the same as above but include some interesting information about solids and vitamin d :

MM

(whew! that took a while to pull together, I hope no one has posted the info in the mean time, lol)
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Old 08-01-2003, 06:32 PM
 
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I know that one of the Family Practioner boards recommends at least two years. There are 2 possible boards for FPs--the AAFP and ABFP. I know that one of them (not sure which) recommends 2 years, and I don't know what the other one recommends. It could very well be 2 years as well.

It's not like the AAP recommends nursing for only one year. Unfortunately, a lot of uneducated doctors seem to think that's what they mean.
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Old 08-01-2003, 08:58 PM
 
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i'm just talking out of my butt here, but i think the AAP as a group would be scared to issue a statement saying babies need human milk for 2 years, because 1) american women as a group are not even making it 6 months now and if you tell them they should be doing it for 2 years, well, they may just give up altogether since they may get disheartened at the prospect of committing so much time to their baby and 2) the formula companies and their deep pockets who are gifting peds and nurses and hospitals; who would want to offend their benefactors by saying their product is second-best and unneccessary?
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Old 08-01-2003, 10:27 PM
 
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Which, Elphaba, is an interesting point, because on nearly every formula can it states "Breastmilk is best.". It's the first sentence!
Go figure.:

~Melissa
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Old 08-01-2003, 10:43 PM
 
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My initial thought is that it may have to do with the availability of quality food and clean water. AAP is an American group, where one can safely assume that if a child stops bf'ing at age 1 there is adequate food to replace those lost calories and nutrients. The WHO is an international group, and might need to make recommendations based on countries that have inadequate food/clean water supply. In that case, its definitely best to continue bf'ing in order to keep baby healthy.

This isn't based on anything other than my intuition, so I could be *totally* wrong .
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Old 08-01-2003, 10:53 PM
 
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The AAP guideline is "AS LEAST one year, and then for as long thereafter as mother and child mutually desire" and the WHO guideline is "AT LEAST two years," so they don't really contradict each other. I agree with Elphaba that the AAP is probably afraid to recommend 2 years for fear that Americans would say "forget it, I'm not even going to try to do it at all!" It's hard enough getting people to do it for a year. Most of them give up by six months. Once most Americans are breastfeeding for a year, maybe they can be encouraged to try for two.

-Alice, SAHM to dd (2001) and ds (2004) each of whom was a homebirth.jpg, who each self-weaned at 4.5 years bfolderchild.gif, who both fambedsingle2.gif'd, who were bothcd.gif, and both: novaxnocirc.gif.   Also, gd.gif, and goorganic.jpg!

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Old 08-02-2003, 02:36 AM
 
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I believe the aap was going to release 2 yrs bf, ex for 8 months but a working mothers group complained saying it was unrealistic.


nak

Mom of a 7 yr old, 4 yr old, and 1 yr old. Wow. How did that happen?
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Old 08-02-2003, 10:35 PM
 
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Here are the exact words if anyone is interested.

American Academy of Pediatrics: (1997)
Quote:
It is recommended that breastfeeding continue for at least 12 months, and thereafter as long as mutually desired.
http://www.aap.org/policy/re9729.html

****************

American Academy of Family Physicians: (1989, revised 2001)
Quote:
Nursing Beyond Infancy
Breastfeeding should ideally continue beyond infancy, but this is currently not the cultural norm and requires ongoing support and encouragement.85 Breastfeeding during a subsequent pregnancy is not unusual. If the pregnancy is normal and the mother is healthy, breastfeeding during pregnancy is the woman's personal decision. If the child is younger than two years of age, the child is at increased risk of illness if weaned. Breastfeeding the nursing child after delivery of the next child (tandem nursing) may help to provide a smooth transition psychologically for the older child.
http://www.aafp.org/x6633.xml

************

The World Health Organization and UNICEF: (joint statement 1990)
Quote:
children should continue to be breastfed, while receiving appropriate and adequate complementary foods, for up to two years of age or beyond.
http://www.unicef.org/programme/brea.../innocenti.htm

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Old 08-03-2003, 02:11 PM
 
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exactly what wlphaba said...

l, <>< wife to my sweetie, proud mama to 3 cubs, 2 who clw & 1 that i i ep for . baby was evicted early by induction due to severe pre-e/hellp syndrome
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Old 08-03-2003, 02:55 PM - Thread Starter
 
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It's not that the AAP contradicts with the WHO. It dosen't. They have a different reccomendation. I was very interested to see that so many other organizations who are reputable also reccomend 2 years plus. I think if the AAP changed their reccomendation more mamas would breastfeed longer.

It was also very interesting on the tandem nursing bit. I have never read any reccomendations on tandem nursing. Up until about two years ago I did not know there was a such thing as nursing past a year or tandem nursing. I only found this through a lot of reading. There should be information on tandem nursing and EBF throughout each of our communities.

I'm going to write an email to the AAP and ask them why the difference in reccomendation. I'll post a responce when I get one.
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Old 08-04-2003, 01:15 AM
 
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Jackson's mama...the WHO is recommending for the whole world, not just ones with unsafe water. In fact we have a not insignificant amount of waterborne illness and malnutrition (even in obese children!) in the U.S. and we are pretty far down on the list in infant mortality. Which is a reason the formula companies claims that the WHO marketing code should not apply here is sort of hilarious, in a sad, sick way. WHO's recommendation is a minimal suggestion for all infants regardless of safe water or alternative infant foods.
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Old 08-04-2003, 02:44 AM
 
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I was actually going to say exactly what Jackson'smama said.

Clarity -- I am sure she knows, as I do, that WHO recommends for the all the world's population, poor infrastructure or no.
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Old 08-04-2003, 12:16 PM
 
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In the WHO link above they describe their ideal as a "global goal" they want to be supported by "all governments." They do not make any mention of developed vs. undeveloped countries anywhere in the document. They mention benefits to mom of extended nursing such as lower rates of breast cancer, which is related to whether mom nurses for a long time, not to what kind of country the mom lives in.

And several of the studies showing health-related reasons to nurse past one year come from Western medical journals:
http://www.kellymom.com/bf/bfextended/ebf-benefits.html

I believe if the AAP recommends a shorter time than other groups, it is due to societal and commercial pressures, (not medical reasons, and not due to the advantages of clean water etc.) The United States has one of the most pronounced anti-breastfeeding cultures in the world, since we as a culture emphasize the rights of the outrageously aggressive formula companies to make money, over the rights of innocent babies and mothers to enjoy good health.

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Old 08-04-2003, 04:09 PM
 
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Delta, the longer minimum suggested by WHO and shorter by AAP has more to do with cultural norms of the US and the longer age of WHO is not just ones in adverse circumstances. My point is that being an american does not guarantee adequate feeding practices, and being from another country does not guarantee the lack - you can't just point to that as the reason for the difference between the two. It's about politics, not health.
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Old 08-04-2003, 04:14 PM
 
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Its interesting to me that the AAFP mentions the cultural aspects of extended nursing in America, while the AAP doesn't mention it at all.

Quote:
Originally posted by Clarity
Which is a reason the formula companies claims that the WHO marketing code should not apply here is sort of hilarious, in a sad, sick way.
I guess I should be glad that its the formula companies' claim that is hilarious in a sad sick way, and not my claim.
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