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To the surprise of many working in infant feeding,
the World Health Organization under the leadership
of Dr. Gro Harlem Bruntlandt is backsliding in its
obligation to mothers and children around the world.
Over the years we had come to expect WHO to champion
breastfeeding protection through the International
Code and the vital WHA resolutions on infant and
young child nutrition. Previous years have seen
the passage of some important resolutions strengthening
and updating the Code. The slipping of breastfeeding
support as a focus of WHO's efforts to improve infant
health is evident in its position on age of introduction
of complementary foods. In both 1992 and 1994 important
resolutions were passed confirming the position
of member states regarding the age of complementary
feeding to be "at about 6 months". Notwithstanding
these resolutions and despite the frustrations of
the global community of health workers, researchers
and advocates, WHO's secretariat has stubbornly
embraced the position of introduction of complementary
foods "from 4 to 6 months".
In March 2000 WHO-UNICEF convened a global technical
consultation on infant and young child feeding.
When the experts present began discussion on the
age of exclusive breastfeeding, WHO staff insisted
that the topic not be discussed. In response 20
of the 28 consultants who were not WHO/UNICEF staff
read an independent statement into the record which
supported "at about 6 months" as the appropriate
age. To support their position of "at about six
months" the experts cited evidence as reviewed by
Brown, Dewey and Allen, in Complementary feeding
of young children in developing countries: a review
of the scientific knowledge. WHO/NUT/98.1: _ there
is no growth advantage for most infants, _ less
nutritious foods are replacing valuable nutrient-dense
breastmilk, increased risk of morbidity especially
from acute respiratory disease, the number 1 killer
of infants between 4 to 6 months. Yet, even without
WHO's support over 60 countries have now adopted
as policy, "at about 6 months".
In response to its critics, WHO has again proposed
to carry out a review of the literature on complementary
feeding and results will be released sometime in
2001.
In the meantime, the infant foods industry has
been lobbying to stall WHO's reconsideration of
its position. The current "4 to 6 months" is a position
they are actively pursuing at the Codex Alimentarius.
If successful, this will become the marketing standard
by which all national food laws and regulations
will be judged in any trade dispute at the WTO.
Lower Codex standards could threaten high national
marketing laws based on the International Code.
Clearly WHO is putting itself in an isolated position
and the global expectations of WHO as the champion
of health for all, no less the most vulnerable,
appears to be seriously compromised.
*Fostering appropriate complementary feeding practices
from the age of about 6 months WHA 47.5 *to ensure
that complementary foods are not marketed or used
in ways that undermine exclusive and sustained breastfeeding
WHA 49.15 *Naylor A. 2000. Statement circulated
at Technical Consultation on Infant Feeding, March
2000, and at the ACC/SCN working group on breastfeeding
and complementary feeding, Washington *WHO/UNICEF
Technical Consultation on Infant Feeding, March
13-17, 2000.

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