What Is Exclusive
by Katherine A. Dettwyler, Ph.D.
Department of Anthropology,
Texas A & M University
Concerning the question of what exactly "exclusive
breastfeeding" means, the World Health Organization published official definitions of
all the terms several years ago. Click here to see their definitions. The term "exclusive" is supposed to mean only
breast milk. Whether the people mentioned who said they exclusively breastfed for a year
meant no solids, or just no formula, only they know. Generally speaking, in a group of 100
babies, say, the average baby will need/want solids in addition to breast milk between 4
and 6 months of age in order to keep up "normal" growth. However, there are
certainly baby/mother pairs where for various reasons the baby is ready for solids
earlier, as well as many many baby/mother pairs where the mother makes plenty of milk and
the baby is content just to have breast milk, and grows just fine on breast milk alone.
Probably, these people who say they exclusively breast fed for a year or more meant just
that -- only breast milk, and their babies are fine. It's not for every baby, though.
That's why guidelines are so hard to write that "fit every baby." I am hoping to
work with the World Health Organization on their revisions of their recommendations for
adding solids to the diet (the say 4-6 months, currently) to include some language
indicating that parents/health workers should also try to read the clues the baby is
sending. In other words, giving babies more control over the addition of solids, as well
as over breastfeeding. The problems with feeding solids to a two month old, in addition to
the ones mentioned, include allergies, and the fact that a two month old isn't able to
communicate very well that they don't want any more. An older baby can turn its head away.
To muddy the terminological waters further, many people in
other cultures who speak other languages tell health care workers that the baby
"didn't eat any food" until they were two years old. In Mali, women say this a
lot, but that doesn't mean the babies were exclusively breastfed for two years. What it
means is the child ate a lot of stuff the parents don't define as "real" food,
such as peanuts, mangoes, other fruits, fish from the market, etc. Only when the child is
eating substantial quantities of the staples (rice, millet, sorghum with sauce) do people
say he or she is "eating food." Likewise, in many Asian countries, you haven't
"eaten" if you haven't had rice.
Prepared August 3, 1995.
Last updated March 11, 2004 , by kad. Contents copyright 1999-2004 Sue Ann Kendall and Kathy Dettwyler. Thanks to Prairienet, the Free-Net of east-central Illinois , for hosting this site from 1999 through 2004.
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