Kathy's Commentaries

What Is Exclusive Breastfeeding?

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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