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Are there any negative effects of exclusive breastfeeding for six months?
It is important to breastfeed exclusively (when possible) and bottle feed exclusively if you cannot breastfeed. In cases of iron-deficiency, instead of feeding your baby iron-rich food, supplemental iron is recommended because it is a much more concentrated source of iron. With other nutrient deficiencies (e.g. vitamins) the best way to ensure your baby gets more, is to ensure you eat more. The vitamins and other micronutrients you eat are passed onto your baby in your breastmilk, and the higher your micronutrient intake, the higher the micronutrient content of your breastmilk.
Disadvantages of introducing solids for baby early
Early introduction of solid foods has nutritional, emotional and physical disadvantages.
Increased risk of under nutrition
Babies who stop exclusive breastfeeding early are more likely to be under-nourished. Breastmilk is the best source of nutrition and contains all the nutrients your baby needs to support its growth until six months of age. Formula milk is a close substitute. Both breast and formula milk are packed with nutrients, so that even though their little stomachs can’t hold much food, babies can get a good dose of vitamins from just a bit of breastmilk. Breastmilk is something like a natural vitamin supplement just for babies.
Nutrients are highly concentrated in breastmilk. Even healthy solid foods like fruits, vegetables and meat contain only a fraction of the nutrients which are found in the same quantity of breastmilk. Regardless of the nutrient concentration of food, your baby can only eat a small quantity because their stomach is tiny. So it is important that the small amounts of food they eat are nutrient-rich, like breastmilk.
Giving your baby solid foods before six months means replacing a highly concentrated source of nutrients (breast or formula milk) with a less concentrated form (meat or vegetable). If your baby starts eating solids too early, they will fill up on these and not drink as much breast or formula milk. This means they will miss out on nutrients and energy which are vital for their growth. Early introduction of solids can also affect a woman’s breastmilk supply and cause her to begin producing less breastmilk.
Over nutrition
Feeding your baby solids before six months of age also increases the likelihood that they will develop problems with overeating, including nutritional disorders like obesity. If solids are given in addition to a full feed of breast or formula milk, a baby less than six months old will be eating too much and they may get into a habit of eating too much. One study reported that formula-fed babies who started eating solids before four months of age were up to six times more likely to be obese at three years of age.
Emotional readiness for solid foods
You probably don’t need to be told that breastfeeding is about more than providing your baby with the best possible nutrition. It’s an important time for mums and their babies to be together and get to know each other intimately. Breastfeeding plays a key role in developing a bond and helping baby develop emotionally. Bottle feeding also promotes intimacy with your baby. If you introduce solids too early, you will probably breastfeed less and miss important moments too bond with your baby.
Physical readiness for solid food
It may seem obvious that you can’t eat solid food unless you can sit up, chew and swallow, but it’s easy for these and other aspects of a baby’s physical development to get lost when you’re trying to decide whether or not your baby’s ready for solids.
Jaw and mouth
If your baby’s jaw and mouth have not properly developed and learnt the movements necessary to swallow food, feeding them solids will not only be difficult, it could be downright dangerous. Until their mouths develop the proper eating reflexes babies have an increased risk of choking. Before about four months of age, baby’s tongue reflex causes it to push its tongue out when anything is inserted in its mouth and this prevents baby from swallowing solid food. While it’s important to ensure your baby can hold its tongue in its mouth before you start feeding solids, this alone is not enough.
Gross motor functions
Another important component of eating is learning the process that goes with it, which involves sitting up, taking food from a spoon and resting between mouthfuls. To do all these things that adults and older kids take for granted, babies need well developed gross motor function (functions controlled by big muscles). Developing the functions needed to support eating and the other behaviours that go hand in hand with it, lays the foundation for a lifetime of healthy eating. But many of these functions depend on baby having adequate neck control and being able to sit up independently.
Feeding solid foods such as puree through a bottle with a wide nipple does not help them learn the process of sitting up to eat, so there is no reason to feed your baby in this manner, just so you can get a few solids into them before six months. However, by 6 months of age babies should have developed their big muscles enough to support their own head and neck and do other eating things like moving their arms (even if they’re still completely uncoordinated when it comes to holding a spoon). Delaying introduction of solids at this time will only be a disadvantage as it will slow down your baby down when it comes to them achieving development milestones like pulling and crawling.
Immune function and risk of infection
A young baby’s immune system is not properly developed at birth and this means it is more likely to get infections which can be introduced through foods and drink. Complementary solid foods and even water contain lots of nasties like bacteria and parasites which breastmilk does not. Even though children and adults can usually eat and drink these things without worrying about infections, babies cannot. They have not developed the antibodies and immune functions necessary to prevent the bacteria consumed in food causing a serious infection.
Introducing solids early also means introducing you baby to infectious organisms which cause diarrhoeal disease (amongst others!) early. Breastmilk is hygienic and also transfers antibodies which protect against infection from your immune system to your baby’s. These include immunoglobulins which prevent bacteria entering cells in your baby’s digestive tract and provide antibodies to diseases which you have developed immunity to, white blood cells which kills micro-organisms and whey proteins which provide protection against bacteria and viruses.
Allergy and intolerance
Breastmilk helps protect against allergies and early introduction of solids increases the risk of allergies. While some guidelines recommend the introduction of solid foods between 4-6 months to reduce allergy risk, evidence to support this is weak. Even if there was some benefit in terms of allergies, the nutritional and other benefits of continuing breastfeeding exclusively until six months far outweigh any small allergy-related benefits.
Digestive system
The components of baby’s saliva which digest carbohydrates are completely absent until 3 months of age and remain inadequate until baby reaches six months. Baby cannot properly digest carbohydrates found in solid foods.
Kidney
The kidney is underdeveloped until six months of age and cannot cope with the sodium (salt) in solid foods.
Maternal health
There are many disadvantages for babies who stop breastfeeding exclusively before they reach six months of age. However mums who stop breastfeeding early are also disadvantaged.
Breastfeeding exclusively until your baby is six months old also has important benefits for mums. Most women have probably thought from time to time that it would be so much easier if they could just do away with monthly bleeding, PMS, period pain and all the other joys of menstruation (and probably more than a few of us have thought about how nice just to have sex and not worry about falling pregnant!). Breastfeeding exclusively is just about the only way you can make both these fantasies a reality- it supressed ovulation and menstruation which means no periods and no PMS and no pregnancy for six months.
It all occurs because breastfeeding changes your hormones. Instead of producing oestrogen, progesterone and all the other hormones with make you bleed, cry at the drop of a hat and feel great during the monthly cycle, your body focuses on producing the hormones needed to produce breastmilk. The process of producing breastmilk stimulates a hormone called prolactin, which reduces the levels of oestrogen and progesterone produced by the woman’s body. When levels of oestrogen and progesterone are low, your menstrual cycle is suppressed and you cannot fall pregnant. Women who stop breastfeeding early also have an earlier return to normal menstrual cycles and fertility.
Finally, breastfeeding (or expressing) is the only way to ensure your breasts keep producing milk. Baby’s suckling during breastfeeding stimulates the production of more prolactin and further breastmilk and the more a baby suckles the more milk is produced. When a baby stops suckling or does not suckle as much, breastmilk production is decreased and you may not produce enough breastmilk to satisfy your baby’s nutritional needs, even if you are giving them other foods.
Exceptional cases in which exclusive breastfeeding is not recommended
There are a few exceptional cases in which women should not breastfeed their babies exclusively for six months. These include when the baby is born premature or the mother has severe nutritional problems. In addition some babies may develop quickly and show signs that they are ready to start solids before 6 months of age. In these cases solids should only be introduced early with the advice of a doctor.
Find out more about deciding whether or not your baby should start solids early
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Find out more about starting your baby on solids |
References
- World Health Organisation. Guiding principles for feeding of the breastfed child. 2003. (cited 30 September 2013). Available from: (URL link)
- Queensland Health. Introduction to Solids. 2008. (cited 13 September 2013). Available from: (URL link)
- Mayo Clinic Guide to Your Baby’s First Year. Mayo Foundation for Medical Education and Research. Good Books. Editors EH Kych, RV Johnson, WJ Cook. 2012. (Book)
- Department of Health and Ageing. Get up and grow: 2009. (cited 30 September 2013). Available from: (URL link)
- Samour PQ, Helm KK. Handbook of Pediatric Nutrition. 3rd Ed. Jones and Bartlett Publishers. 2005. (Book)
- Age four months through seven months. Chapter 8 in Caring for your baby and young child. American Academy of Pediatrics. 5th Edition. SP Shelov and TR Altmann Editors. Bantam. 2009. (Book)
- World Health Organisation. Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals. 2009. (cited 13 September 2013). Available from: (URL link)
- Anderson J. Confused about introducing solids? Australian Breastfeeding Association. 2012. (cited 30 September 2013). Available from: (URL link)
- Pediatrics: A Primary Care Approach. 4th Ed. Editor CD Berkowitz. American Academy of Pediatricians. 2011. (Book)
- Department of Health- Western Australia. Baby’s first foods. 2011. (cited 30 September 2013). Available from: (URL link)
