The emphasis in health policy on breastfeeding promotion seems to escalate steadily,and yet in many countries the consequences are disappointing. In Australia and New Zealand mothers have one of the highest initiation rates of breastfeeding but more work needs to be centred on extending the duration.
Several recent studies have shown that New Zealanders again have as high a prevalence of low iodine status as prior to the 1950swith many of all ages across the population being below WHO minimum levels. Since there has been no obvious recurrence of goitre or functional consequences, one might wonder whether the finding is of real significance, although it has been taken sufficiently seriously that as of the end of September 2009 iodine is added to almost all bread.
The protein level of ready to feed infant formula is significantly higher than that of human milk. This was a deliberate choice because firstly cow milk protein was considered not to be as well digested as human milk protein, and also the aminoacid composition which can be achieved with a mix of cow milk proteins [currently 60% whey and 40% casein] does not accurately match that of human milk proteins in terms of the blood levels of individual aminoacids produced in the infant. Indeed small amounts of some single aminoacids may be added to formula to try to correct this.
While “everyone knows” that babies usually lose some weight in the early days of life, the amount of loss and its timing are surprisingly not well documented. This is especially surprising since “failure to gain” is an indication for investigation both of feeding adequacy and for some abnormality of health.
The view that Sudden Infant Death Syndrome is a preventable condition has been reinforced by the positive results of numerous campaigns in several countries. Sometimes advice about the relevance of breastfeeding is given, sometimes it isn’t.
One might expect that there would be a relationship between postpartum depression, a condition more common than usually recognised, and the success of infant feeding, but surprisingly little has been written about it.
Of all the afflictions of young children, one of the worst has to be food allergies. Some families have a genetic predisposition to allergies of a variety of kinds, the commonest in infants and toddlers being to milk proteins, and gluten (celiac disease), but a large number of foods can be potentially allergenic.
Although the routine supplementation of pregnant women with folate and iron is widely practiced, the possible role of supplementation with other micronutrients is not known.
Studies have shown that the B vitamin folic acid (folate) is involved in the development of the fetal brain and spinal cord and that malformations of those areas, in the form of spina bifida and less often, anencephaly can sometimes be due to low levels of the vitamin in the mother.
The widespread use of folic acid supplements during pregnancy has resulted in a reduction of 50 to 70% in the proportion of infants born with neural tube defects, but it is not certain that greater levels of supplementation will improve the figures further.
The Infant Nutrition Council is committed to supporting both breastfeeding and infant formula.
