The WHO recommends exclusive breastfeeding for the first 6 months of a child's life.

Review of evidence has shown that, on a population basis, exclusive breastfeeding for 6 months is the optimal way of feeding infants. Thereafter infants should receive complementary foods with continued breastfeeding up to 2 years of age or beyond.

Their website mentions "review of evidence", but what is that evidence? Why 6 months and not 4 or 5 or 7 or 8 or 9 or anything like that?

Can anyone give which review is WHO talking about?


I guess this is the review (ISBN: 92 4 156211 0) that they are referring to.

We found no objective evidence of a “weanling’s dilemma.” Infants who are exclusively breastfed for 6 months experience less morbidity from gastrointestinal infection than those who are mixed breastfed as of 3 or 4 months, and no deficits have been demonstrated in growth among infants from either developing or developed countries who are exclusively breastfed for 6 months. Moreover, the mothers of such infants have more prolonged lactational amenorrhea. Although infants should still be managed individually so that insufficient growth or other adverse outcomes are not ignored and appropriate interventions are provided, the available evidence demonstrates no apparent risks in recommending, as public health policy, exclusive breastfeeding for the first6 months of life in both developing and developed country settings. Large randomized trials are recommended in both types of setting to rule out small adverse effects on growth and to confirm the reported health benefits of exclusive breastfeeding for 6 months.

However, another report suggests that exclusive breastfeeding for a long time may lead to deficiency of some nutrients which cannot be supplemented via maternal diet.

The dual dependency on exogenous dietary sources and endogenous stores to meet requirements needs to be borne in mind particularly when assessing the adequacy of iron and zinc in human milk. Human milk, which is a poor source of iron and zinc, cannot be altered by maternal supplementation with these two nutrients. It is clear that the estimated iron requirements of infants cannot be met by human milk alone at any stage of infancy. The iron endowment at birth meets the iron needs of the breastfed infant in the first half of infancy,i.e. 0 to 6 months. If an exogenous source of iron is not provided, exclusively breastfed infants are at risk of becoming iron deficient during the second half of infancy. Net zinc absorption from human milk falls short of zinc needs, which appear to be subsidized by prenatal stores.

Both these reviews are from WHO website; you can search for different WHO research materials on the site.

Note: WHO does not say that breastfeeding should not be continued till a later stage. As noted in the review, exclusive breastfeeding for more than six months can cause some nutritional deficiencies. However, reducing exclusive breastfeeding to 3-4 months can reduce the immunity of the infant.

  • 1
    $\begingroup$ So basically they found the optimal time for exclusive breast feeding was between 4-6 months. I wonder what reason they listed 6 instead of the range?. $\endgroup$
    – John
    Feb 25 '19 at 16:48
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    $\begingroup$ @John In such studies it is difficult to make fine measurements. Perhaps they just tried with 4 & 6 and didn't check other durations. $\endgroup$
    Feb 25 '19 at 17:23
  • $\begingroup$ I liked the answer, but now I really want it to change, WHO should not make vague guidelines without sufficient data. $\endgroup$ Feb 28 '19 at 11:05
  • $\begingroup$ @AnubhavGoel WHO is trying to do best with whatever data they have. Note that whatever they say is a recommendation and general guideline. It is always better to consult a doctor for specific cases. $\endgroup$
    Feb 28 '19 at 11:08
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    $\begingroup$ I am a medical student myself, and the part is doctor here dont see it as guidelines but as sacred stone line. $\endgroup$ Feb 28 '19 at 11:10

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