Sub-optimal breastfeeding, especially non-exclusive breastfeed- ing in the first six months of life, results in 1.4 million deaths and 10% of the disease burden in children younger than five years old.1 The World Health Organization (WHO) recommends that breastfeeding should be exclusive for the first six months of life2 and thereafter, should continue with the gradual introduction of safe, adequate complementary food.3 In the previous issue, I described how Adequate Intakes (AI) of nutrients for full-term infant nutrition were derived from the nutrient concentrations in the milk of healthy, well-fed mothers between 2–6 months of lactation who produced on average a volume of 780 mL of milk / day.4,5 For an infant to obtain AI of nutrients, the WHO recommends exclusive breastfeeding for the first six months of life.2 Unfortunately, although mothers in de- veloping countries can produce the necessary volume of milk for the breastfed infant,6 there is considerable evidence that both the required volume and nutrient concentration are not obtained in many settings. Moreover, many infants are born with low birth weights and / or are delivered pre-term, and are thus unlikely to possess the nutrient stores that a term infant would.7 Exclusive breastfeeding for the first six months of an infant’s life is sadly uncommon in many settings and there is evidence that maternal malnutrition impairs milk quality. This highlights the need for ongoing interventions that promote and protect breastfeeding, and raise awareness regarding the nutrient status of pregnant and breastfeeding mothers and women of childbearing age. There is widespread evidence of growth faltering8 by just three months of life, and there are frequent reports of micro- nutrient malnutrition during the first six months of life that we cannot neglect to consider.4 In this issue, however, I look at the importance of continued breastfeeding during the subsequent period of infancy from six months through to 24 months of age, and at some of the attempts being made to combat malnutrition in this age group.
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