Pediatric medical societies take issue with WHO guidance on cow’s milk

The recent World Health Organizationย (WHO) guidelineโ€‹ aims to provide evidence-based recommendations on complementary feeding (CF) of healthy term infants and young children between the ages of 6 and 23 monthsโ€”both breastfed and non-breastfedโ€”living in low-, middle- and high-income countries.

Eleven societies have shared their concerns about the guidelines in a newly published position paper, in Journal of Pediatric Gastroenterology and Nutritionโ€‹, saying some โ€œmay have the potential to cause unintended harm in infants and young children.โ€

They also question the process used to develop the guideline as there appeared to be no wider stakeholder involvement nor an open consultation process.

Excess protein and obesityโ€‹

The WHO guideline states: “For infants 6โ€“11 months of age who are fed milk other than breast milk, either milk formula or animal milk can be fed. For young children 12โ€“23 months of age who are fed milk other than breast milk, animalย  milkย  shouldย  beย  fed.ย  Followโ€up formulas are not recommended.”

Previously, the advice was that animal milkย should not be given as a drink to babies until they are 12 months old due to concerns thatย it does not contain enough iron to meet a baby’s needs.

However, the new report outlines some concerns around formula, stating that although formulas have been continually altered to be as similar as nutritionally possible to breast milk they “lack its immunological properties and do not include all nutrients present in breast milk.”

It states: “Because milk formulas have been aggressively marketed and are associated with child morbidity and mortality, an International Code of Marketing of Breastmilk Substitutes was nearly unanimously approved by the World Health Assembly in 1981.”



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