Early additional food and fluids for healthy breastfed full-term infants

What is the issue?

Internationally, exclusive breastfeeding for the first six months of life is recommended but the practice of giving breastfeeding infants other fluids and/or foods before six months is common in many countries and communities.

Why is this important?

Given that many infants are not exclusively breastfeeding for six months it is important to examine the possible benefits or risks associated with giving breastfeeding infants liquids other than breastmilk or complementary food in the first six months after birth.

What evidence did we find?

This review includes 11 randomised controlled trials involving 2542 infants.

Giving babies small amounts of artificial milk for a few days after birth in addition to breastfeeding did not effect the number of infants with any breastfeeding at hospital discharge though did slightly increase the likelihood of any breastfeeding at three months of age. There was no difference in the level of maternal confidence between the groups. The use of artificial milk before breastfeeding had a slight protective effect against allergy symptoms at 18 months of age compared to exclusive breastfeeding, however the trial did not perform diagnostic challenges or other tests to confirm the allergy symptoms noticed and thus requires caution in interpretation.

The likelihood of infants continuing to breastfeed was higher in the exclusive breastfeeding group than the group provided with additional water or glucose water in the first few days after birth. There was no evidence of benefit related to glucose levels, temperature, weight loss to breastfeeding newborn infants who were given additional water or glucose water.

Breastfeeding infants receiving complementary foods at four to six months did not show reduced risk of food allergy, eczema, or food protein-induced enterocolitis syndrome reactions. There was no difference between the early complementary foods and the exclusive breastfeeding groups for the percentage of days of cough, congestion, nasal discharge and hoarseness, fever, iron deficiency or weight gain.

What does this mean?

This review did not find sufficient evidence for disagreement with the recommendation of the World Health Organization and other international health organisations that as a general policy exclusive breastfeeding, without additional foods or fluids, should be recommended for the first six months after birth.

Authors' conclusions: 



Read the full abstract...




Search strategy: 


Selection criteria: 


Data collection and analysis: 


Main results: 




