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The recommendation of the National Breastfeeding Committee remains unchanged: babies should be breastfed exclusively for the first four to six months

12/2015, 30.04.2015

Opinion of the National Breastfeeding Committee on the change of the S3 guideline on allergy prevention

The National Breastfeeding Committee (NSK) at the German Federal Institute for Risk Assessment advises that its recommendations on the duration of breastfeeding and introduction of solid foods continue to apply. According to these recommendations, infants should be breastfed exclusively at least until the beginning of their fifth month of life. Babies should be given solid foods in addition to breast milk no earlier than this point in time and no later than their seventh month. The opinion of the NSK is occasioned by an update of the S3 guideline on allergy prevention which deviates from previous recommendations. This has frequently led to confusion among parents and health professionals in recent months.

The S3 guideline on allergy prevention was developed by medical associations and last updated in 2014. In contrast to the recommendations of the NSK, the S3 guideline recommends full breastfeeding in the first four months and solid foods after the fourth month. The reasons given for the change of the solid food recommendation are the increased nutritional requirements of children and the contribution of solid foods to allergy prevention.

The National Breastfeeding Committee has issued a statement on the change of these recommendations of the S3 guideline on allergy prevention. The experts conclude that there are no scientific reasons for changing the existing NSK recommendations on breastfeeding, nor the start of solid food intake. They notably argue that no scientific evidence exists for increasing nutritional requirements that would generally necessitate the introduction of solid foods from the fifth month onwards.

In the opinion of the National Breastfeeding Committee, the following recommendations continue to be valid:

• Infants should be exclusively breastfed until at least the beginning of their fifth month of life.
• Even after solid foods have been introduced - no earlier than the beginning of the fifth months and no later than the beginning of the seventh month - breastfeeding of infants should continue.
• At what point the infant additionally needs solid foods within the mentioned time window depends on the child’s development and ability to eat.
• The overall breastfeeding period should be determined by the mother and her child.

The committee developed these recommendations jointly with paediatric associations. Apart from nutritional and physiological aspects, data on the effects of exclusive breastfeeding and / or solid foods on the growth, development and subsequent health risks of the child were considered. Thus babies who were breastfed exclusively for four to six months have a significantly lower risk of infection, for example of the respiratory tract. Other illnesses which are less common in breastfed children later in life include overweight and diabetes mellitus type 2.

The detailed opinion of the National Breastfeeding Committee on the change of the S3 guideline on allergy prevention can be viewed at the following link (in German):

http://www.bfr.bund.de/cm/343/update-der-s3-leitlinie-allergiepraevention-weicht-von-stillempfehlung-der-nationalen-stillkommission-ab.pdf

Further information on the work of the National Breastfeeding Committee is available at the following website:

http://www.bfr.bund.de/en/national_breastfeeding_committee-742.htm

About the National Breastfeeding Committee

The National Breastfeeding Committee was founded in 1994 with the aim of promoting a breastfeeding culture in the Federal Republic of Germany and to ensure that breastfeeding becomes the normal form of nutrition for infants. The Committee is composed of members of medical professional associations and organisations who are committed to the issue of breastfeeding in Germany.

About the BfR

The German Federal Institute for Risk Assessment (BfR) is a scientific institution within the portfolio of the Federal Ministry of Food and Agriculture (BMEL) in Germany. It advises the Federal Government and Federal Laender on questions of food, chemical and product safety. The BfR conducts its own research on topics that are closely linked to its assessment tasks.

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