Breastfeeding and infant growth

Globally, mothers from a wide variety of socio-environmental contexts often assume slow-growing babies are underfed and erroneously attribute perceived growth retardation to inadequate milk supply or poor milk quality [1]. These assumptions frequently prompt replacement of breastmilk with formula or other nonbreastmilk foods to encourage infant weight and length gains [1]. This tendency to truncate breastfeeding to accelerate growth is exacerbated by some features of contemporary environments in both developing and developed nations such as growing rates of maternal obesity and caesarean section that interfere with breastfeeding. Unfortunately, regardless of the primary reason for truncation, cessation of exclusive breastfeeding before 4–6 months and of continued breastfeeding before 12 months is associated with increased risk of gastrointestinal infections and poor immune system development in infancy, and obesity and a variety of non-communicable diseases in later life [2]. Although stunting and wasting in children do represent major public health challenges in lowand middle-income countries, these phenomena should not be confused with unfaltering growth less than two standard deviations below global averages. EVOLUTIONARY PERSPECTIVES