The dietary advice set out by the Department of Health and Social Services in ‘Present-day Practice in Infant Feeding’ differed substantially from the practices which were current when the booklet was produced, as well as from those which were common when the NCHS (Hamill, 1977) and Tanner, Whitehouse & Takaishi (1966) growth reference standards were being compiled. This short review assesses the likely consequences for infant growth if the DHSS advice were more widely adopted. We have been investigating prospectively derived growth patterns in the city of Cambridge, where a much higher proportion than usual of mothers have changed their infants' feeding practices in accordance with official recommendations.

Feeding practice

The basic recommendation in DHSS (1980), recently updated in a statement from the Committee on the Medical Aspects of Food Policy (COMA, 1987), is that during early infancy, human milk or an approved infant formula should be the sole source of nourishment. The panels producing both sets of recommendations emphasized that breastfeeding provides the best milk for the young infant and that if an alternative to this sort of milk has to be introduced, it should be as an approved formula at least up to 6 months of age. The recommendations state, furthermore, that solids may be introduced from about the age of 4 months to complement the milk feeding.

Figures 1 and 2 show secular trends in the incidence of breastfeeding during the 60 year period from 1920 to 1985 as well as changes in the average age for the onset of the introduction of solid foods.