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Breast-feeding: A Commentary by the ESPGHAN Committee on Nutrition

Agostoni, Carlo*,1; Braegger, Christian; Decsi, Tamas; Kolacek, Sanja§; Koletzko, Berthold||,1; Michaelsen, Kim Fleischer¶,1; Mihatsch, Walter#; Moreno, Luis A**; Puntis, John††; Shamir, Raanan‡‡,2; Szajewska, Hania§§; Turck, Dominique||||,3; van Goudoever, Johannes¶¶ESPGHAN Committee on Nutrition:

Journal of Pediatric Gastroenterology and Nutrition: July 2009 - Volume 49 - Issue 1 - p 112–125
doi: 10.1097/MPG.0b013e31819f1e05
Special Feature

This medical position article by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition summarises the current status of breast-feeding practice, the present knowledge on the composition of human milk, advisable duration of exclusive and partial breast-feeding, growth of the breast-fed infant, health benefits associated with breast-feeding, nutritional supplementation for breast-fed infants, and contraindications to breast-feeding. This article emphasises the important role of paediatricians in the implementation of health policies devised to promote breast-feeding.

The European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Committee on Nutrition recognises breast-feeding as the natural and advisable way of supporting the healthy growth and development of young children. This article delineates the health benefits of breast-feeding, reduced risk of infectious diarrhoea and acute otitis media being the best documented.

Exclusive breast-feeding for around 6 months is a desirable goal, but partial breast-feeding as well as breast-feeding for shorter periods of time are also valuable. Continuation of breast-feeding after the introduction of complementary feeding is encouraged as long as mutually desired by mother and child.

The role of health care workers, including paediatricians, is to protect, promote, and support breast-feeding. Health care workers should be trained in breast-feeding issues and counselling, and they should encourage practices that do not undermine breast-feeding. Societal standards and legal regulations that facilitate breast-feeding should be promoted, such as providing maternity leave for at least 6 months and protecting working mothers.

*San Paolo Hospital, University of Milano, Milano, Italy

University Children's Hospital, Zurich, Switzerland

University of Pecs, Pecs, Hungary

§Children's Hospital, Zagreb Medical University, Zagreb, Croatia

||Dr von Hauner Children's Hospital, University of Munich, Munich, Germany

University of Copenhagen, Copenhagen, Denmark

#Deaconry Hospital, Schwaebisch Hall, Germany

**Escuela Universitaria de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain

††Leeds General Infirmary, Leeds, United Kingdom

‡‡Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel

§§Medical University of Warsaw, Warsaw, Poland

¶¶Erasmus MC/Sophia Children's Hospital, Rotterdam, The Netherlands

||||Jeanne de Flandre Children's Hospital, Lille University Faculty of Medicine, Lille, France


2Committee Chair;

3Committee Secretary.

Received 16 January, 2009

Accepted 19 January, 2009

Address correspondence and reprint requests to Dominique Turck, Unité de Gastro-entérologie, Hépatologie et Nutrition, Département de Pédiatrie, Hôpital Jeanne de Flandre, avenue Eugène Avinée, 59037 Lille, France (e-mail:

The authors report no conflicts of interest.

© 2009 Lippincott Williams & Wilkins, Inc.