I very much appreciate the article by Thompson et al1, which clearly shows that women with greater blood loss after a significant PPH are less likely to continue ¿full breastfeeding¿. However, I am concerned with the definition of breastfeeding used in this study. Authors indicate on page 2, under the heading ¿Quantitative data¿, that they have used the 2008 WHO definition2 for categorizing the breastfeeding practices. However, they have grouped infants who were being either ¿exclusively¿ or ¿predominantly¿ breastfed into one category of ¿fully breastfeeding¿; while this method of categorization is merely based on the older WHO3 breastfeeding definitions and are not suggested in the latest version2.
In addition, authors define ¿bottle feeding¿ as the state in which infants are ¿not fed any breast milk¿; this does not match the 2008 WHO definition of ¿bottle feeding¿ which is ¿receiving any liquid (including breast milk) or semi-solid foods from a bottle with nipple/teat¿2.
Since breastfeeding definitions suggested by the WHO are the most reliable and widely-used, this comment serves to bring this issue to readers¿ awareness.
Mahsa Jessri
Human Nutrition Division, University of Alberta
Edmonton, AB, Canada
References:
1. Thompson JF, Heal LJ, Roberts CL, Ellwood DA. Women's breastfeeding experiences following a significant primary postpartum haemorrhage: A multicentre cohort study. Int Breastfeed J. 2010 May 27;5:5.
2. World Health Organization: Indicators for assessing infant and young child feeding practices: conclusions of a consensus meeting held 6-8 November 2007 in Washington D.C., USA. Geneva: World Health Organisation; 2008.
3. World Health Organization: Indicators for Assessing Breastfeeding Practices: Reprinted report of an informal meeting, 11-12 June 1991 Geneva, Switzerland. Division of Child Health and Development. World Health Organization; 1991, WHO/CDD/SER/91.14.
International Breastfeeding Journal
Breastfeeding Definition
24 October 2011
Dear Editor,
I very much appreciate the article by Thompson et al1, which clearly shows that women with greater blood loss after a significant PPH are less likely to continue ¿full breastfeeding¿. However, I am concerned with the definition of breastfeeding used in this study. Authors indicate on page 2, under the heading ¿Quantitative data¿, that they have used the 2008 WHO definition2 for categorizing the breastfeeding practices. However, they have grouped infants who were being either ¿exclusively¿ or ¿predominantly¿ breastfed into one category of ¿fully breastfeeding¿; while this method of categorization is merely based on the older WHO3 breastfeeding definitions and are not suggested in the latest version2.
In addition, authors define ¿bottle feeding¿ as the state in which infants are ¿not fed any breast milk¿; this does not match the 2008 WHO definition of ¿bottle feeding¿ which is ¿receiving any liquid (including breast milk) or semi-solid foods from a bottle with nipple/teat¿2.
Since breastfeeding definitions suggested by the WHO are the most reliable and widely-used, this comment serves to bring this issue to readers¿ awareness.
Mahsa Jessri
Human Nutrition Division, University of Alberta
Edmonton, AB, Canada
References:
1. Thompson JF, Heal LJ, Roberts CL, Ellwood DA. Women's breastfeeding experiences following a significant primary postpartum haemorrhage: A multicentre cohort study. Int Breastfeed J. 2010 May 27;5:5.
2. World Health Organization: Indicators for assessing infant and young child feeding practices: conclusions of a consensus meeting held 6-8 November 2007 in Washington D.C., USA. Geneva: World Health Organisation; 2008.
3. World Health Organization: Indicators for Assessing Breastfeeding Practices: Reprinted report of an informal meeting, 11-12 June 1991 Geneva, Switzerland. Division of Child Health and Development. World Health Organization; 1991, WHO/CDD/SER/91.14.
Competing interests
None