Breastfeeding is best. Sound familiar? It should. For decades it has been the dogma of breastfeeding advocates—parents, health professionals, legislators and government officials alike, citing as evidence breastfeeding’s many health benefits.

According to Berry and Gribble in a short communication published in the January 2008 issue of Maternal and Child Nutrition, there are growing concerns that the “breast is best” message fails to communicate the pivotal role breastfeeding plays in the growth and development of infants and young children. The authors suggest that it is time for health professionals to “rethink the way they consider breastfeeding” and “change the way that they speak to mothers and the community about the importance of breastfeeding.”

For years, measures of normal growth—growth reference charts—have been based on data collected between 1920 and 1975 by the United States National Center for Health Statistics (NCHS) using a sample of ethnically homogenous infants—few were breastfed beyond 3 months, and most were routinely supplemented with infant formula.

In 1994, the World Health Organization (WHO) Working Group on Infant Nutrition recommended the development of a new standard that would describe how children should grow, rather than how some children grew at a particular time and place. The WHO Multicenter Growth Reference Study (MGRS) followed 8500 ethnically diverse children in 6 countries for a period of 6 years. The data validate concerns that prior growth charts do not describe normal growth (gaining more weight in the early weeks and less in later infancy), and make it likely that early feeding difficulties were overlooked.

So what does this have to do with “breast is best”?

“The emphasis on the “breast is best” message has come to obscure the fact that infants who are artificially fed are at a greater risk of developing a number of acute and chronic illnesses,” assert Berry and Gribble.

“[ ] ignorance of the risks associated with artificial feeding has led many women and many health professionals to view the use of infant formula as benign,” add Berry and Gribble.

“Until the importance of breastfeeding for normal growth and development, and the risks and costs associated with premature weaning, become salient to mothers and to the wider community, it is unlikely that appropriate resources will be provided to enable mothers to breastfeed their infants,” said Berry and Gribble.

The fact remains—breastfeeding isn’t good, better, or best—it’s normal.