Remarks

• The GDG made strong recommendation in favour of exclusive breastfeeding (EBF) until 6 months of age despite the very-low-certainty evidence because they considered the potential harms of less than 6 months of EBF to outweigh the potential harms of having at least 6 months of EBF.
• In making the decision, the GDG also considered the results of a systematic review of 42 studies (89 638 infants) comparing mother’s own milk with infant formula in babies aged 0–6 months (60). This review showed consistent harm from the use of infant formula on a critical outcome (morbidity: necrotizing enterocolitis) in the first 6 months after birth. It also reported no evidence of benefit from infant formula over the same period.
• The GDG also considered that EBF until 6 months of age is the standard of care for preterm and LBW infants across many high-, middle- and low-income countries and is the foundation of many national policies and programmes.
• The GDG also felt that mothers should be encouraged and supported before and after birth to provide their own breast-milk (including colostrum) for their infants.