Exclusive breastfeeding

Exclusive breastfeeding means giving a baby only breastmilk — whether fed directly at the breast or expressed — with no other food, drink, or liquid during the first six months of life. The WHO defines it as "only breast milk with no additional food or drink, not even water," though oral rehydration solution and vitamin or mineral drops are permitted exceptions. The NHS recommends exclusive breastfeeding "for around the first 6 months of your baby's life."

Why does the WHO recommend six months of exclusive breastfeeding?

The WHO states that "exclusive breastfeeding for the first 6 months is the optimal way of feeding infants," citing advantages including a lower risk of gastrointestinal infection for the baby compared with shorter durations. The WHO also notes that "no adverse effects on growth have been documented with exclusive breastfeeding for six months." Following exclusive breastfeeding, the WHO recommends introducing nutritious complementary foods while continuing breastfeeding up to two years of age or beyond.

What happens after six months of exclusive breastfeeding?

The NHS advises that "Breastfeeding alongside solid foods is best for babies from 6 months" and that continuing breastfeeding "into your baby's 2nd year or beyond, alongside other foods, is ideal." UNICEF UK's Baby Friendly Initiative, which is aligned with WHO recommendations, supports exclusive breastfeeding for six months and continued breastfeeding with complementary foods thereafter.

Is any supplementation compatible with exclusive breastfeeding?

Under the WHO and NHS framework, supplementation with infant formula ends exclusive breastfeeding. The NHS cautions that formula top-ups reduce the frequency of breastfeeding, which can lower milk supply: "Your baby will want to feed less if you are topping up with first infant formula milk." The NHS therefore advises waiting until breastfeeding is well established before introducing formula if combination feeding is planned.