We appreciate the sentiments expressed by Dr. Srivastava in response to our article(1). We appreciate that there could be circum-stances when a mother may not be able to provide breast milk to her infant. However, the only point we wish to reiterate is that the Pediatrician, when counseling such mothers not wanting to breast feed their infant, should ascertain that there are compelling reasons for doing so which are justified and not compromise the infant’s interest. We are not contesting the fact that pediatrician’s need to be informed regarding breast milk substitutes, but the source of such information should not be that solely provided by the manufacturers of infant milk substitutes. It is here that scientific bodies such as pediatric associations can provide evidence-based information to the medical community.

The issue of the role of breast milk in reducing infectious disease in infancy especially in the poor and under-privileged communities is undisputed. In the absence of evidence one cannot conclude that the same benefit may not be seen in the affluent populations of developing countries. However, we are also concerned by the fact that often poor families are influenced by the practices of the affluent, with often disastrous outcomes for their infants. The other issue that is emerging as a concern is the role of infant milk substitutes in some adult diseases.

The article should be read in its spirit and not in its words only. The aim is to educate masses and not an exceptional individual. We hope that this communication will help in removing doubts regarding infant feeding practices from the minds of our pediatrician colleagues.

Satish Tiwari,
P. Chaturvedi.
Correspondence:
Dr. S. Tiwari,
Associate Professor in Pediatrics,
Medical College,
Amravati, Maharashtra,
India.
Email: [email protected]

1. Tiwari SK, Chaturvedi P. The IMS Act 1992: Need for more amendment and publicity. Indian Pediatr 2003; 40: 743-746.