title: Lifetime health outcomes of breast-feeding: a comparison of the policy documents of five European countries.
abstract: OBJECTIVE
  To (i) identify and describe prevailing infant feeding policy documents in five diverse European countries; (ii) analyse types of health outcomes for the infant that are associated with feeding breast milk rather than formula milk in the documents of different countries; and (iii) assess the extent to which documents reflect the WHO global recommendation of exclusive breast-feeding for 6 months.
  
  
  METHODS
  Documentary review and analysis.
  
  
  METHODS
  Five geographically dispersed countries of Europe (England, Finland, Germany, Hungary and Spain).
  
  
  METHODS
  Policy documents on infant feeding were identified; statements that linked choice between breast- and formula-feeding to a health outcome for the infant were extracted.
  
  
  RESULTS
  Twenty-six documents (varied authorships, dates, length and character) were identified: four from England; two from Finland; nine from Germany; six from Hungary; and five from Spain. There was no consistency in the way in which health outcomes were cited as factors in the recommendations for breast- rather than formula-feeding. Seven documents contained no reference to the health implications of infant feeding choice. Of 203 statements in remaining documents citing health outcomes, 24.1 % mentioned general health effects, 32.5 % protection against infections, 31.5 % long-term conditions (e.g. diabetes, CVD) and 11.8 % mentioned allergy. Health outcomes were linked to exclusive breast-feeding in only 25 % of statements.
  
  
  CONCLUSIONS
  Policy documents in the study countries varied in the extent to which they reflect the health outcomes for the baby of breast-feeding, and this may limit effective promotion by health professionals. There is scope to improve the process of bringing evidence and recommendations into policy documents.
authors.affiliation: Department of Paediatrics, University of Granada, Granada, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Martin-Bautista
authors.forename: Heather
authors.initials: H
authors.lastname: Gage
authors.forename: Julia
authors.initials: J
authors.lastname: von Rosen-von Hoewel
authors.forename: Viktoria
authors.initials: V
authors.lastname: Jakobik
authors.forename: Kirsi
authors.initials: K
authors.lastname: Laitinen
authors.forename: Martina
authors.initials: M
authors.lastname: Schmid
authors.forename: Jane
authors.initials: J
authors.lastname: Morgan
authors.forename: Peter
authors.initials: P
authors.lastname: Williams
authors.forename: Tamas
authors.initials: T
authors.lastname: Decsi
authors.forename: Cristina
authors.initials: C
authors.lastname: Campoy
authors.forename: Berthold
authors.initials: B
authors.lastname: Koletzko
authors.forename: Monique
authors.initials: M
authors.lastname: Raats
mesh_terms: D001942:Breast Feeding; D005060:Europe; D019983:Guideline Adherence; D017408:Guidelines as Topic; D006291:Health Policy; D006293:Health Promotion / Q000379:methods*; D006304:Health Status; D006801:Humans; D007223:Infant; D041943:Infant Formula; D007227:Infant Nutritional Physiological Phenomena; D014944:World Health Organization