Yes, it's late. But I recently needed to look at studies and analyze them, and this was one I looked at (turned out I needed something else, but that's beside the point.)
The article is here for reference: http://www.bmj.com/content/342/bmj.c5955.full
I will refer to the full-text of the article, which is free. I will also refer to the citations used by the authors.
The article starts off with an odd statistic. It states that although the WHO recommendation is six months of exclusive breastfeeding, that 65% of all European Union states and the United States "elected not to follow this recommendation fully." This appears to sound as though those nations disagreed with the recommendation; however, the citation for the claim is simply an article on breastfeeding rates rather than policy. For the record, the American Academy of Pediatrics agrees with WHO and recommends six months exclusive breastfeeding. While the nation may agree it is best, and many women may try to follow the recommendation (initial breastfeeding rates are high), actual six months exclusive rates are low.
The article continues by attempting to discount the systematic review the WHO recommendation is based on - "the review included 16 eligible studies, seven of which were developing countries." This seems to be a primary point throughout the article (and many others that attempt to discount exclusive breastfeeding through six months) that while breastfeeding exclusively for six months is best in poor developing countries, it is not so for developed countries (because we have scientifically engineered stuff that is supposedly better than natural).
Breastfeeding adequacy is questioned later, as the authors cit a study by Wells and Reilly and state that "many mothers who exclusively breastfeed would not support their infant's energy requirements to six months." Unfortunately, no further information backing this up is given (unfortunately for them!). The study cited is actually only a hypothesis proposed for developing countries and the authors Wells and Reilly would like further studies to see if this hypothesis is true.
Later in the article, low iron levels are looked at. The authors cite a study that found lower iron levels in United States infants breastfeed exclusively for six months as opposed to four to five months. However, when I looked up this citation, the study also found that the differences were "statistically insignificant." The other studies cited here are ones linking iron deficiency to low cognitive performance and development; a valid point if the difference in iron levels had been significant and of concern.
The article then addresses food allergies, citing a study that found introducing gluten prior to three months and after six months increased the risk of gluten allergy. The authors claim this justifies introducing solids between three and six months. Unfortunately (for them), when i looked at this citation, the study only included infants deemed "at risk" for such an allergy, rather than infants as a whole. The authors the article then state that exclusive breastfeeding to six months is directly challenged by this evidence of higher risk for celiac disease.
The article's purpose is to demonstrate the need for randomized trials regarding breastfeeding rather than the current observational studies. Some may argue this is unethical, particularly in light of the author's own statement that early feeding practices directly influence the rest of a child's life.
Of particular interest, the article ends by addressing competing interests. While none of the four authors received "external funding in connection with the preparation of this manuscript," three of the four "have performed consultancy work and/or received research funding" from infant food and formula companies in the last three years. I think that is particularly telling in light of the article's flaws.
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