weaning at four months

[Smerlin]

Hi all

Just come back from first hospital appt with the gastro paed and he has recommended we start weaning.

Bit of background- we struggled with bf so baby was on formula and EBM. Once I was expressing large amounts, she went onto 100% breast milk but due to faltering growth, GP said to reintroduce formula as my breast milk must be deficient in protein due to expressing it(!!) We have gradually moved more and more onto formula so she is just recently 100% on formula. Weight gain has been very slow through all of this and she hates feeding (screams and refuses) hence the referral to the hospital.

Paed says nothing physically wrong with her but could be a psychological aversion and so early weaning could help and be a more positive experience for her. Plus as she has had formula, the 100% gut protection from sticking to breast milk doesn't apply.

The thing is, I'm terrified of doing another thing 'wrong' - everywhere says wait till 6 mths and I can find almost no advice on starting at 4.

Has anyone done this on clinician's advice? In terms of the signs, she picks things up and accurately puts them in her mouth, she sits well supported but despite her best efforts (think stomach crunches!), can't bring herself to sitting or balance only using her hands and I'm not sure how to check her tongue thrust reflex.

WWYD?

[JiltedJohnsJulie]

Well you can check her tongue thrust reflex by offering her a bit of beg purée on a spoon. No need to do anything special, just offer make some of the veg you are eating smooth by blending or sticking through a sieve.

Has you Paed suggested allergy testing? Do you think she may be cows milk protein intolerant? Could be worth ruling out

[Smerlin]

Yes I went cows milk free to test this but I couldn't get her to take more than 30ml of the hydrolysed formula that she was supposed to have alongside the breastmilk (instead of normal cows milk formula) so we had to give up the trial as she point blank refused to eat! Don't blame her..it smells of rotten cheese!

[BertieBotts]

You could try baby led weaning if you want to. If she can sit with support in a high chair without lying back then it's safe to try - just put food in front of her and see if she can get it to her mouth. They don't need to sit unsupported.

I would post in breast and bottle feeding too, I'm not sure how expressing can reduce protein content of milk, that doesn't make sense? Where does he think it has gone?! If you've only just stopped then it would be possible to get supply back if that's something you want to do.

I wonder if she has tongue tie.

[Smerlin]

I wondered about tongue tie too but nobody suggested it. To be honest, I was not in a fit state to take her to tongue tie or bf clinic/cafe after delivery as I had a major PPH and couldn't leave the house which is partly what scuppered my plans to bf.

The same GP told me that I wouldn't be able to express for more than a few weeks as my milk would dry up without baby sucking directly- also not true!!!

[Christelle2207]

I didn't do it on medical advice but I started weaning ds at just over 4 months and sounds like he was less ready than your dd. Not sitting up(though he does now) or putting much in his mouth. Now just over 6 months he's done really well (spoon fed purees only) and has a variety of cereals, fruit and veg. Just went very slowly at first with a few spoonfuls of porridge and fruit puree. Meanwhile I just learnt that I was weaned at 7 weeks

[Smerlin]

Will definitely try with finger foods then- she's pretty adept at putting everything she sees in her mouth!

[geekaMaxima]

to a paediatrician saying expressing leads to lower protein content in bm. What absolute bollocks! I'm afraid you seem to be stuck with yet another hcp who knows sfa about bf.

Op, to be honest, I think the paed's rationale for weaning at 4 months is pretty tenuous. A paediatric gastric specialist is not really the best person to make claims about psychological conditioning in a 4 month old. Nor am I, for that matter: it's just that the reason given would sound shaky coming from anyone.

If you think it's worth a shot because you're stuck, then go for it cautiously - it could make things better, worse, or make no difference at all. But just in case you're feeling pressured into something you're not comfortable with - not sure from the tone of your post - then you could look at getting a second opinion. Either way, good luck.

[ReluctantCamper]

I started weaning my son at about 21 weeks. It was all fine. I found this book super helpful with advising what to start with, how to make sure he was getting the right balance of food, when introducing meat would be appropriate, etc

www.amazon.co.uk/Stress-free-Weaning-Teach-Yourself-General/dp/1444103059?tag=mumsnet&ascsubtag=mnforum-21

I also found it helpful as it advocates providing finger food alongside purees - I was far too paranoid about my baby's weight to be OK with exclusive baby led weaning!

Good luck, and I hope your DD's weight gain improves.

[HazleNutt]

there is actually research stating that weaning only after 6 months might not be so great after all www.bbc.co.uk/news/health-12180052

[Smerlin]

Thanks for the advice. I think I'm going to hold out till 21 wks/5 months as my instinct is against starting quite this early.

Am going to use this month to sit her at the table with us so she can watch us eat/let her play with spoons etc and do some reading- have ordered the book you recommended ReluctantCamper

She is already fascinated by watching us eat, can easily pick something up and put it in her mouth (and holds the handle of her empty spoon and puts the bowl of the spoon in her mouth) and sits with her back straight in the Bumbo/on our laps 90% of the time so I think in a few more weeks her sitting will be spot on.

[purplemurple1]

I started at 4 months as DS was showing signs (similar to yours plus I knew his tounge thrust was gone as he had medicine on a spoon each day). The greneral adivce in Sweden (where I live) is to give tastes of food from 4 months and a 6 months to give anything and everything with a mix of spoon and finger foods. BLW did not work for DS as he gets angry about not getting enough food quickly enough.

We actually had a similar start to you with failed bf, failure to thrive, etc and starting him on solids which really cut down his throwing up. Although that seems to be getting worse now we have introduced a wider range of foods at 6 months, but may be it was to much to soon for him.

I think the main concern for you will be to make sure you have high cal foods as starting solids has really slowed down ds weight gain, which was ok as he was by then quite a chunky monkey, but maybe not so good in your case.

[Smerlin]

Hmm she has her meds via a syringe but I could try on a spoon to check the tongue thrust. Yes purplemurple1 - I am spending a lot of time googling high calorie fruit and veg- avocado seems to be the main suggestion.

If only she would take more milk

[purplemurple1]

I found rice pudding cooked with formula went down well in the early days esp if when it had some banana or stewed apple in it.

I also used formula to make mashed pototo (I also used some marge but maybe the UK rules are different).

Not really high cal food but its better than carrots and pears at least!

[KelYoung8]

Hi, I started weaning at 17 weeks as suggested by my GP and Health Visitor as my little boy suffered from reflux. We started off with baby rice and then introduced fruit and vegetable purees a week later. At 6 months he began eating finger foods and now eats the same as us - it's also encouraged me to eat more healthily as I now cook without salt and make my own sauces. The guidance seems to change all the time and so I wouldn't worry too much. It certainly didn't do him any harm and now at 9 months he eats absolutely everything! Another good first finger food you can try is pollenta as it's quite soft. Good luck!

[tiktok]

Hazel, that link is not research.

I don't think there is anything too terrible about weaning at four mths under a doc's guidance (though less protein cos of expressing is rubbish).

But a speculative piece that bf exl to six mths is absolutely not research and in any case the op's baby is not bf, so it applies even less !

[Smerlin]

Yes I kind of got the impression from the paed that as I hadn't managed to exclusively bf, it mattered less about introducing solids as the advice on 100% breast milk only till 6 mths didn't apply. He seemed to be suggesting that weaning early (4-6 months) wasn't often a problem for gut maturity but they say wait till 6 months because of the positives of sticking to breast milk only until then rather then because of the negatives of solids if you see what I mean.

[Seeline]

My DD is 9 and in those days the advice was to wean at 4 months - don't know when the advice changed. Both my DCs were therefore weaned at 4 months and it doesn't appear to have caused any problems.
I know weaning is controversial these days, but when there are other factors such as poor weight gain, you have to balance out the pros and cons.
As a PP suggested, first 'foods' I tried relied on a expressed/formula milk base eg porridge, rice pudding, baby cereals, semolina and baby yoghurts/fromage frais.