Interesting talk today from a Paeds allergist re weaning ,allergies etc.

[LaDiDaDi]

Was at a talk from Prof John Warner today where he was talking about allergies.

He suggested that an overlap period between breastfeeding and weaning was more important than exclusive breastfeeding to 6 months then weaning. He also suggested that the guidance regarding what pregnant women should eat during pregnancy may be changed and that the evidence behind the idea of slow weaning, ie waiting before introducing certain foods that are thought to be more allergenic eg kiwi, was minimal at best. He thinks that soon pregnant women with a personal or family history of allergy will be told not to avoid allergenic type foods unless they are specifically allergic to it.

It was very interesting and I wanted to tell mumsnetters about it. Wasn't sure where to post but thought here was as good a place as any.

[CoteDAzur]

There is an Allergies topic where this would be most welcome.

I am not surprised, by the way. As someone with several severe allergies who has no relatives with any allergies, I ate peanuts, kiwi, etc and gave them to DD.

[terramum]

What you mean mean by "an overlap period between breastfeeding and weaning was more important than exclusive breastfeeding to 6 months then weaning"?

[CoteDAzur]

I took that to mean the overlap between breastfeeding and introduction of solid foods - i.e. continuing to breastfeed as new foods are introduced, rather than cutting it off quickly.

[Christywhisty]

I have heard recently that most paediatricians don't agree with the 6 months weaning , and often advise to wean earlier.
Unfortunately I did eat a lot of peanut butter when I was pregnant and ds had peanut allergic ( his last test was clear) and is still allergic to most treenuts and seseme seeds.

[LaDiDaDi]

Yes cote D'Azur that's what he meant. He felt that it was more important to continue to breastfeed whilst you were introducing potential new allergens than it was to breastfeed exclusively to 6 months then start to introduce a bit of purreed carrot and sweet potato for a couple of weeks then move to formula. Obviously I'm paraphrasing a bit here but that was the gist of it.

He was presenting some work on hyperactivity and food stuffs as well.

[welliemum]

I've been reading about this - it's very interesting.

It looks as if there might be a trade-off between exclusive breastfeeding and introducing allergens.

As soon as you stop exclusive breastfeeding, your child's risk of infection is significantly higher (including risk of being admitted to hospital).

So I imagine that for each child, you would need to balance the risk of allergy vs the risk of infection when you decide when to wean them.

There's no evidence so far that waiting to 6 months increases the risk of allergy, whereas there is evidence that it decreases the infection risk, so the balance is still strongly in favour of weaning around 6 months - when most children become able to self feed - and I'm sure that's no coincidence.

[AitchTwoOh]

that's very interesting. it really does make sense, but what of formula, did he say anything about that?

[LaDiDaDi]

No, he didn't mention formula.

[AitchTwoOh]

i wonder what difference that would make, given that there are no immunities to be passed on there? i am just grateful that i let dd feed herself... i was barely involved in the process.

[LaDiDaDi]

I suspect, and this is just me extrapolating from what he said, that he would advise exclusive formula feeding till 6 months then weaning with whatever you/baby fancies.

Whereas if you are bf he seemed to be saying that in terms of preventing allergy there was no disadvantage in weaning earlier than 6 months so long as you continued to breastfeed until most potential allergens had been introduced to the diet. I stress though that this was from the pov of preventing allergy not infection and other benefits of bf.

[CoteDAzur]

Who are these "most babies" who can feed themselves at 6 months? Mine could barely sit on her own at 6 months, let alone hold the spoon and successfully find her mouth with it

[princessosyth]

Formula feeding exclusively until 6 months? I always thought it was the opposite.

[Christywhisty]

Welliemum there have been several studies lately that show that exclusive breastfeeding until 6 months actually increase allergies.

[MsHighwater]

CoteDAzure, surely feeding oneself need not necessarily involve cutlery?

[LaDiDaDi]

Princess, I think that you are misunderstanding me.

If breastfeeding then he felt it was more important for there to be a considerable overlap between starting weaning and ending breastfeeding than to breast feed exclusively for 6 months. The idea was that exposure to potential allergens via the gut makes you less likely to become sensitised than exposure through skin. Eg in a population where a lot of peanuts are eaten, so relatively lots of poetntial for skin contact, you were more likely to become allergic if the introduction of peanuts to your diet was delayed so that you were first exposed via broken skin.

[welliemum]

Christy, I think we'll have to agree to disagree on that one - in my opinion observational studies of allergy are weak because of reverse causation and confounding bias, and I find it hard to draw any reliable conclusions from them. I'm going to keep my bum firmly on the fence until I see a good randomised controlled trial ( I understand there are some in the pipeline).

That said, I wouldn't be surprised if exclusive breastfeeding beyond a certain point has disadvantages - I'm no expert but it seems to be the way of biological systems that nothing is 100% good 100% of the time - you trade off one risk against another.

So rather than seeking a "right vs wrong" answer for weaning age, I'm guessing that it'll be more about finding a sensible balance point between various risks.

[belgo]

that's interesting. I have friends who are paediatricians, I will ask them about it.

Coted'azur, aitch is referring to 'baby led weaning' which is basically allowing the child to pick up the food with their fingers and put it into their mouths so no, it does not involve cutlery as MsHighwater says

Aitch has an indepth blog on the subject
here

[Aitch]

didn't you talk about that 'research' before, christy, and when you linked to it it turned out one was a discussion paper with no data whatsoever and the other was a piece of research that was effectively a self-fulfilling prophecy because it had chosen subjects with allergies in the family or something like that?

[CoteDAzur]

I don't know about 'baby led weaning' but didn't dare give DD solids at 6 months, as she got her first teeth at 9 months. Maybe next time I will be less precious about my baby choking on solids she can't chew, but I doubt it.

[ruddynorah]

they don't need teeth to chew. they chew with gums. did you baby never bite you with her gums? hurt, didn't it?

[OverMyDeadBody]

I thought everyone overlapped milk-feeding and weaning? Isn't this the norm anyway? Milk for first year for nutritional content and food for exploring and descovering?

[CoteDAzur]

DD's paediatrician recommended me to slowly wean at 4 months. I breastfed for another two months, giving her different purees every day.

This sounds like the advice of the doctor in OP.

(Where we live, a paediatrician checks out a baby at birth and then follows her with monthly checks for the first year, quarterly checks for the second year, and then annual checks. Also sees the child every time he is sick, hurt, etc and advises on diet, sleep, motor development, etc.)

[CoteDAzur]

I'm glad your baby chewed well with her gums, mine didn't. She choked on everything. It was purees for us until she got her teeth in and got the hang of chewing well.

[verylittlecarrot]

Don't we chew with molars rather than incisors though? I thought molars only came through quite late. (we are still all gums chez carrot)

Not meaning to stir, though CoteD'Azur! I just thought the first teeth were pretty redundant as far as chewing goes, because incisors are for scissor biting / gnawing, rather than chewing.

[CoteDAzur]

I didn't say "first teeth".