To expect weaning guidelines to be evidence-based?

[xtinak]

Well, perhaps they are evidence based but I'm having a hard time locating the evidence! Please help. My daughter is now 4 months and I am still so confused.

I know the NHS guideline is based on the WHO guidance, which is to wait until 6 months, or rather to exclusively bf for 6 months before introducing complementary foods.I get that it's a guideline. It seems unlikely that there wouldn't be differences between what exactly is best across, for example, countries, breast/bottle/mixed fed babies and of course for individual babies, but still the WHO guidance has to offer an answer that will do the whole world.

Thing is, I still cannot see a strong argument for the difference between 4 and 6 months when it comes to the UK. For example, the fact that ebf longer might possibly delay the return of my period seems beyond irrelevant!When it comes to increased infection risk, the increased risk seems quite marginal, the types of infection non-serious, and the whole thing is complicated by the fact that formula is defined as a complementary food, so sometimes such infection may be associated with introducing formula rather than solids. And we know that formula introduces this small extra risk and most people accept this small risk quite happily!There doesn't seem to be an adverse effect on weight gain of solids at 4 months, despite the logic of milk being more nutritious than solids.

Often on MN I see an argument is presented that the gut may still be 'open' at 4 months. I had assumed this was true as it is so often cited, but it doesn't seem to be!? I've been searching for a relevant study to no avail and the Science of Mom blog discusses it here:

scienceofmom.com/2016/05/03/whats-up-with-the-virgin-gut-do-babies-really-have-an-open-gut-until-6-months-of-age/

The NHS also gives a mysterious list of foods not to introduce before 6 months if you do start solids early. Fair dos on honey - no one wants botulism. But this list also includes for example, dairy. But why? A majority of babies will have already encountered dairy in formula. Or gluten. Why? Where is the evidence that gluten at 4 months is bad but at 6 months is ok? I can't find it.I'm actually going mad trying to get to the bottom of it all. And if you can show me with science that some of what I've asserted above is false I will be all to happy to learn. Please someone rescue my sanity.

To be fair, pre-chewing is the equivalent of mashing food, not pureeing it - it is true that cave woman didn't give Annabel Karmel style slowly graduating textures from completely runny to lumpy, and nor do most societies. But I still don't see why that's particularly relevant to how to wean a baby who isn't going to grow up in a cave.

The basic principle is to offer them normal food albeit with a few tweaks/exceptions so surely all those pinwheels and specially made things go against this???

Ah, you do also get this on the groups, the THEY EAT WHAT YOU EAT purists. I've never made pinwheels but I have made some things I wouldn't normally have made, like bean and vegetable fingers, because sometimes it's convenient to be able to feed him when my food just isn't suitable, and because there are foods I'd like him to eat, like pulses, that are very difficult to give without making them more user-friendly for a baby who doesn't have a fully developed pincer grip. Also, lots of people like cooking for their babies. The pinwheelers aren't doing anyone else any harm (though it would be good if they learnt to Google rather than constantly ask for a 'recipe'!)

@TheInventorofToasterStreudel I read Expecting Better and I thought it was quite interesting and helpful. I believe she has a new book out next month about the first years called Cribsheet which I intend on buying!

I don't quite understand how BLW has turned into the One True Way of weaning
Because of MN. MN must have been the worst thing to happen for weaning. It made people scared to feed their babies. There were 2 posters who ruled the roost for quite a long time and nobody was allowed to post anything about weaning the day before 6months or your child would be doomed to stomach problems for the rest of their life. They could never provide any proper evidence.
It you actually look at the EAT study they started weaning at 12 weeks on some of the babies. I very much doubt that they would have ethical approval if there was any evidence that was harmful.

bruffin - that makes sense. From the time I was first pregnant, I noticed that there's a tendency in a lot of parenting spaces for practices that aren't evidence-based to get elevated to hard rules. Because if you ask for evidence, you get the head tilt and the "But if there's even the tiniest tiniest possible risk that X might be bad and they just haven't discovered it yet, why would you want to take that risk with the most precious thing in your life? I could never forgive myself if I hadn't done everything within my power to keep my precious lil bean/ cuddlebug/ the most precious thing in my life safe and healthy. But I guess that's just me and everybody's different!"

See also: the same few posters who flame any parent thinking of sleep training and when it's pointed out that there's no evidence of harm they demand an impossible standard of 'proof of no harm', ie a logical impossibility

The guidelines about your baby sleeping in the same room as you have, similarly, been turned into 'leaving your baby for 10 minutes while they're asleep is more or less the same as handing them over to a wolf' on MN

That said, all of these things are very different 'in real life'. MN might make it seem that everyone waits until 6 months on the dot but a tiny, tiny proportion of UK parents actually do that. BLW might seem ubiquitous on MN but it's a very minority choice (and gets a lot of resistance in real life, in my very limited and anecdotal experience). A bit like breastfeeding, though, how close to the 'average' your experience of how common these things are is very dependent on the socioeconomic profile of where you live

From the time I was first pregnant, I noticed that there's a tendency in a lot of parenting spaces for practices that aren't evidence-based to get elevated to hard rules.

Yes drives me crazy. "Food before one is just for fun" really drives me mental. It's not true - baby's iron stores begin to deplete from 6 months, they need iron-rich foods introduced into their diets. When presented with evidence from health authorities I was still shouted down by a few zealots.

To be fair, pre-chewing is the equivalent of mashing food, not pureeing it - it is true that cave woman didn't give Annabel Karmel style slowly graduating textures from completely runny to lumpy, and nor do most societies.

It's splitting hairs though. The hardcore BLWs I know don't give mashed food either. They just hand Junior an apple wedge. I've have the privilege to live around the world and I know in parts of Africa and in East Asia they give babies various thin porridges (e.g. pap, congee) which texture wise are quite similar to pureed veg.

Yes, you're right, it is splitting hairs, sorry. What the huge variety in weaning practices around the world show is there clearly isn't one right way, so both the hardcore BLW-ers and the hardcore 'each stage for two weeks exactly' people are talking nonsense when they suggest that 'done wrong' babies will just never learn to chew.

I wish on this, like so many parenting issues, we could all live and let live a bit more. As someone who had BLW thrust upon me by my little spoon refuser I feel a bit out of both camps, because I don't feel committed to the principle and would spoon-feed some foods if I could, and do worry about things like iron intake, but I do also feel very attacked when people suggest it's lazy or that I must not care as much about him as they do their babies if I can bear the thought of him choking (I've had both of those said to me in real life)

Oh and the health visitor was awful about it. Her genuine suggestion was that I just spoon food into his mouth while he cries 'so that he gets used to it'

Thank you so much for this thread OP. It is great to read so many comments about actual evidence.
I have a number of attachment parenting friends who talk about - women in traditional societies don't have blenders. And - food before 1 is just for fun. I have tried to make many of the points raised in this thread, and they are just ignored, so I have stopped saying anything.
I don't care how you wean your baby, unless what you are doing is dangerous. But the false evidence stuff really annoys me.

I also hate the stuff about how if you leave your child to cry for 5 minutes they will get brain damage. This is based on babies who in Romanian orphanages were never handled, cuddled or spoke to, and fed with propped up bottles. Yes this severe level of deprivation leas to the brain not developing properly. But no leaving your baby to cry does not cause brain damage.

Advice always used to be 4 months old and my DM told me when I was a baby they actually advised you add baby rice into bottles for particularly hungry babies as young as one month . We all survived...

I weaned my first DC at 4.5 months with purées. Bought a blender, puréed everything and thought I was doing the right thing at the time. No idea if this is why but he is by far the fussiest eater. Did BLW at six months with the next two and they eat anything. Actually DC3 barely ate solids until she was one, she was mostly EBF.

I just think whatever works for you and your baby really. I’m waiting till six months with DC4 and will be doing BLW again.

I started DS at 17 weeks. He was 2 weeks overdue, so maybe he was more like 19 weeks ? He sat up with his arms propping him up a few days before we started. I only gave fruit and veg purées. I did give some baby rice porridge, but since read that it's not ideal, it was just texture really. He loved food. I didn't drop any breastfeeds.

It's totally up to you. Do what you feel is best, the guidelines are just that guides.

Once he hit 6 months we did baby lead weaning. I continued to breastfeed him alongside eating until 2 years old.

He doesn't have any allergies, but yoghurt seemed to make him sick when weaning but is now fine. Maybe it was because I tried giving those natural ones sweetened with fruit juice and now I give him the sugar laden ones with Paw patrol on them

But the MN weaning obsession was ~ten years ago now and seems to have died down a bit - hence nobody on this thread turning up insisting that it's six months or the death penalty. We have been there, done that. It's not interesting any more.

However judging by Reddit etc BLW has recently hit the US parenting mainstream in a big way so they are having their obsession about it now, hence the explosion on social media etc.

If you're worried about iron, @xtinak, then give a supplement that contains it. The Wellbaby liquid is a multivitamin that also contains iron, for example.

This may be unpopular as posters on here take things very seriously but my eldest child was born when the weaning guidelines were 4 months and MN didn't exist, mothers just got on with it, no stress or angst, the HV gave me a book with information and guidance and talked about it with friends in RL.

By the time my youngest was born it had changed to 6 months and everyone was obsessed with BLW

I really not sure that anything changed in those years except making new mums anxious.

With the usual caveats about medical conditions and bonkersness your baby is likely to be fine whenever you wean, don't sweat the small details. Life's too short to study peer reviewed papers on every aspect of child rearing.

NewAccount270219 - I agree with you about the MN interpretation of the room-sharing recommendations. For most families, there's no workable way that they can completely avoid popping into the next room for five minutes while their baby sleeps, for the whole first six months (or year, depending on who's talking) of the baby's life. How does it work if you have more than one child? If you don't have a partner? If you have a whopper of a baby like mine who couldn't be carted to the bathroom in a moses basket while you brush your teeth and remove your make-up? Yet it seems that some people on here interpret the guidelines as "taking a quick bath while your baby sleeps = playing Russian roulette with its life" , and I've seen some pretty poisonous emotional blackmail along the lines of "I bet all those people who lost babies to SIDS would do anything to turn back the clock and follow the guidelines to the letter" (no, really, I have).

Plus it's by no means consistent. Posters who are cutting corners with the safer co-sleeping guidelines, or introducing a soft toy to the cot earlier than the recommended age, might get picked up on it by a couple of Mumsnetters, but a poster who wants to watch fifteen mins of television while their baby sleeps in the next room will get flamed. So I think fashions/ what's trendy at the moment definitely plays a part.

Oh wow glad I missed that part of MN - here you get told to room share for the first year but also put them outside alone for every nap from two weeks old (my youngest only did it for a while, was too hot this summer and then he got used to napping inside)

Thank you for this thread, OP.

Similar to many, I don't get the BLW devotion. Seems to me, not much "baby-led" about waiting for six months exactly on the clock and then shoving a stick of cucumber or chicken leg (yes, really) in your baby's hand and hey presto! They just learn.

In my own quest for evidence, I remember happening upon this: www.newscientist.com/article/dn28366-should-babies-be-given-solids-earlier-to-prevent-food-allergies/ and another article that I now can't find, which pointed out the link between the change in advice (to 6mo), and maternity leave in the UK. But both made the link with the politicisation of BF.

Personally, I don't buy BLW because it seemed illogical but also those that follow it are so unquestioning and I think you must be allowed (encouraged!) to ask questions about how and why things have come about. I also fail to see what's so wrong about purées, or 4mo. On neither topic did I ever get an answer that was clearly linked to evidence or a study. It always felt too close to dogma for my liking.

I did BLW with both my children, a couple of weeks before they were 6 months. There is nothing wrong with purée, and the NHS guidelines are never to wean before 17 weeks and preferably nearer to 6 months. If you decide your baby is ready to wean at 4 months that is within guidelines. You do what you think best for your own circumstances.

I enjoyed doing BLW and both my children eat well. They did "just learn", in that they learnt to pick up, chew the swallow food in their own time. It's not a crazy thing to do, and it's no more or less illogical than spoonfeeding.

BertieBotts, I agree. About 10 years ago (when BLW was this new thing in the UK), there was this really weird thing going on, with a lot of posters who were just incredibly militant about never weaning five seconds before six months, and the ones who just bored on and ON about BLW (I don't mean just sharing their experiences when asked which is obviously fine, I mean the people who would jump onto a thread titled "Which silicone ice cube tray for freezing purees?" and yell "Have you heard about BLW? It's brilliant! So much better than shoveling mush into babies by force" bla bla).

I think what has happened over the past 10 years is that a) many of the BLW ideas have just become mainstream/normal (it's become normal to give a range of textures include finger foods from much earlier on than it used to be, and there is a lot less fussing about "stages" and introducing foods one at a time), and b) some of the BLW claims have turned out to be kinda bollocks, because we all have had time to watch our kids grow up and it turns out that the ones who did self-feeding only, are no less fussy/allergy-prone than the ones who had some spoon-feeding as well as finger foods.

And as for the six months thing, it seems like the advice has not worked in terms of arresting the rise in allergies, and it may be that slightly early exposure is in fact optimal (though I suspect the differences are small either way, esp for formula fed babies, who are the majority of babies in the UK).

I suppose the Americans are going through Stage 1 of the above developments at the moment. Plus ca change.