Query around first solids - why does 4 months seem to be quoted as a key milestone?

[HandMini]

This is not intended to be controversial - I am fully aware that healthcare guidelines are to begin introducing solids at 6 months.

However, I keep seeing/hearing reference to introducing solids at the 4 month mark - on the internet; in baby care reference books (such as What to Expect in the First Year, Heidi Murkoff); on baby food packages, some of which say suitable from 4 months; and from my mother's generation.

Is it the case that solids USED to be introduced at 4 months, and this is now out of date advice that seems to hang around? I'm just interested to know, as it seems to crop up a lot.

Thanks

Basically, yes. It used to be 4-6 months, but more recently the guidance has been amended to around 6 months. It's not law which is why the baby food companies haven't changed their packaging - it's not in their interest to as they would lose 2 months of sales to parents that buy pre-made baby food.

Yes, it is the case that solids used to be introduced at 4 months. Everyone is agreed that solids before 4 months (17 weeks) is actively dangerous to babies' health. In 2003 the guidelines were changed from (I think) 4-6 months to 6 months. Many HCPs and the general public seem to think that solids from 4 months is a good thing, but the WHO advises that children should have nothing but breastmilk until around 6 months. The NHS recommends starting with finger food earlier than 6 months if your baby is able to sit unsupported and can pick up and eat finger foods.

Of course it's in the interests of baby food manufacturers to suggest that food should be started from 4 months rather than 6 months as the earlier your starts solids, the more likely it is that you'll need/want to buy baby food. If you start from 6 months, your LO can just eat the same food as the adults. And what the 'suitable from 4 months' label actually means is 'completely unsuitable for children under 4 months'.

Personally I don't rate the Heidi Murkoff books - the info on breastfeeding isn't great IMO.

If you want to read more detail, Complementary Feeding by Gabrielle Palmer is supposed to be very good.

I read something interesting on this the other day. The guideline set out by the WHO is set for the whole world. The advice for 6m+ is basically set for those is third world countries where their food is generally not as safe to eat, as with the water.

However we are in the lucky position to have access to clean food and water. Which is why the advice is over here 4-6m and why many HCPs agree with this. It is a case of when the child seems ready... When my DP was raising his daughter as a single parent, he weaned her at 4m and the health visitors were raging at this. They even threatened to report him to social services. Weaning at 4m did not harm her in the slightest, she is so healthy! A little picky and doesn't like some stuff with her food but apart from that, healthy.

I would probably start with homemade purees at 4 months and soft foods, but definitely not full solids (like stealing off my plate) until 6m

Thanks all, interesting to hear these views. I will speak to my HVs / GP as well as friends and relatives before I start introducing any solids. DD is only 15 weeks at the moment, so we have some time to plan for her first munchies.

The WHO guidelines for Europe say around 6 months - it's not only for developing countries. The NHS guidelines for Britain say 6 months too, not 4-6 months (see here for the NHS weaning website. Unfortunately many people (including some HCPs) mistakenly think that the WHO guidelines only apply to developing countries which is why some suggest starting before 6 months.

Oops, cross-posted with you, OP.

IMO the BLW book is a really useful read, even if you decide to spoon feed. The NHS recommends introducing finger foods from 6 months even if you spoon feed as well.

I did BLW just because I was too lazy to bother with the whole faff of purees!

Thanks, I'll certainly have a look at the BLW book. I have been reading up on puree approach / BLW approach and I guess it depends on when we start.

Yes, purees are only really necessary if you want to start solids before your child is able to eat finger foods.

Mmmm Innocent not so sure about that. WHO guideline is based on evidence from developed countries too - if you are interested in that sort of thing you can read the big research review it was based on here: www.ncbi.nlm.nih.gov/pubmed/15384567

But you know early weaning has been fashionable in the UK since the 70s - and it takes a long time for everyone (even health professionals) to get used to the new approach. People used to start their babies on solids at 3 months or even earlier!

Give it a few years, eventually most people will accept 6 months. Honestly, given the choice I don't understand why anyone would put themselves through the hassle of weaning 2 months earlier. It's like potty training at 18 months. You can, but why bother?

I know I'll get flamed for this, but I have started to wean my DS last week (19 weeks then). I thought I'd try him on some baby rice, as a bit of an experiement. He loved it and so I went to speak to my HV, slightly panicked. We spoke about his eating habits (pretty much insatiable!), the fact that he's almost sitting unaided and can sit up in a highchair, doubled his brithweight and tongue reflex was settling down.

She told me to crack on, I was expecting an absolute rollocking...but she said that every baby is different. Yes, the guidelines are there. But not every baby follows them. In the same way that they all grow differently, some walk sooner than others etc, some will be ready for food a bit earlier.

You're so right on that, boob. Weaning was fun but it would have been so much more convenient for me if DS had been one of those children who had refused all solids till 10/12 months. I look back fondly to the days when I could go out without taking a huge bag of snacks and meals with me!

Isn't it to do with the lining of their gut not being mature/ready until nearer the 6mth mark?

All children are different and I started DD on solids a week or 2 before she was 6 months. She showed no interest before that time. But she refused purees and would only eat semi mashed and finger foods the picky one! So I suppose I did BLW but unintentionally.

I do think sometimes people confuse growth spurts with the need for solids (I think this was my SIL case IMO, but if you think this is the best for your child then why would anyone have te right to judge?

Guidelines are there to help, not to make you feel bad or make life difficult.

You are so right Surprises!

I believe the academic types working in this area reckon the 'weaning window' is much wider than many of us think: 5 - 7 months would be more like it. The advice is 'at about 6 months' not 'at 6 months exactly'.

And in any case most babies - given the choice - won't be eating 3 meals a day til about 9 months or later. Loads of mums feel pressurised to get on with it at a rapid pace, which again is a shame cos it makes life more stressful than it needs to be.

It's a common myth that the WHO guidance on all sorts of baby-related stuff such as weaning, formula feeding, term breastfeeding and so on is based on developing countries and therefore doesn't apply to "us". Fact is, our UK guidelines are around 6 months and this is based on the best research that we have at the moment.

There are a number of reasons for the guidelines, such as:

• A baby's gut only matures enough to start to be able to digest solids at around 6 months
• Before 6 months (or so) the gut allows allergens to pass across the gut into the body, which may trigger allergies which might not happen if foods are held back until later (note this is under review but this is the current understanding)
• At around 6 months a baby can generally sit up unaided and their oral development is at the point where they can safely manage proper food. Bypassing this with puress has no value
• At between 6 and 12 months a term, healthy BF baby will be STARTING to need additional foods to compliment (NOT REPLACE) breastmilk as the baby's natural stores that he was born with begin to be being depleted. This is not a 6 month "switch" and there's loads of time (months and months) for food to start to top up these needs.

In the same way that some babies are ready at about 5 months, others aren't ready until 7, 8 and even later, and that's fine too.

I am a huge fan of BLW as it's soooo easy compared to purees - personally :)

I remember my nephew (4months at the time) crying his eyes out not wanting to eat more and SIL almost forcing it down his neck saying she wanted him ready for nursery routine and that meals were a huge part of that.
Maybe there is some sort of pressure to reach the next stage? I don't know.

boobmeister X post and you're absolutely right.

Surprises, of course you're right, there is pressure to reach the next, more "independent" stage if you are going to put your child into a nursery / go back to work or whatever. I think the most important info for me is around guts not being mature enough to process properly and/or allergies being triggered. Will be doing further reading.

"solids before 4 months (17 weeks) is actively dangerous to babies' health"

This is overstating the case in a completely unhelpful way.

The guidelines changed, in order to promulgate what current evidence shows to be best (and it is possible there will be changes again if/when further evidence emerges - for the 4 month guideline was also evidence-based). There was no endangered population of babies a decade ago.

I'm really interested in the BLW, having been given a lot of Annabel Karmel books as baby gifts. Is there an equivalent in the BLW genre? I'd love to have more practical advice on BLW as opposed to spoon feeding (I followed the other link, so it's going to be a bumper amazon order along with the Politics of Breastfeeding!)

meditrina - advice has been 4-6 months since at least 1994. It's been recognised for more than a decade that early weaning (before 17 weeks) is harmful for babies and leaves them more prone to infections and intolerances.

Baby-Led Weaning by Gill Rapley www.amazon.co.uk/Baby-led-Weaning-Helping-Your-Baby/dp/0091923808/ref=sr_1_1?ie=UTF8&qid=1316635067&sr=8-1

and to understand the science - and cultural reasons about how we've historically weaned better: www.pinterandmartin.com/product/Complementary_Feeding%3A_Nutrition,_Culture_and_Politics_978-1-905177-42-4

"There was no endangered population of babies a decade ago." Sadly not so. There is a great deal of evidence about how weaning too early can seriously impact a child's health. Like everything, not EVERY child will be harmed (hence the anecdotal "I was given baby rice at 3 months and I'm alright Jack blah blah"). No more can I say for sure that the reason my oldest has bowel problems is due to me weaning him at 4 months, but I still wish, now I know the risks, that I hadn't done so as what he suffers from CAN be triggered by early weaning. :(

I think that all children are so different, my dd has never had much interest in milk and was getting less and less so at 5 months I introduced puree food, she really likes it but now has very little milk as she refuses it no matter how hard i try. I have spoken to HV who said this is fine but need to get dairy into her diet and has milk in food and lots of yogurt. My dd is a child who would eat nothing if it was put infront of her as in BLW, but clearly needed food. All children are different. I do find it difficult that when it was 4 months it was a slow process of introducing foods/textures etc, now the HV is telling me as I started at 5 months at 6 months I need 'to get a move on' and introduce everthing quickly and get onto lumpy foods, I feel so pressured to get it right.

I don't understand this HV obsession with getting all babies onto 3 meals a day by 6 months either - unneccessary pressure, as you say Megastar. Some babies don't get interested in food at all until 9 months, some will be on 4 meals a day as soon as possible and some only want 1 meal a day for months.

the dietitian\nutritionist at our surestart centre is not a fan of BLW.
have to be honest,i also don't 'get' it, i see lots of brocolli being sucked\held and squished and not an awful lot going in
(tried ds with it at bang on 6 weeks, didn't see much evidence of him eating solids in his nappies iyswim) as a sahm i was in no rush to move him on and was available to bf on demand, suspect the access to boobs kept him on his centiles...went to mix of both puree\fork mash and blw and he thrived,is still doing a mix now and is a very healthy 14month old.