Weaning 4-6 months; new research?

[InFrance2014]

Hi,
I'm based in France (obviously!), and just took my 4 month old for her vaccinations & general check up. Our paediatrician is very nice, but surprised me by insisting I start weaning her now.

Before everyone says "Outdated French advice!", I called him out on it, and said I wanted to exclusively BF until 6 months, as per NHS advice. He replied that the 6 month guidance is now itself outdated, and that recent research supports gradually introducing veg & fruit as less likely to cause allergies. He didn't tell me any specific studies, but he was quite adamant that waiting until 6 months is now supposed to not be such a good idea.

Having spent ages absorbing the "Nothing before 6 months" message (especially on mumsnet!), I'm now confused
My French isn't good enough to explain I was worried about general gut maturity as well as allergies, or to bring up the WHO guidelines.

Any BF experts out there can give thoughts about this? I'm not sure what to do, and want what's best for the baby. She can't yet sit up fully unaided but isn't far off.

Thanks in advance.

I think there's some emerging evidence (Google EAT study and Israeli peanut study) which suggests early weaning (4-5 months) might have an upside. But the NHS still thinks the weight of evidence is behind 6 months.

the EAT study isnt finished yet though so there are no results yet to support weaning before 6 months which is why the guidance remains 6 months for the moment.

Yup, the study isn't complete. Anything before 17 weeks is not recommended for gut maturity here. With the general advice to wait to roughly six months.

The difficulty is there are two parts to this controversy.

1. Allergies (which is what the EAT study is about, really) and whether 'early' intro of solids might ward off allergy, or reduce its effects, in susceptible and non-susceptible babies. It's a reasonable hypothesis, but there is no good field-based, real-life evidence to support it

1. Overall health and nutrition. There is not much controversy about this - there are no observable risks to 'delaying' solids to 6 mths, and no observable benefits in starting sooner than this. If a baby is happy, thriving, growing well on breastmilk alone, there really is no reason to give anything other than breastmilk.

BUT: There's not much evidence that you are harming your baby if you give solids between four and six mths. The gut maturity thing does not stand up as a general rule for all babies - it really doesn't. As long as you wait until four mths, your baby will probably be fine - but don't let anyone kid themselves that babies need solids at four months for health/nutritional reasons, 'cos (mostly) they don't.

Your French paed is jumping the gun about research. I would also ask him why fruit and veg at four months would be a good thing, given that we don't know yet if it helps prevent allergies (the EAT study doesn't even look at fruit and veg anyway - it looks at rice, cows milk yoghurt, fish, sesame, egg and peanut butter, deliberately allergenic foods.

If the point of early weaning is about allergies then why would he recommend fruit and veg? I haven't noticed a sweet potato allergy epidemic.

Tiktok, I am interested in your comment:
"The gut maturity thing does not stand up as a general rule for all babies - it really doesn't."
Are you basing this statement on the various studies that have been completed? Could you clarify please? Thank you.

Noonie I am on my phone so linking is hard but if you google espghan weaning you will find the top hit takes you to a good paper which discusses the issues.

Link here for others:
www.opleiding-jgz.be/bestanden/2009-2010/espghan%20committee%20on%20nutrition%202008_van%20winckel.pdf

Thanks for that paper tiktok, the abstract is a great run-down of advice. Interesting it's dated 2008 and yet the NHS advice is still to wait until after 26 weeks. They do seem a bit outdated from that perspective.

I was wondering if my paed was talking about this study www.bbc.com/news/health-12180052
He was also I think trying to say that as the baby grew bigger, it had greater energetic needs, but I understood that breastmilk was more calorific than most weaning foods anyway, especially green leafy stuff like spinach, which is what he advised to start on.

Think you might have misunderstood ESPGHAN, INFrance - it is consistent with NHS advice, not sure why you think it is different. There is a slight tonal difference, in that ESPGHAN seem to think that 26 weeks is an outer limit, and there is not quite that emphasis in UK guidelines. I linked to the ESPGHAN piece as it discusses gut maturity.

NHS guidelines are not out of date. If further evidence emerges, and it's good evidence, we could prob expect them to change the public health message.

The link you include in your post is not a study....it is an opinion piece. If you can, read the original paper, which is not saying that bf babies are 'better' weaning earlier at all. It is wondering if the public health guidance is a bit too rigid. That's all :)

Thank you for the clarification Tiktok.