Have I started weaning my breastfed baby too soon?

[MsPea]

Hi there,

Yesterday, on the advice of my HV, I gave my 19 week old dd baby rice and again today. This was because she has dropped from the 9th centile where she was born and stayed until recently onto the 2nd centile. Also she looks interested in our food but has not noticeably begun feeding or waking more often.

Since the first baby rice she has had watery diahorrea so that virtually every nappy change involves changing her clothes. Also she had a bad night (though of course she dose have them; it could have been concincidence).

Shall I stop? Have we started too early? Sad to see her with the squits.

[yellowrose]

MsPea - babies and toddlers often stop putting on weight when they are teething or sick. It's normal.

[joolsandoliver]

Well perhaps I will upset you all in that my baby is 12 weeks old and I am going to start introducing baby rice in about 2 weeks!! However I wanted to make a couple of points.

Firstly the slow down in weight gain is probably related to her recent illness and as she has only dropped one centile is no cause for concern. Most children will drift between a couple of centiles at some point or other. Secondly (and very importantly), the centile charts in the red book are based on bottle fed infants growth, BF infants have a different growth curve. You can find the appropriate centile charts for BF girls/boys on the WHO website.

I am suspicious of all "expert" advice as I'm not quite sure who the "experts" are. Am I? No. As a doctor I feel just as unsure of my parenting abilities (and hate immunisations with a passion for my own child despite recognizing their necessary evil!!).

The guidelines to wean at 6 months come from the WHO and are guidelines for just that - the world. There is little evidence of harm by weaning at 4 months in the developed world, unless there is a strong history of serious food intolerance eg. coeliac disease. Most of us were probably weaned at about 4 months and most likely wolfed our food down. In the developing world (where formula is often still viewed as superior to breast milk) it is crucially important to delay weaning for a variety of reasons. Poor sanitation means that early weaning can lead to death, and the reduced fertility whilst BF is beneficial where family planning is not available/acceptable. Conversely, exclusive feeding after about 6 months is damaging as it does not provide all the nutrition a growing child needs. A friend of mine who is a paediatrician in a london teaching hospital with a large asian community tells me she sees babies brought in fitting because they are so deficient in certain minerals because they have not yet been weaned at the age of 1 yr!!

My reasons for weaning earlier are this, reflux - as a feed thickener I hope baby rice will cool his fire and therefore lessen his pain. Also, as I return to work at 6 months I want my DS to be happily weaned by me in a calm, loving environment before he has to cope with the abandonment he may feel by being cared for by a childminder. If I can get him to happily accept EBM and some puree during the day, hopefully he will not find the transition so hard in a few months time.

Anyway, I've gone on too much but mainly I wanted to say, I wouldn't worry about the centiles too much and do what suits you and your baby. Your baby will continue to need lots of milk even after solids have been introduced and breastmilk remains nutritionally superior for a long time, but that is not to say it doesn't need supplementing. As we all know, advice changes all the time. Hey once upon a time smoking was considered cool and consultants smoked on their ward rounds!! If your baby did like it, give it to her again! Just a small amount slopping around in lots of milk might excite her by the different texture and is a good introduction to proper foods later. If you don't want to, then don't!!

[yellowrose]

jools - as a doctor though (are you a GP or a speciliast ?) what is YOUR advice to MsPea.

Is it ok to give solids BEFORE 6 months or not ?

Sorry, but I lost your conclusion somewhere along the line !

[anonymousdr]

joolsandoliver

Some of what you say isn't correct.

The WHO guidelines about exclusively breastfeeding to 6 months are for both developed and developing world children and this is made explicitly clear in the guidelines.

Sorry if I'm being a bit abrupt - am typing in a big hurry - happy to discuss further tomorrow.

(I'm a paed by the way)

[anonymousdr]

Jumping in here, but I don't think ANY doctor should advise MrsPea online.

Advising on the internet, when you don't have all the info and can't see the child, is very very dangerous.

I feel very strongly about this.

[fishie]

well joolsandoliver, where shall i start?

actually i have to go to bed, but must contradict you on one point, the charts are based on all babies. tiktok has posted on this many times, easy to search in b&bf threads for more.

also interesting you cite doctors smoking and giving solids early in the same point. hmmmm.

[anonymousdr]

MS Pea - beg her pardon

[yellowrose]

AD - I agree with you. I don't think it is appropriate for jools to say she is a doctor and then set forth as though she is giving medical advice on the net.

Which is why I was intrigued to find out what she was trying to do.

[AitchTwoOhOhSeven]

joolsandoliver... if you aren't an expert i'll have my taxes back then, please. what did we all pay to send you to uni for if not to learn, to keep up to date and to have a passion for whatever your chosen specialisation?

[hatwoman]

anonymousdr - joolandoliver said exactly that - that the guidelines are for the world - ie both developed and developing. she then points out some of the arguments concerning the differences between the developed and developing.

[anonymousdr]

hatwoman, yes but as I read it she's implying that the appropriate time to wean is different between developed and developing - which is not what the guidelines say.

I would certainly accept that for an individual child there could be other factors to consider.

[yellowrose]

hatwoman - how is any of what jools said RELEVANT to MsPea ?

She just wants to know whether to give baby rice or not at 19 weeks, FFS !

Sounds like MsPea (very sensibly) has weighed up all the arguments already and decided to stop the baby rice for now.

[hatwoman]

she said there's no evidence of harm for earlier weaning in the developed world. in essence she was disagreeing with the guidelines not, as you implied, mis-representing them

[hatwoman]

erm - the point about no evidence of harm is surely relevant no? plenty of us here weaned our dcs earlier than 6 months cos only 4 years ago that was the advice. If I was ms Pea - having already offered some rice - I would find it reassuring.

[anonymousdr]

I really, really must go (I keep saying this!) but I wish I had a pound for every time I've been sat in outpatients looking at a perfectly healthy baby whose HV has suddenly decided that because they weren't following some random centile there must be something desperately wrong and Something Must Be Done.

They wind up the parents, the GP, everybody... and yet the baby is FINE.

[yellowrose]

"there's no evidence of harm for earlier weaning in the developed world"

Nonsense.

MsPea is bf her baby. One of the well-known "harms" is that weaning onto solids earlier than 6 months MAY lead to baby taking in less breastmilk and mum's supply going down. That is serious harm.

In fact there is plenty of other scientifically based, evidenced based possible "harms" re. early weaning.

Jools is a doctor. She should be doing her research before she makes such statements on a website that may lead to one woman undermining her bf.

[hatwoman]

i totally agree that uncritical use of growth charts and worrying about dropping a centile is ridiculous.

[mears]

Yes stop. Breastfeed more often instead.

[mears]

Yes stop. Breastfeed more often instead.

[hatwoman]

less breastmilk is "harm"? thin ice methinks.....(best go now)

[anonymousdr]

There's definite evidence of harm before 4 months.

There's no definite evidence of harm after 4 months - but also no evidence that it is totally safe. In other words, the jury is still out.

It's a minefield in research terms because you can't perform a randomised controlled trial which is really the only way of settling the matter with current knowledge.

WHO's approach is to look at what happens to babies exclusively bfed to 6 months - are they OK. The answer so far is pretty clearly: yes, up to 6 months of age, babies don't need solids. Wherever they are.

That's the message really, no more, no less.

I would like to see the evidence of harm in late weaning mentioned by jools because I suspect she is quoting a well-known but old and now discredited line of research.

Currently, there is no evidence of a universal cut-off point beyond which it's harmful to delay weaning.... presumably for each child, there has to be a moment when they really do need solids.

Evidence so far is that this is usually sometime quite late in the first year though.

[yellowrose]

MsPea - please read kellymom.com and the La Leche League websites on introducing solids before you read any more of this thread. Kellymom also has growth charts based on WHO stats. for excl. bf babies.

If you are at all concerned about what you have read here, please talk to one of the many helpful advice lines: NCT, LLL, BFN, etc. If you would like their no's please let me know. I can give you the no. for my local LLL.

Take care

[yellowrose]

Also, listen to mears. She knows what she is on about

[yellowrose]

YES, less breastmilk is harm if mum and baby are happy to bf excl. for 6 months and longer.

[hatwoman]

before i go to bed, I just wanted to say that the only reason I posted was because I felt jools was unfairly jumped on. she didn;t misrepresent the Who guidelines and her only message to ms pea was don;t worry about the centiles, and do what feels right. sorry if defending her mucked up your thread MsPea