Is my child a bottemless pit or am I doing something wrong?

[turtle23]

Growth spurts..I know they're bad, but...DS is 22 weeks and at the moment is having 3 meals a day (cereal with fruit, 3-4 cubes veg at lunch, 2-3 cubes fruit with rice at tea), a 7 oz bottle of formula at bedtime, and is BF every 1.5-2 hours for about half an hour. That includes from 1030pm on. Dont want to give any more formula, only doing that so I get a little break. Should I be giving him more food? This started a few days ago and I am so very tired...

[msdemeanor]

MrsJ, the WHO recommends breastfeeding until six months to avoid gastro infections (ie diarrhoea). This is because breast milk actively protects against infection.
There is no mention of 'gut maturity'. As far as I can tell, the gut 'seals' very early in the newborn's life. The mucosal can be damaged in infants as in adults by allergens (as in coeliac disease). You shouldn't wean too early (ie before 17 weeks at the earliest really) because the baby may not have developed the right digestive enzymes.
This study says an age-dependent decrease in intestinal permeability in humans has been demonstrated only during the first few days of life (27,28), www.jpgn.org/pt/re/jpgn/fulltext.00005176-200401000-00020.htm;jsessionid=L5HR8hYFGPGTjw15tXtQ20cTyJK JRdXQJx2p8vJnLXRlVcZ4fmQq!231517226!181195629!8091!-1#P59

The immune system and intestinal flora, however, is not fully mature for a couple of years, as far as I can tell.

This study is quite interesting I think. It says:
The role of the physiologic barrier function of the small bowel and its possible role in health and disease has attracted much attention over the past decade. The intestinal mucosal barrier for luminal macromolecules and microorganism is the result of non-immunologic and immunologic defense mechanisms. The non-immunologic mechanisms consist of intraluminal factors such as gastric acid, proteolytic activity, and motility and of mucosal surface factors like mucin and the microvillous membrane. The immunologic mechanisms include secretary IgA and cell-mediated immunity. Both types of mechanism are not completely mature at birth. Maturation of this barrier is not finished before the 2nd year of life.
www.informaworld.com/smpp/content~content=a787327841~db=all

I have not seen anything that suggests anything happens to gut permeability in the 4-6month period.

[3andnomore]

mrsdemenour...your first link was well old...material from 2001 was used....

also, it ws talking aout malnutrition there...hardly a wstern world problem

[3andnomore]

and that last link is 1992, isn't it?

[3andnomore]

link to Kellymom website with lots of other links to show where the info comes from

[3andnomore]

and I do realise that some of the info might also not from most recent research....but it was the research that the "new" guidelines are based on

[msdemeanor]

3andnomore - I don't think the human gut has evolved much since 2001, or 2002 come to that.
As for the Kellymom site, I agree it has lots of useful information on it, but it is not gospel and also has plenty of inaccurate information. For example, it continues to claim, against the evidence, that breastfeeding is protective against allergy. The most recent and reliable studies indicate this is not true at all. This one is from 2007
www.staffnurse.com/nursing-news-articles/no-breastfeeding-protection-against-asthma-or-allergy-2633. html
There is even another 2007 study that indicates that if you have allergies, breastfeeding may even increase your child's lifelong risk of allergies.
www.ei-resource.org/news/allergy-news/breastfeeding-may-increase-allergy-risk-if-mother-has-allergie s/
I see no scientific citation for the assertion about the gut 'sealing' at 6months.
The 'virgin gut' article has no scientific references at all. There seems to be evidence that some foods may slow the development of the gut, but it still occurs well before the six month mark! And of course, this stuff about formula has little relevance to the debate as to whether weaning after 17 weeks but before 6months has the potential to cause harm, and I have found zero evidence that it does, aside from the risk I mentioned of a higher possiblity of diarrhoea due to gastro bugs.
I think breastmilk is great stuff, but I also think it is important not to make claims unsupported by evidence, especially if those inaccurate claims are used as a stick to beat mothers.

[3andnomore]

no one actually claims that it will take exactly 6 month though, the reason that 6 month is set as the benchmark is, because by that time you can be sure that the gut is sealed...iykwim....

Obviously humans did not evolve since then, but findings since than may have changed...I mean...we could just say, otherwise, oh don't thorugh out money into research, we have not evolved since the year so and so anyway....it is about finding out more and obviously new findings may change ooutdated advice....

[3andnomore]

but your first link was still addressing malnutrition issues, so, not really relevant to this!

[msdemeanor]

yes, but the evidence as far as I can see is that the gut 'seals' (if you like) in teh very first neonatal period - not months later. If anyone can find evidence to the contrary I will be interested to read it.

The VERY first link did not just apply to places where there is malnourishment - it said it 'particularly' applied in those cases, not exclusively.
There is no evidence at all that babies grow better if exclusively fed on breastmilk for six months, and that some babies may grow less, which is highly applicable to the issue of weaning, especially when people wheel out the old 'breastmilk has more calories' thing, which implies (at least to me) that a weaned baby of 4months plus is getting fewer calories and so will be hungrier and grow less well. That appears to be completely untrue.
And I say this as someone who breastfed damn near exclusively (a bout of severe mastitis meant I tried - rather unsuccessfully to give a bottle of formula at about two months) to six months, and fed for over two years with my last child. I did it for all sorts of reasons, but frankly, this 'virgin gut' stuff is far more likely to put people off breastfeeding than encourage them. If people think that hospital top up given when they were ill will make breastfeeding pointless, then they are far more likely to give up altogether which would be such a shame. I actually think in an ideal world, every baby would get some breastmilk.

[LackaDAISYcal]

msdemeanour, I don't think anyone here is using poorly founded claims as a stick to beat mothers with

and the recent two articles that you have linked aren't really arguing your point terribly well as far as I can see.

you appear to have missed this rather salient point from the first article: "But they warn against jumping to conclusions. "We cannot be confident that the experimental intervention actually caused the increased risks," they write. "We feel on safer ground in inferring no reduction in risk." " ie they cannot prove that excl BF to six months increases the risk at all.

And the second article states that "What the team found was that although the current thinking is correct up to a point, it is not necessarily true when a mother has allergies herself, or a family history of allergies. In this case breastfeeding may not help protect against allergies later in life and may even increase the risk of their development slightly" which is saying that the risk 8may* be increased where the mother has allergies herself or where there if a familial predisposition. this is not a blanket statement for the whole population and again tells me that there is no conclusive proof.

I stand by my first statement regarding the calorifc value of fruit and veg purees c/f that of breastmilk and nothing you have linked has made me think otherwise.

and to repeat myself and tiktok, this is an interesting debate that deserves it's own thread.

[LackaDAISYcal]

that old "breastmilk has more calories thing"...

Do you think people make this stuff up?

BM has a calorie content of 20 calories per fl oz. There is approximately 45 calories in an average apple. As a breastfed baby takes an average of 5fl ozs per feed, ie 100 calories, they would need to eat the equivalent of more than two apples to get the same calorific value. I doubt this amount of apple can be condensed into three icecubes or be consumed by a 20 week old baby at one sitting. Notwithstanding that, breastmilk is a complete food; an apple is not.

And I am not saying that the baby will be getting less calories, I am saying that they will up the frequency of their feeds to maintain their own calorie intake. They can be quite clever like that.

[turtle23]

So, anyway...do we think that if I cut out solids or cut down that maybe he might get a bit more milk and therefore let me have 10 minutes sleep at night? He was sleeping at least 7-2, 215-630 for the last few weeks and now is up most of the night. Am assuming that it is a growth spurt/likes to practice rolling/teeth may hurt and not the pattern for the rest of eternity.

[LackaDAISYcal]

I think it's worth a go turtle....and like all phases that they go through; this too shall pass

You should give the baby led weaning a try; it's great fun for the baby and they get used to eating as part of the family.....be prepared for lots of mess though.

aitch's BLW blog

[monthlymayhem]

Hi Turtle, as you know from the March thread my LO has been following quite a similar pattern to yours (i.e. no sleep!). Last week we tried a suggestion from a Mnetter - the theory was that if you sleep with or near to your LO at night they can smell your milk and when coming into a light sleep will wake to be fed.

Whether this has any basis I don't know, but my DH and I changed sides of the bed so that he now sleeps next to the cot. The first night LO woke up fairly frequently but went back to sleep when DH put in his dummy (LO normally always wants BF back to sleep), every night since it has gradually got a bit better and last night he had a feed at 11.30pm, woke at 03.30am for a feed and then not till 07.15am . That is bl%$dy marvelous compared to normal!

Whether it is coincidence I don't know, but an easy thing which might be worth trying?

[turtle23]

If I don't feed him he gets very awake and very upset...do you think I should not feed him? DH wont help, so it would just be me trying to settle him. Glad to hear yours is improving!

[LackaDAISYcal]

turtle if he is waking and wanting a feed then he still needs it, so I would continue to offer him the breast as he is still very young.

There is no magic age at which they sleep through unfortunately as all babies are different. Mine have both slept through from 11-7 from around 9 weeks, but they both still woke to feed in the night during a growth spurt (DS was FF and DD was BF)

[monthlymayhem]

Hmm, it's definitely more difficult to try if DH won't settle him. I had tried that before we swapped sides, and always caved in and fed LO... I always worried too much that maybe he was really hungry, but this last week has now made me wonder if it was always just for comfort/to get back to sleep

[msdemeanor]

Lackadaisical, in your post to me, you really do repeatedly claim I said things that are actually quite the opposite of what I DID say. For example, I never once said that the second study cited proved that breastfeeding increased the risk of allergy in the entire population. In fact, I said (and I quote) "if you have allergies, breastfeeding may even increase your child's lifelong risk of allergies" (with that emphasis), which is precisely what the study suggested. And what I said about the first study is that it showed that breastfeeding did NOT reduce the risk of allergies, which, again, is precisely what this very large, long-term, peer-reviewed study showed. And I quoted them to show that Kellymom, while very useful in many ways is not gospel and exaggerates or even gets things wrong in order to promote breastfeeding. I certainly think breastfeeding deserves promotion, but only for things for which there is evidence (eg the absolutely proven and well-understood reduction in gastro infections) and not for other stuff. I've seen women on this site absolutely crucifying themselves for not exclusively breastfeeding because they believe they caused their child's allergies. It's very sad.
Yes, breastmilk has more calories ml for ml than an apple, but this baby is also getting cereal and rice mixed with breastmilk. I don't know about you, but I find a bowl of cereal with milk more filling than milk alone. Babies weaned post-4months do not gain less weight than exclusively breastfed to six months babies (I think we all agree on that), yet my experience and that of most people I know was that when given food, babies tended to have fewer not more breastfeeds, so I think I can assume they made up their calories from solids.
In the case of the OP I woulds say that IME a major developmental spurt (which learning to roll or sit definitely are) always led to much more unsettled nights. I think there are changes in the brain and body happening. Or it might be teething, or even thirst. Or even habit. Or they just fancy it because breastmilk is so yummy. Or they might even have tummyache from guzzling so much food, in which case, yes, cut down! Hard to tell with babies, mysterious little critters that they are

[LackaDAISYcal]

apologies if I misunderstood you msdemeanour, but I think perhaps we are talking at cross purposes. From the links I understood that you were pointing out that BFing may increase the risk of allergy, fair enough, but I was merely pointing out that the article says that this is only releveant for babies who may be predisposed to allergies in the first place, not the population as a whole, therefore there is no reason for those not predisposed to allergies to stop exclusive BFing before the 6mo guidleine.

As to the first article, my reading of it is that BFing does indeed protect against allergies for the first few months of a babies life, and that although it didn't appear to have this effect after the first few months, they could not conclusively state that this. Or perhaps I am reading it wrong.

And although these studies have been done, and are no doubt being looked at by the relevant authorities; the current guideline is exclusive BFing (or FF) to six months before introducing solids and I assume it is still that for a very good reason.

[LackaDAISYcal]

I have checked my posts as well and I don't think I credited you with saying anything that you hadn't; I said that from my understanding the articles quoted didn't back up your argument terribly well, and that there was nothing in them to disagree wiht what I originally said to the OP, and in my reply to your post linking the two articles, I don't think I said that you "stated" anything.

And back to an earlier argument, I personally think that the reduced liklihood of gastro infections is reason enough to follow the guidelines and as for harm, I was weaned onto rusks at about 10 weeks old, and now have coeliac disease and other autoimmune issues such as asthma and eczema. I prefer to draw my own conclusions regarding harm.

[msdemeanor]

I was confused because I felt I was interpreting the studies in a similar way to you. The one which suggests an increase in allergies when mothers with allergies breastfeed is only one study. But really, breastfeeding doesn't appear to prevent allergies at all, sadly. My son has an allergy and I felt terrible that he had formula in hospital before being fully breastfed. I think people need to know that it's not their fault.
As far as I can see, the reasons the WHO gives for the exclusive breastfeeding to six months guidelines is a/it helps prevent gastro infections - esp important in developing countries but relevant to most of us and b/because it helps women not get periods which helps prevent anaemia. The studies showed that in the vast majority of babies, breastfeeding to six months does not stunt growth, so then the gastro/anaemia thing is more important. But no studies anywhere that I can find state that weaning after 17 weeks is in any way harmful to babies. As I said before, I think the best thing about education about six months is that it might prevent weaning before three months, which is potentially harmful to a person's (not just a baby or child's) lifelong health.
I think breastfeeding is fab. I am interested in the possible reduction of breast cancer rates in women who were breastfed, as well as women who breastfeed, for example.

[msdemeanor]

I was confused because I felt I was interpreting the studies in a similar way to you. The one which suggests an increase in allergies when mothers with allergies breastfeed is only one study. But really, breastfeeding doesn't appear to prevent allergies at all, sadly. My son has an allergy and I felt terrible that he had formula in hospital before being fully breastfed. I think people need to know that it's not their fault.
As far as I can see, the reasons the WHO gives for the exclusive breastfeeding to six months guidelines is a/it helps prevent gastro infections - esp important in developing countries but relevant to most of us and b/because it helps women not get periods which helps prevent anaemia. The studies showed that in the vast majority of babies, breastfeeding to six months does not stunt growth, so then the gastro/anaemia thing is more important. But no studies anywhere that I can find state that weaning after 17 weeks is in any way harmful to babies. As I said before, I think the best thing about education about six months is that it might prevent weaning before three months, which is potentially harmful to a person's (not just a baby or child's) lifelong health.
I think breastfeeding is fab. I am interested in the possible reduction of breast cancer rates in women who were breastfed, as well as women who breastfeed, for example.

[LackaDAISYcal]

I agree with you there . People should be made aware of the pros and cons and allowed to make their own decision regarding FF and weaning. They should not be made to feel bad for their parenting choices, provided those choices have been made with all the available information at their fingertips. It's unfortunate that the information either isn't available, or is being filtered out by HCPs into what the individual HCP believes.

Interestingly enough, it is my breast fed DD who has the skin problems in our household, and not my DS who was fully FF from 6 weeks. Neither or them seem to be affected by coeliac disease though, DS who had gluten from 4 months, or DD (she came along after my diagnosis) who didn't have gluten until she was 9months. But, it's too early to tell I suppose.

Interesting articles though; I clearly need to do more of my own research on the subject.

[3andnomore]

msdemenour..some Babies may well be perfectly fine if weaned at 17 weeks....however you can not see if the gut is ready or not unless you would do invasive tests to find out.....This is why they say 6 month....because they know that by then the gut will be ready.

[msdemeanor]

o, that is NOT why 'they' say six months. The WHO recommendations have NOTHING to do with 'gut maturity'. Here is a copy of the policy statement for anyone interested. www.who.int/gb/ebwha/pdf_files/WHA55/ea5515.pdf
They are to do with research that shows that most babies do not suffer growthwise with the extra two months without complementary foods (though some may) and there is a reduced risk of diarrhoea, which is a killer, and provides other health benefits in terms of immunity and risks of obesity and diabetes.. It is also good for women's health in terms of reducing anaemia. Unicef also believed that breastfeeding prevented allergies, which has since been discredited.
This is from the Unicef site.
"UNICEF and WHO recommend infants should be exclusively breastfed for the first six months of life and that breastfeeding should continue to contribute an important part of a baby?s diet through the second year of life and beyond.

The benefits of breastfeeding

Breastmilk has all the nutrients babies need to stay healthy and grow.
Breastfeeding boosts children?s immune systems, protecting them from diarrhoea, acute respiratory infection, ear infections and allergies.
Breastfed babies have faster mental and motor-skills development.
Breastfeeding helps nurture children and builds the mother-child bond.
Breastfeeding helps delay the next pregnancy, giving mother and child time to recover and grow.
Children and adults who were breastfed as babies are less likely to suffer from diabetes, allergies, high blood pressure and other risk factors for heart disease.
The longer a mother breastfeeds, the lower her risk of breast cancer in later life. She is also at lower risk of osteoporosis and ovarian cancer"
Nothing at all about 'gut maturity' - which is basically achieved in the week after birth at term, as far as I can see, though production of enzymes and gut flora changes after this, and the child's immune system takes years to fully develop.