Apparently the latest advice is NOT to delay introducing solids until 6 months??

[phdlife]

Took dd to be weighed today and the nurse said I could start introducing other foods. I rather snippily said that wasn't the best advice I was aware of, did she have any research?

Surprised (and I must say, impressed) when she dragged out a bulging folder and showed me two articles with sections highlighted etc. Alas, with dd trying to suck my thumbnail off and ds falling asleep on the floor I did not have the wit to take down the references - am rather hoping some MNer with PubMed access can check for me?

Here's all that I can remember: One article was 2008, the other 2007. The 2007 one was a position statement; Peter J. Smith was one of several authors on the 2008 one; they were both about "complementary foods" (or feeding?); iirc one of the journals was something like "Paediatric Immunology and Allergies"???

Am sorry to be so vague - I was pretty floored by this info and a few other things she said, but she seemed pretty cluey, would really like more info if anyone can help!

As tiktok pointed out (or alluded to, at least), three percent of babies in the UK are exclusively breastfed at five months, and the number exclusively breastfed to six months will be smaller still. So if allergies in the UK have shot up in recent years then armies of women exclusively breastfeeding to six months seems rather unlikely to be the cause.

There have been at least four different people posting on this within the last week, syaing that their health visitors have been told the guidance is changing, and then all saying the same change. There may have been more but I don't read every thread.

Each time, everyone says 'No it is rubbish there is no change' but really how certain are we about that?

Once, maybe an error, twice, perhaps, but so many people independently saying the same thing all at the same time is beginning to sound a bit less like a coincidence.

Sorry make that five different people, just seen another one on this thread.

I e-spoke to Michael Kramer, the WHO paediatric advisor, this week. His view is that the evidence about allergies is less strong, wrt breastfeeding, than some of the other evidence about the benefits of breastfeeding. But that was all. (He's also hopping mad at the way he was reported in the Times, btw.)

I emailed the Department of Health about 3 months ago to ask when there was a week when several people posted about HVs saying it was going to change. They replied saying that they had no plans to change the policy, and if they did, it would be following the WHO changing theirs - and there is nothing going on there either.

Why not email the Dept Health and get an answer straight from the horse's mouth?

Their address is [email protected] . You could even send links to this and the other recent threads. If the info HVs is giving out is inaccurate, some policy people might be v interested to know...

Ooops... x posted with dibbler .

I posted on another thread recently to say that my post-natal group were told this by a HV 18 months ago.
Not surprisingly, we're still waiting...

God, you can take my BLW-ed-at-6-months dd (2.9 now) to any HV who says that waiting causes speech problems, and try to get them to her to Shut Up. God knows I can't...

jombobsmummy - you said last week one of the HVs you worked with told you. You said you would ask her details - can you do this?

I cannot see why there would be any plans to change the guidance...the process for any change would normally be open and transparent and would start with a commissioned review of the evidence by SACN (the committee which advises on this matter). There has been nothing from SACN and their minutes are on the web.

jimbobsmummy - you said last week one of the HVs you worked with told you. You said you would ask her details - can you do this?

I cannot see why there would be any plans to change the guidance...the process for any change would normally be open and transparent and would start with a commissioned review of the evidence by SACN (the committee which advises on this matter). There has been nothing from SACN and their minutes are on the web.

Yes I will ask her - I went to the surgery for the injections on tues and I was intending to ask her then. But unfortunately there was a mess up with the appointment times and by the time I had seen the nurse both the HVs had gone so I didn't get the opportunity. I'll ask next time.

I DID email the Department of Health and I posted the link to the reply I had on the last thread where this was discussed.

They said there are no plans to change the weaning age from six months and asked me for further details of where people were hearing it, so if anybody would like to email me on hunkermunker at gmail dot com that would be lovely, thank you.

Here is the link again.

Yes I saw that, but that was almost a year ago and there have been a couple of reviews/European group statements published since then, so things may have moved on.

Perhaps it is worth asking again.

I might also ask the RCPCH.

jimbobsmummy - thanks for asking, that will be useful.

You say there have been "couple of reviews/European group statements " since the DH statement confirming 'no plans' at the end of last year.

Can you clarify what reviews and European group statements these are? Since end 2008?
Thanks.

If by 'European group statements' you mean ESPGHAN's position statement, we went through that last week. It is virtually identical to UK guidance and published in Nov last year...there's not going to be any further 'European group statement' to contradict this, surely?

No, I was referring to that ESPGHAN posotion statement. Being published in November, this was after the response from the DoH that hunkermunker mentioned above.

I disagree that it is identical to the current UK guidance. The details are very similar but the tone is different in relation to the exclusive breast feeding for 6 months as we discussed before. ' recommendedfor six months' versus 'a desirable goal'. We may disagree about how significant that it - I actually think it is really quite a significant shift, you don't, but that is just my opiinion and really a question of semantics.

The truth is noone really knows where this has come from.

I think that if and when the advice changes the majority of mumsnet will find it very hard to come to terms with. This whole debate has become so polarised, so very much about being a good parent that walking back from that to a position where as long as weaning takes place at some point upwards of 17 weeks we all mind our own business would be very hard.

Currently I think some people embark on a breastfeeding endurance test - how long can they hang on - and it's achieving the timescale which feels like the end goal not nurturing the baby. Because if you don't 'last' till 26 weeks then you've done the 'wrong' thing.

I actually think that no weaning before 6 months may be harming breastfeeding rates - when you're struggling at 2 weeks the idea of carrying on exclusively for another 24 weeks - to the day of course - is nigh on impossible. That is purely my own view, I have no evidence at all to back that up - just years of talking to other mums.

The whole allergies thing is so difficult - I know someone with a strong history of allergies and she is being very, very careful what she eats in pregnancy. If the baby has allergies though there will be no way to know if it is because of a genetic susceptibility and would have happened anyway or because a lack of exposure has actually provoked the reaction. It's very, very hard to know what the right thing to do is.

jimbobsmummy - so you really think the DH/NHS might be considering a departure from current guidance which is:

• Exclusive breastfeeding is recommended for the first six months (26 weeks) of an infant?s life *Six months is the recommended age for the introduction of solid foods for infants
• Parents should be advised of the risks associated with weaning before the neuro muscular co-ordination has developed sufficiently to allow the infant to eat solids.
• Solid foods should not be offered before four months (COMA 199423). However, if an infant is showing signs of being ready to start solid foods before six months, for example, sitting up, taking an interest in what the rest of the family is eating, picking up, and tasting finger foods then they should be encouraged.

(these are the relevant extracts from Infant Feeding Recommendation - it's on the web as a pdf. This is a public health recommendation)

You think that what ESPGHAN (the European Society of Paediatric and Gastric Health and Nutrition) say in their paper is different enough to provoke a possible change - well, lets see what ESPGHAN say:

"Exclusive or full breast-feeding for about 6 months is a desirable goal. Complementary feeding(ie solid foods and liquids
other than breastmilk or infant formula and follow-on formula) should not be introduced before 17 weeks and not later than
26 weeks."

The difference between a 'recommendation' and a 'desirable goal' is invisible, surely? I said last week I thought there was a difference in tone. I now take that back. I cannot see any difference except in choice of appropriate vocab: you would use the word 'recommendation' in a public health statement to HCPs delivering advice and support to parents; you say 'desirable goal' when you are making a clinical assessment and not actually telling people what to do

What are the other reviews you said you had seen?

NorthernLurker, you may be right. The recommendation was put in place in 2003 (in the UK) with no training of HCPs and no research into how best to support parents. The notion that all babies are 'ready' for solids on exactly the same day is preposterous - but the evidence is that as a public health recommendation, 6 mths is about right. What has never been got across is the 'about'ness of it, and that individual babies may differ on either side of that date, and we should 'watch the baby' not the calendar.

I think it's mad, frankly, that mothers are ticking off the days to 6 mths and awarding themselves Brownie points the nearer they get to the magic day....and then panicking if the baby shows no interest at 6 mths plus a day! Mad, but understandable, because of the way the message has (not) been put across.

now I'm confused again

I think I'm getting my terms all muddled.

so bf rather than bottle feeding til 6 months?

or bf rather than anything else at all til 6 months?

no solids til 4 months (ok can get my head round that part) but solids betweeen 4 and 6 months is ok if the child is interested in eating? or just finger foods if the child is interested in eating?

so hv advice to wean onto solid food between 4 and 6 months would be following guidelines but hv advice to wean off bm onto formula between 4 and 6 months would not be following guidelines?

glad I'm not a hv - my head is spinning

in rush so have not read all posts. But re speech development: our dd was bfd and did not show interest in food until 10 mths. She spoke early and fluently. As someone else said, bfdg encourages muscle development necessary for speech.

Six months as per WHO and DofH. And who knows? At some point research may show that delaying introduction of solids even later may be more beneficial.

morocco -

• breastfeeding to 6 mths with nothing else is 'recommended' (UK) and a 'desirable goal' (European gastric paeds boffins).

• that's the time to start solids whether you are bf or ff

• if you don't want to follow these guidelines, then you need to know not to do it before 4 mths because it's def. not a Good Thing

• babies who are showing clear signs of being ready for solids before 6 mths (and make sure you know what the clear signs are) can have 'em

ahh tiktok, you really should work for the DoH in the 'making things make sense' dept.

so, to summarise it is better to wait to 6 months before offering food but if baby is slobbering at the chops and stuffing food into his gob, he's probably ready?

actually, I think that's what my friend's hv probably said. I thought it was all to do with gut not being ready and physical signs like grabbing at food and shoving it in gob didn't mean gut was necessarily ready. learn something new every day

morocco: " if baby is slobbering at the chops and stuffing food into his gob, he's probably ready?"

Yup