EAT Study - WWYD?

[LifeOfKate]

Hi All,

We have had an invitation in the post to join a weaning/allergy study, details here

Basically it is a study into the effects of early introduction of allergenic foods (from 3 months old). The control group would be told to carry on as per current advice (exclusive BF until 6 months), the experimental group would have allergenic foods (wheat, dairy etc) introduced from 3 months old.

The researchers seem to think that it is actually later weaning that increases the risk of allergies.

I'm not sure whether to entertain the thought of being involved in this study, so thought I would ask all you lovely people on MN, WWYD or what do you think?

I'm also posting this on the weaning topic.

personally I would not give potentially allergenic food to my child and certainly not at such a young age.. there is a history of food allergies/bowel issues/ excema in the family and i would steer well clear of anything less this, not least a 3 month old does not need food. does not sound terribly ethical to me, but there you go

Everyone gets asks as far as I am aware and i wasn't prepared to give my 3 month old what the study wanted. It also seemed like a lot of hassle with a young baby. i don't know anyone who has done it.
I did offer to be part of a study about allergies (but i wasn't allergic enough) so it is not that I am anti-studies (or lazy) per se.

There are ethical issues with this study - introducing solid foods at 3 mths old is likely to increase the risk of infection.

NCT bfcs have raised doubts about it for this reason.

The reason for current guidance to bf excl to 6 mths has little to do with allergy.

I wouldn't be happy giving food to my 3 month old baby, especially dairy and wheat.

I also got an invitation for this a couple of months ago (ds now 5 months nearly 6) i just ignored the letter as i didn't want to put ds at any risk of developing allergies and have just started weaning now

Never mind the risk of allergies and infections- at 3 months I couldn't get 2.5ml of Calpol into DS from a spoon! How I would have managed to feed him a measurable amount of puree I have no idea.

Now, of course, he does a feeble cough and says 'I'm ill. Need medicine', while looking hopefully in the direction of the bottle

I'd normally agree with Tiktok - but the evidence on weaning/infection has changed recently! Here is the quote from the EAT study:

"One reason put forward for not introducing solids before six months is concern about an increased risk of gastrointestinal infections. However, the Millennium cohort has recently reported (Quigley, 2008) that the age of introduction of solids had no effect on risk of hospitalization for diarrhoea or lower respiratory tract infection."

And here is the link to the study mentioned - it's a very good quality one in terms of sample size and methodology, so not to be dismissed. I imagine this is why the EAT study got ethical approval.

The reason why early weaning is linked to infection is because, in Britain, it generally means stopping or reducing breastfeeding, which removes the strong protection against infection provided by breastfeeding. (BTW, this same study affirms the clear link between breastfeeding and reduced infection risk). Which is why I doubt anyone is going to change the 6-month recommendation anytime soon.

I guess this is why the EAT study are so keen to make sure that the mothers in their study don't stop or reduce breastfeeding - as per their FAQ

er ... hope that makes sense ...

It does make sense but surely if a 6 week old baby is full of wheaty dairy whatevers it will bf less therefore bf will decrease anyway...?

I feel sceptical.

Yeah - I know what you mean.

They don't seem to think it will be a problem though ...

"In the EAT study, the decision has been taken to give the cow?s milk protein exposure as yoghurt rather than cow?s milk based formula. The reason for this is that introducing formula milk can affect the pattern and duration of breastfeeding. A recent large Swedish study (Hörnell et al, 2001) showed that the introduction of solids was associated with no or minor changes in breastfeeding frequency and suckling duration. Breastfeeding frequency remained constant the first month after the introduction and then declined slowly, while daily suckling duration started to decline slowly when solids were introduced. Breastfeeding duration was not associated with infants' age at introduction of solids. However, in infants given formula, as soon as regular formula feeds started, the breastfeeding frequency and suckling duration declined swiftly.
Therefore all mothers in the EAT Study will be encouraged to breast feed for at least 6 months and to avoid formula milk during this period."

i found my kids fed a little less when weaned to solids, but as i was expressing to mix with the food - they were getting BM either way.

what i suppose this study is after, is that formula feeding interferes with BF, therefore weaning to formula can lead to bf being stopped sooner..yet solids won't stop duration of BF. There is plenty of evidence of the positive benefit of long-term BF, so a means of making it less onerous (how many times do we read threads about 12-26 week old babies feeding non-stop!) on the mother - may help more women BF for longer and actually be of benefit.

either way, this study encourges mothers to bf until at least 6mo - which is greatly better than the national av of about 6 weeks.

boobmeister - I am unconvinced. In this country (not Sweden) age of introduction of solids is very closely linked with a reduction in and earlier cessation of bf (see UK Infant Feeding Studies, passim). This is what happens in the UK. It is well-ingrained, and solids at 3 mths will mean less bf, both overall and in the individual babies.

It is naive to present a Swedish study as evidence that solids will make no difference to bf - their bf environment is very, very different. In any case, the team studying the Dundee cohort found solids before 15 weeks increased risk of respiratory illness in both bf and ff babies.

Early solids introduces the risks of reducing and curtailing bf - 'encouraging' continued bf by the research team (how? leaflet? phone call? Pious pleas?) may have no effect at all. With less bf, there will be more infection.

regardless of what studies and research say, for me, it would feel absolutely counter intuitive to give a 3 month old anything other than milk and certainly i would not want to give something that could potentially cause trouble maybe years down the line..

if you gave your 3 month old the wheat/dairy and they did end up with issues, how would you feel?

it just seems a bit if a useless study and not ethical, it goes against the NHS and DoH advice too, so why is it allowed?

how the hell did this proposal get past an ethics committee?

Tiktok - is it worth complaining that the study is unethical?

I think I half agree with you Tiktok. Reducing BF is absolutely a risk - and you are right about the very different environments in Sweden and Britain. The 6 month exclusive BF recommendation is an extremely good corrective to the peculiarly British notion that solids = 3 meals a day and no BF.

On the other hand, it's unclear how much solids the study is actually proposing to give? I mean they are talking about yoghurt - they don't say anything about the amount or frequency. I don't think I'd be particularly worried if they were suggesting, say, a spoonful of yoghurt every other day. They need to clarify this. Strongly agree with you that guidance via leaflets and pious pleading isn't enough.

I think it's an interesting and important study. The field of allergy is massively neglected in Britain, despite childhood asthma (which my dd has) reaching epidemic proportions. We really need answers on this stuff ...

Hmm, well you've all raised more questions than answers!! I think that I won't become involved in the study, as the idea of giving any solids before at least 17 weeks sits very uneasily with me, and I am so determined to carry on BF as long as possible and overcome my BF problem (one-boobed BFing!) that I'm not really willing to do something that might jeopardise it. Thanks All!

Sorry not got through the whole thread, this may have been mentioned- but if the intro of solids does decrease suckling, albeit slower than formula, as per boobmeister's quoted bit, then what about impact on fertility?

Lactational amenhhorrea (spelling!) prevents more conceptions than all other methods of contraception put together (Politics of BF). Ok, it's not a major issue in the UK but worldwide...?

not really relevant to the UK - the guidance for third world countries would stand, no doubt.

I have enrolled my son on the study as we have allergies in our family and I am keen to wean him in a controlled and supported environment where he will be fully checked before, during and after to see whether he does have any allergies.

The WHO guidance on breastfeeding refers not only to the developed world but also to the developing world where sterilisation is an issue. Hence delaying weaning.

This is what WHO recommends:

"Initiation of breastfeeding within the first hour of life
Exclusive breastfeeding ? that is the infant only receives breastmilk without any additional food or drink, not even water
Breastfeeding on demand ? that is as often as the child wants, day and night
No use of bottles, teats or pacifiers"

I personally didn't like the idea of putting my little baby through blood tests etc. as part of the study. If it wasn't for that I probably would have taken part, to help children in the future.

Interesting about WHO guidelines, I exclusivly breast feed but I use bottle (with expressed breast milk) once a day (so DH can feed DS, which I think helps with bonding) and pacifier as DS was using my nipple as a dummy (and if that had carried on, I would have got sore and possibly stoppped breastfeeding).
I think we must always do what feels right for us and our babies. I know the recomendations have studies that back up what they say, but can you really apply strict rules when everyone is individual?

only read the oP but this sounds like an incredibly ethically dodgy study - ignore!!

Just read the rest of the thread and I'm shocked this seems to be a 'proper' study. I have a 5 month old and didn't hear anything about it.

I have started to realise why people wean early - my 5mo looks longingly at our food, reaches out to grab it, cries when we're eating but doesn't want a bf...but at 3 months she was still so tiny and sleeping most of the time, showing interest in nothing other than people interacting with her and milk really. She DEFINITELY did not need any food.

I am involved in this study. My son fell into a high risk group for allergies. The GP was unable to offer us any screening so when this invitation landed on my door mat I was eager to find out more. Following extensive diaogue with the reasearchers, my GP, a paediatrician friend and my own research on the researchers I felt that we had to take part and was excited that my son was randomised into the early weaning group. He was initially seen at 15 weeks, and I started feeding him baby rice at just short of 17 weeks. It took him a little getting used to but less time than it took my daughter who was 23 weeks when weaning commenced.
I personally have no doubt regarding the ethics of this research, the researchers or the need for this to be done. Ok, so my son had a blood test, I feel sure this was forgotten about by him sooner than it was by me! The centre in St. Thomas's hospital is europes largest paediatric allergy centre and the uk's leading.
Where do you people think all our current guidelines come from? Do you all critique the research papers that support them? I am not prepared to carry on with a system of weaning that is obviously not protecting our babies from food allergies. Unfortunatley my son is already severly allergic to egg, but if I can prevent him from developing further allergies, blatantly I would sell my soul to the devil if it would keep my babies safe.
There is no monetary renueration for this study, and I am asked to give informed consent every step of the way.
Sorry if this post is jumbled but I am quite angry at some of the flippant comments on here.
Oh, and my son eats 2 small meals a day, well spaced. He enjoys them, and his breast feeding hasn't reduced at all!

Thanks to Shensmum for providing a balanced well-researched view.
Most of you on this thread have not looked at the study proposal and how it is to be conducted and I feel you are promoting panic and criticism of what could be a groundbreaking study.

I received the leaflet yesterday and looked at study on web site this morning. (www.eatstudy.com)
Babies are screened for allergies before and during the study, if there is a risk of allergy in the family the first foods are introduced under medical supervision. The first foods are introduced in tiny amounts between 3 and 5 months of age

Weaning at 6 months is a new concept and perhaps it is flawed? Most 30 something adults were weaned at 3 months and I dont know many adults with gastro intenstinal probs but I do know lots of kids with eczema, asthma and allergies who were weaned at 5- 6 months

I am interested in being part of this study as my first son had severe eczema for first 2 years of his life and I felt the GPs brushed us away with comments like 'he will grow out of it' and 'its very common' because they had little understanding of allergies and conditions in babies. Also I know 2 babies who are currently allergic to eggs and peanuts but GPs have little help and advice to offer.
We now have a healthy baby under 3 months who is being breastfed - if we can contribute to preventing allergies then we should as the risk to our baby is low.

I decided not to because decided I didn't want DS2 to have anything other than BM until at least 5 months. I was given babyrice at 8 weeks (along with SCM) and suffer from IBS. I have no allergies though.

Might not be connected but wouldn't want to take risk. Also thought that if I was assigned to EBF group, I might want to introduce formula/food after 5 months rather than 6 so wouldn't want to be beholden to a study.

FWIW my DN was on LEAP study in peanut avoidance group and now has to carry epipen as has serious peanut allegy.