Weaning advice different in other countries?

[babypanther]

I have been trawling mumsnet looking at threads about when to start weaning, as my mum and MIL keep suggesting that I start trying DD on purées/baby porridge from 4 months. She has quite bad reflux, and has to have thickened anti reflux milk. Both my mum and MIL said that they started giving their kids purées from 4 months.

Obviously the NHS guidance is to wean from 6 months unless advised otherwise by a doctor etc., but I’ve seen a few posts on mumsnet where commenters have said that in other countries the advice is to wean from 4 months (I think I remember them being Scandinavian countries?), also my friend is from the US and said that when she lived there, all her mum friends gave their babies baby food from approx 4 months.

I’m not overly bothered about waiting until 6 months to wean as that’s the advice, but I’m just wondering why the advice or at least practice seems to be different in other countries?

No idea why it varies from Country to Country, but my ds had bad reflux and we were advised by the H.V to wean at 17 weeks. It definitely helped.

@MissyB1 oh really? Did you start your DS on porridge or purées if you don’t mind me asking? I’m a bit worried it will upset her tummy as she’s had such a struggle finding a formula that doesn’t make her sick or constipated! X

@babypanther we started him
on pureed veg (carrot, butternut, parsnip, swede, sweet potato etc) then moved onto puréed fruits, then porridge. By six months he was on very mashed meals, 3 a day.

I think it's all down to the risk of developing allergies, if you introduce food too early their guts can have an inflammatory response that leads to allergies, too late and they're much less keen to try new things, won't have been getting the right nutrition etc.

The research is complex and each country has regulators who produce guidance slowly (like they revisit it every 4-5 years maybe) plus there are cultural differences in how people approach healthcare so it's not the same everywhere. eg I think in France your due date is 41 or 42 weeks, not 40!

And different countries also approach weaning differently - try one food at a time for a week, or vary it a lot etc

In UK food puree from 3-4 months used to be the done thing, they changed it to reduce risk of allergies, but prob 5 months ish is fine really - it's all about relative risk on a population level.

In the UK and US there's been a trend for baby led weaning where you give baby real food not purees and babyfood, supposedly helps their oral development, encourages eating more things and social skills etc as it's preferable not to be spoon fed passively. On the other hand it's messy and older generations think it's barmy!

Just be a bit careful as some of the baby foods and pouches look like they're savoury but are actually a lot of carrot, apple, parsnip etc that are really sweet - the baby likes it but gets a taste for sweet stuff and won't eat much else!

Personally I'd say the baby rice and baby porridge, baby rice cakes etc are not particularly healthy (super processed) and have a huge markup, we used to give microwaved porridge left to cool and cut into fingers.

I think the advice varies because there are competing factors to balance (when is best for exposures to to different allergens, how physiologically ready the baby is for different foods, what's the level of risk if people misunderstand the guidance or say 'oh, a little bit early won't hurt') and the science isn't always completely clear on what is best even for a single factor, e.g., introducing gluten. To make it more complicated, the actual 'best' time varies baby to baby.

In contrast to @MissyB1 's baby, DD2 had bad reflux, and I was advised at 4 months (when I asked) that I could try her on a bit of baby rice or vegetable puree if I really wanted to, but they didn't think it would help in her case. And for her, they were correct – we eventually started at about 5.5 months, and she just brought up milk and food. But her reflux was quite stubborn, none of the stuff about keeping her inclined or even upright made a great deal of difference for example.

I was also advised to wean ds at 17 weeks due to reflux, he still remained on meds but I started with just veg puree and then gradually added in other stuff

Advice has fluctuated over time, between 4&6 months seems to be the consensus and if you wean before 6 months you should only feed foods which are low allergy risk (I was told no wheat, eggs, dairy etc before 6 months)

When I went on a post natal course with DD the nurse running it said that lots of people start weaning earlier than advised, so when the NHS used to advise starting at 4 months people were starting at 2/3 months so they moved the NHS guidelines to 6 months.

It's better to wait until 6 months as their little tummies can handle it better by then.

Although, I didn't wait until 6 months first time around. She was taking so much milk and showed signs of being ready. She absolutely was and it was the right decision.

Her sister had bad reflux and I thought they might advise early weaning but they didn't. I was glad as I didn't think she was ready, even at 6 months she wasn't. I tried but it was pointless and I didn't properly start trying until 7 months. Still awful and we had to do blw as she refused purées and being spoon fed.

and older generations think it's barmy!
I am older generation and I don't think baby led weaning is barmy I think it is sensible and to be honest ita not that different from how my children were fed from six months.

Baby led weaning is nothing new, it’s just the wheel being reinvented. Even in the late 60s I was weaned on a mixture of mashed food and finger foods.

OP I would encourage you to use Solid Starts (app, website and Instagram) for amazing, straightforward, practical advice.

Weaning isn't about just getting food into babies tummy, it's about them learning how to eat solid food, chewing, moving it around with their tongue, the protective mechanism of gagging vs choking etc.

6 months is advised because that's around the age babies start showing signs of readiness (can sit up independently, can grasp and bring food to their mouth, and shows an interest in food) ....the signs of readiness are more important than just age

It really is down to when they are ready. Both of mine had very severe reflux, I was told to start ds1 on solids at 4 months as he was undernourished (he sicked up all his milk). We started him on pureed veg and added in things as directed by his gastroenterologist. By the time he was 5 months you could give him a whole banana and he would happily eat it by himself. By the time he was 6 months he was having pasta with meat sauce. He went from off the charts underweight to 90th percentile in 6 months.

I tried ds2 on purees at 4 months. He had no clue what to do with them, he just pushed them out with his tongue. I tried him again at 5 months, 6 months, 7 months and it was the same. It wasn't until he was 8 months old that he managed to eat any at all. And then only sporadically with little enthusiasm. He was never undernourished (kept the milk down better than ds1), but never really started on food until he was closer to 10 months.

They're each ready when they're ready. Guidelines are just that, guides, and you should see what works for your child and go with that.

Hi OP
my baby had bad reflux too. Such a nightmare.
we didn’t wean until he was 100% ready (sitting unaided, good head control, taking things to mouth, interest in food)
for the same reason, didn’t want to upset his poor tummy anymore than it already was with the reflux!
id suggest waiting and do it when you feel it’s right
the older generation don’t understand why we wait but there is updated guidance for a reason.

My eldest here in Germany is nearly 25, and the advice back then was already to wait 6 months or get as close to that as possible. Definitely not 4 months or 4-6 months, but equally a paediatrician wouldn‘t see it as the end of the world if it ended up being 5 months instead of 6. There‘s also a much higher rate of breastfeeding at 6 months here (although nowhere near as much as countries like Finland) so lots of mothers would go straight from breastfeeding to first puree without using bottle milk.

4 months (week before 6 certainly) is actually better from an allergy perspective. If you start 'early' make sure you introduce allergens to minimise the risk of them developing allergies and intolerances.

The UK advice mirrors the WHO advice. You may think this is sensible, but the WHO advice is worldwide, and most of the justifications that tribe simply aren't applicable in the uk. Their reasoning has NOTHING to do with gut readiness - I read their long document on the evidence for 6m, that they produce. The WHO advice (and therefore the UK's) is because:

• staying with breastmilk for longer delays introducing food that could cause food poisoning. This is less of an issue in the UK, and where a child gets a tummy bug, it's rarely life-threatening here.
• longer exclusively breastfeeding delays the return of periods and therefore reduces the risk of back to back pregnancies, which are higher risk.

-** the extra 2m exclusive breastfeeding means more time for feeding to help lose baby weight (in reality, using the ability to pop out to the gym because you aren't the sole source of food would also work).

I started my first child at 4m, on high allergen weaning, and my second at 5m because she didnt seem quite as ready as my first. Its anecdotal I know, but no issues with allergies etc here.

I live in the US now and actually the advice is 6 months here as well! Many pediatricians are not up to date with current research so they keep saying 4 months, however the recent studies show it’s better to wait til 6 months due to maturity of the gut.
https://www.aap.org/en/patient-care/healthy-active-living-for-families/infant-food-and-feeding/

I think the norm is to start somewhere between 5-6 months when the baby is showing genuine signs of readiness. I know some people who weaned earlier on advice of a GP if the reflux was bad - if you feel its being managed well with the thickened formula I wouldnt rush it. There is nothing to be gained from weaning earlier outside of that exception but plenty by waiting.
Plus honestly once the novelty has worn off its SUCH an arseache!

I thought the reason the advised to wait until "around 6 months" was due to the growing evidence that weaning earlier was linked to digestive disorders in later life like IBS?

Also, breast milk or formula is going to be lot more calorie dense than some purée carrot or baby rice (which has no benefit as far as I can tell) and babies need a high calorie diet because they are growing so quickly.

Also, in "traditional" weaning with purées, children would naturally have begun being offered "finger foods" at around 6 months anyway, so it makes perfect sense to do baby led weaning and as far as I remember reading, is supposed to help when they're going through their picky phases.

One thing I wish I had done differently when weaning my DD was that one of the reasons you need to wean from 6 months is this is around the time the iron stores start to deplete, I wish I had made more of an effort with offering iron rich foods as she was eating such a tiny amount and this is what her body really needed.

Obviously it is ultimately up to you what you choose to do with you're own child, but I would say it is worth looking further into the matter to make an informed choice because there is a reason the NHS recommend this age (since 2003). Your older relatives are going to have lots of opinions about lots of things to do with their grandchild, but when we know better we do better and it's no reflection on their choices if you decide to go with the most current advice as they seemed to have done the same.

Basically the evidence points to weaning after 4 months and by around 6 months as being best/safest/healthiest.

Don't give anything but milk before 17 weeks, and don't delay beyond 6 months.

Depending on your situation and priorities, it might be that exclusively breastfeeding til 6 months is optimal.
If you're formula feeding and want to avoid allergies, or your baby has a milk allergy or reflux, 4/5 months might be better.

So much depends on your individual situation and baby's health, getting advice from your own doctor or HV about when to wean in that 4-6 month window is best.
For most people, if you and your baby are happy to wait til 6 months then do that.

https://www.food.gov.uk/research/food-allergy-and-intolerance-research/eat-study-early-introduction-of-allergenic-foods-to-induce-tolerance this study shows early introduction of allergens could help reduce them, particularly peanut allergy

It varies because there's a lot of competing things to balance. Personally I'd say it depends on the baby. If I had my second again I'd start weaning around 4-4.5 months as she was definitely ready and was no longer satisfied by or much interested in breast milk, while my oldest (prem) was only just ready at 6 months.