My reply to a query from Organix...

[colditz]

()

Hi there *,

Thank you for your mail concerning the recommended age for weaning by
the WHO.

We do adhere to their guidelines and whilst they have said from 6
months
they have also confirmed to us that it could happen any time between 4
to 6 months so we are still allowed to say this on our foods. If you
look at competitor products like Heinz, Hipp and Cow and Gate they are
doing the same.

The reasons they have directed us to do this is because many babies are
ready to wean before 6 months of age and parents are frustrated that
they have to wait until 6 months of age to feed their hungry babies.

The coin is two-sided. We will always follow guidelines and
legislation
and have always done so. We have had it confirmed that we are able to
say in our literature that Health Professionals recommend that weaning
shouldn't take place before 6 months so if you want to start the
process
sooner than this you need to consult a Health Professional.

We are following guidelines and we have had confirmation that we can
say
this on our packaging. When and if that situation changes of course we
will change it according to what we are told and guided to do by the
government and health professionals.

We are always very open and honest within our communications and will
always adhere to rules and regulations concerning babyfoods and
otherwise.

I am sorry that you feel disappointed but I do hope this has helped
answer some of your concerns.

Kind Regards
Marie Van Hagen
Brand/Customer Service Manager

What do you all think? I think Hunker will be interested in this reply, as she is known to get rabid on the subject

NQC, I see absolutely why it is bad to give those things before 6 months and the simplest way to prevent anyone doing it is to tell everyone not to give their babies anything. But I think the problem is that people feel patronised by that - as if we're being treated as not capable of making the distinction between the food that risks causing allergies and the food that is unlikely to do harm.

Kathy, you have misunderstood me..maybe I wasn't very clear.

I am saying the research into risks of early weaning doesn't make a distinction between 'suitable' and 'unsuitable' solid foods but it comes from different parts of the world where different foods are given to babies. The results are consistent - early weaning has health risks. There is no basis for saying 'weaning is fine at 4 mths as long as you give baby rice and not pureed Kentucky Fried Chicken and BBQ sauce'.

On reflection, I wonder why you think it is so much better to give baby rice than anything else? I ask again - what is the big deal about baby rice? It's handy, I suppose, if you really, really want to give a 4 mth old baby something else, 'cos you pour it out the pack and then just add water/formula/ebm, and it's a reasonably 'mixable' thing if you want to add pureed veggies and stuff to it, and the taste of it is so bland babies seem to accept it...but it's still not milk!

Kathy, I don't think the message is "don't wean until 6 months, but after that it's fine to feed your babies junk". Early weaning is linked with an increased risk of developing allergies: as Tiktok said, studies do not differentiate between "suitable" and "unsuitable" weaning foods. And you should also bear in mind that for every person like you who carefully tries to evaluate the evidence before them, there are probably ten who let themselves be guided by what it says on the side of a jar of Cow & Gate Fruity Chicken Casserole.

It is also the case that early weaning is associated with an increased risk of IBD. My husband was bottle-fed and weaned at six (yes, six!) weeks. He developed Crohn's disease at the age of 30. Is there a link? In his case, I guess we'll never know. But if you have ever seen how ill conditions like Crohn's and colitis can make you, I doubt you'd want to take any risks with your own children. BTW, there was no family history, so the diagnosis came out of the blue. What I'm trying to say is, you never know which of our children might turn out to be susceptible to things like IBD and , of course, although a tendency to allergies can be inherited, this is not always the case. Why the eagerness to wean earlier than six months? Why take the chance? Can you find any evidence that weaning before this stage is beneficial?

LucyJu, good points. I don't know why people get so defensive about this. FWIW, my older children were given solids before 6 mths because I didn't know any better - I don't get hung up about the guidance changing!
Apart from anything else, why bother giving something more than milk before you need to? All that faffing with spoons and bowls and mixing and pureeing and wondering if they can have aubergine or should you wait a while and what about peeling courgettes.....blimey, when you wait until the kid's older it is so much easier!!

I weaned my DS1 at 16 weeks, when the advice was 4-6 months. It's partly because of that experience that I was eager to go 6 months with DS2.

I don't feel guilty about weaning DS1 early, but I do feel annoyed and silly for having done it.

LucyJu, you are absolutely right about people following the 'advice' on jars. I have a well-educated, intelligent friend, who is weaning her third child. She has been fretting over how much to give him and told me that she had started to buy the jars (having previously been doing her own purees) because they must contain the right amount.

The advice does not keep chpping and changing.

The advice has changed very, very little.

People's health visitors have obviously been utterly hopeless and confused.

The advice was 4-6 months for a long time (something like 20 years) and this was underlined in 1994 which reiterated the then current guidance,

Then in 2003 the UK came into line with the rest of the world in making the guidance 6 mths.

This is not a huge change, anyway - it just removes that window. 4-6 mths includes 6 mths anyway.

Of course, if you think the advice changes every year or so, then you are going to wonder what else is going to change....but it hasn't, so don't :)

Haven't read every post (sorry) but there is no way on earth we would have survived if I hadn't weaned ds1 before 6 months. Or he may have done but he would have been feeding every 2 hours and I couldn't have done that. He was bf and hungry - he would go the 4hours per Gina and be ready to feed then but would feed for up to an hour (great for getting through lots of books...) but he was ready to at 16 weeks and wolfed down his food. Ds2 was the complete opposite and would have happily waited until 6mo (but started tastes at 5mo).

Tiktok - but the fact that research is based on what happens in different parts of the world rather than diets within a society is precisely why it is inconclusive - there is no proper control as there are too many other factors.
Re the advice changing - I agree it doesn't 'keep' changing, but I have seen old babycare leaflets that say 4 months, so it has changed at least twice (4 months/4-6 months/6 months) albeit at least in a consistent direction. I wonder if another reason people feel confused is that the advice about 'how to tell if your baby is ready for weaning' ends up conflicting with the 'when to wean' advice - so many babies show signs of being ready to wean (though people below are saying these signs may not be genuine, which is a really interesting point I would like to hear more about) before they reach 6 months, which puts you in a difficult situation as a parent.

Lucyju - about your dh's Crohn's disease - I had a partner with this and it is awful. So, yes, I do know how ill it can make you. But the idea that weaning at 4 months is as dangerous as weaning at 6 weeks is a bit odd. With respect though Lucyju, I do find your comment, 'But if you have ever seen how ill conditions like Crohn's and colitis can make you, I doubt you'd want to take any risks with your own children' a touch judgemental - er, maybe comments like this are (to answer Tiktok's question) the reason people get defensive?

I always wonder why jars containing MEAT are also branded OK from 4 months?

Kathy, your understanding of inconclusive is different from mine, then.

The research comes from all over, where different babies are weaned onto different foods. Consistently, the research shows the same thig.

If you want to, you can look at country-specific research but it won't reveal anything different.

There are babycare leaflets and babycare books saying all sorts of rubbish over the years. Anything that said '4 mths' and not '4-6 mths' was not reflecting official guidance.

Kathy, sorry if you thought I sounded a bit judgemental. I'm not 'judging' anyone; I genuinely don't understand why people want to wean much before the 6 month guideline.

The point I was trying to make was that ill-effects (if any) of weaning early might not become evident for decades. So, even if a baby seems fine after being weaned early, there is nevertheless a possibility that some damage may have been done. No doubt MIL assumed that dh was fine after being weaned as early as 6 weeks, given that his illness didn't show up for another 30 years. And maybe he would have developed Crohn's anyway. We'll never know.

"Why are some of you so keen on weaning early and so reluctant to accept the latest research findings?"

I'm not 'reluctant' to accept the 'latest' research findings (there's probably a new one not been published yet...). HOWEVER, I do wonder (idly) whether if it's all down to gut maturity which doesn't happen until 'around 6 months' - surely as with all things 'body' related (hormone that they need to be able to be dry at night, when they get their first teeth, when they loose there first tooth, when puberty starts, when they stop growing etc etc etc) this age isn't 'exactly' 6 months for every baby??

Is it?? If so - how do you define that '6 month' marker - presumably that's 6 months after the date on which they would have been 'full term' (so that they're all exactly the same age). But then what about those babies that were 2 weeks late - surely their gut would be mature at 5 1/2 months, babies who were 2 weeks 'early' would have a mature gut at 6 1/2 months...that is of course presuming the 'dates' were right in the first place.

I honestly fail to see how we can set an 'exact' time when each human body is different - and although they all do certain things within a set time scale - no two are alike.

I'm also curious about those who talk about 'baby led weaning'......but say that the 'signs' of being ready to wean are made up.

WHO themselves say "Feeding young infants requires active care and stimulation, where the caregiver is responsive to the child clues for hunger and also encourages the child to eat. This is also referred to as active or responsive feeding."

So the child must show some signs for WHO's advice there to happen??

Just to prove I'm not making it up, here is a paper which explains some of the problems with 6 month weaning and the limitations to the evidence for weaning before 6 months being harmful: \link {http://adc.bmjjournals.com/cgi/content/full/88/6/488\weaning article}
The link may not work as I'm doing this on a university computer and it might only work here cos we have a subscription to the online journal archive, so the publication details, if anyone's interested, are: Foote and Marriott 'Weaning of infants'
Archives of Disease in Childhood 2003;88:488-492.
The abstract says,
'The WHO 2001 global recommendation is a one size fits all approach to weaning, an approach which may not take sufficient account of the special needs of some infants and fails to allow for the different problems encountered in the industrialised nations compared with economically developing countries. For the healthy normal birth weight full term infant born in an industrialised country, current research supports the benefit of exclusive breast milk feeding until 4–6 months. Evidence of harm through introducing solid food to these infants earlier than this is weak. Infants should be managed individually according to their needs.'
They link to a lot of the original articles which people claim to show certain things, so you can check it out for yourself.

Sorry, must have done something wrong there in posting that link

\link{http://adc.bmjjournals.com/cgi/content/full/88/6/488\weaning article again}

There's another one, mostly not relevant to this issue, but includes some discussion (and again, links to original research papers) of the evidence for children being less likely to a good range of foods if they're weaned late, and also of iron deficiency in late weaned children. However, this is based on a small group of children among the Asian population in Tower Hamlets so may or may not have wider relevance:

\link{http://adc.bmjjournals.com/cgi/content/full/archdischild%3B89/2/154\other nutrition paper}

This one's Archives of Disease in Childhood 2004;89:154-158
© 2004 BMJ Publishing Group & Royal College of Paediatrics and Child Health

Nutrition in the 21st century: what is going wrong
R J Harris

Sorry to be a pain posting all these links, but I do think it's important to emphasise that the research isn't as clearcut as some people are making out. BTW I am not a medic or nutritionist, don't want to claim any expertise.

Kathy, thanks for those links. The Foote paper (first link) is quite well known, and outlines some challenges to '6 mths' mainly on the grounds that there's not enough robust evidence for a world-wide 'one size fits all' approach. They re-look at the evidence which led to the '6 mth' guidance and find exceptions.

Even so, they say ' For the majority of healthy full term infants, a sufficient volume of breast milk from a well nourished mother should supply the nutrient needs of the infant until about 6 months of age' and point to the big Belarus study which showed increases in gastro infection in babies given solids before that age.

The second paper is, as you say, limited in its wider applications. It's not really examining the difference between 4-6 mths and 6 mths, but looking at the implications of extended, mainly milk (bottle) feeding that goes into toddler hood with inadequate 'quality' solids.

Tiktok - yes, they absolutely say exclusive bm is fine for the majority of infants for 6 months. There is pots of evidence for that.
My problems with what has been said by some in this discussion (and the reason why I posted the first paper) are twofold: firstly, the idea that advice should not be individualised, and secondly, the idea that there is conclusive proof for the benefits of late versus early weaning in this culture as they are generally perceived - and by late versus early I mean 6 months rather than 4, not 6 months as opposed to say, 6 weeks! (For instance, many people, incl. some on MN, seem to absolutely take it as read that early weaning is behind the increase in allergies in the UK in the last 20 years. I think they would be surprised at how weak the evidence actually is for that - I know I was.)
The Belarus study looks incredibly strong methodologically. We need more research like that! If they follow up long term it will be even better - as Lucyju was saying earlier some illnesses (like Crohns) don't show up till well into adulthood.
What I would really like to see now, though, is more thought about 'individualisation'. As I noted earlier, I and most other mums I know go by what the majority of childcare books say about signs that your baby is ready to be weaned (doubled birthweight, stealing food from your plate and stuffing it into their mouth and so on!). Some people on this thread have cast doubt on these. I have never seen any research on the matter though - either backing them up or questioning them. (Would be interested if you know of any.) Secondly, the advice usually seems to be to consult your HV on the matter, but this seems to be such a lottery - as I said earlier, I had one HV who was extremely well read and scientifically literate and capable of making very nuanced comments about the evidence, but others seem to have HVs who just promulgate the worst of the old wives' tales.

BTW Tiktok what is your background if you don't mind my asking?

Kathy, I am a breastfeeding counsellor with NCT.

I think a major issue is indeed this individualisation. Common practice until recently in the UK has been to tell every mother that their babies must start weaning at 16 weeks (why 16 weeks? This has never been an official let alone evidence bsed age). So common is '16 weeks', that the UK Infant Feeding Survey noted it, and redefined' four months' to mean this.

We have never really had individualisation for term, healthy babies. Common sense tells us that some babies will need a widening diet at different ages. Very prem babies, whose iron stores run out sooner than term babies, are an example (they don't get the last boost to iron stores 'cos they were in an incubator in the final weeks of pf, and not the uterus); babies for whom milk feeding (of any type) is a struggle (all sorts of reasons why this might be the case); babies whose growth is faltering and whose parents can't/are unwilling to give more milk....all of them might be 'individualised' to 'early' weaning.

What has irritated breastfeeding supporters in particular is the utter bone-headedness of health visitors who have stuck to 16 weeks and who are now still sticking to 4 mths and throwing doubt on the ability of women to feed excl to 6 mths - and when faced with bouncing babies doing just fine, feel compelled to tell them the baby needs something more. This is not individualisation.

Babies whose growth is faltering before 6 mths are likely to do better on more breastmilk - this should be the first option offered to the mother, but instead the usual advice is to give solids. Bone headed, as I said :(

Signs a baby needs more? Often, the 'signs' are 'signs that a baby is four months', not signs of hunger or readiness.

If you need a date to start, then 6 mths has a good evidence base as routine guidance. But it is daft to think of that as cast in stone - and the belief that babies must have other foods by this date (or any other date) is the cause of a lot of grief.

Individualisation will mean that 'about 6 mths' is a good time to start making solid foods available, for healthy, growing, thriving babies, and that babies who are not healthy, growing, thriving, or who have a history of problems, may need to be 'individualised' differently.

BTW, I have never said, nor do I think, that early weaning (pre-6 mths) is behind any putative increase in allergies in the UK.

However, I think there is enough evidence to suggest to mothers with a history of allergy in the family that excl bf to 6 mths is worth doing.

I don't think we have any evidence to suggest this would appply to formula or mixed-fed babies.

Tiktok, clearly we have a lot in common in both demanding evidence!

Interesting what you say about mothers being told they must wean at 4 months. This is ridiculous, and astonishing that some HVs are still saying it - don't HVs have to do Continuing Professional Development? You'd think this would be a key element....
I do think, though, that a lot of mothers (perhaps numerically fewer than those at the other end of the scale, but the ones I know at any rate) now are suffering a lot of unnecessary guilt and anxiety because of the guidance that is now saying you should not give solids before 6 months; as you say, 6 months shouldn't be carved in stone any more than 4 months, but if you look at perceptions on Mumnsnet there are clearly many mums who think it is.

One q though - what do you mean about more breastmilk as an option offered to the mother? If you are breastfeeding on demand surely your baby is already getting all the milk it can anyway, so extra isn't really an option, is it? (unless you have supplies of expressed milk in the freezer, of course).

Health visitors - the honest ones, anyway - will say their training is sadly lacking in this area.

You ask about giving more bf to a baby whose growth is faltering, as opposed to offering solids.

It's almost always possible for a baby to get more breastmilk simply by offering it more often. By the time the baby is four months, say, most mothers in the UK are not feeding all that often - the baby may be sleeping through, the mother might have put the baby on a schedule, even a 'flexible' one, and also may be offering other ways of comforting the baby rather than feeding (dummy, rocking) or even limiting time at the breast.

Even one extra short feed in 24 hours will give the baby several hundred more calories in a week - far more than a daily couple of spoons of pureed fruit or veg, and also quite a lot more than baby rice. Giving a baby solids to gain weight does not make sense at all. In fact, the solids take longer to digest, kidding the baby he is not hungry, and making his net intake of milk even less.

I have seen this happen in practice a lot.