weaning research

[bigbird2003]

I am currently writing a thesis and am interested in weaning techniques

Please could someone send me a link about the gut problems for babies weaned under 6 months.

I can't find annything relating to it anywhere. I have found 1 article that recommends gluten free before 6 months. HAve also found others that discounts the previous theories on allergy increases.

I'm very interested to where this came from as WHO and UNICEF don't mention it either, they just say it doesn't harm to wean after 6 months , it doesn't say it does harm to wean early.

Also a link about the food is fun before one, as again, I can't find where the research is. All I can find is a baby needs a varied diet from 6 months as breastmilk may not be high enough in iron and some nutrients

IMO the recommendations are to keep babies breastfed for longer (good thing). Does anyone have statistics of last few years, comparing babies weaned at 6 months to those weaned earlier? Whether allergy or gut problems have increased for example

Update; have been directed to kellymom to see some research and again all I can find is a few papers, with very small study groups regarding under 15 weeks or it directs you back to a different kellymom page. I can find no research regarding the gut (I have spent weeks on this and mumsnet has thrown up issues that no where else has)

I really would like to see the research that many on here keep referencing as I'd like my thesis to be totally current

So does that mean i am going to die earlier? My mum weaned me in the days when they didn't have the research they have today so i was on solids before 6 months. In fact there have been generations of babies that were weaned before 6 months, i am not being smart i am now thinking do we have loads of people out there who are damaged health wise because they were weaned before 6 months?

rebelmum, all that article says is once they stopped the breastfeedng, the children didn't have good diets. Doesn't mention early weaning and I doubt very much they did wean early

Just proves breastfeeding proves all the nourishment needed

Sorry but felt that was a misleading

yep, there probably are loads of people who were damaged health-wise by being weaned early. although you'd have to take that in conjunction with all the other environmental factors. however, allergies, IBS, Crohns are all on the up and up...

Early weaning does not mean early death - that's not what the archeologists found. They found that breastfeeding protected babies from the worst effects of a poverty-riddled life. This is repeated in poor areas of the world today; it's when babies/toddlers/children stop breastfeeding thay they become more vulnerable. Not only is breastmilk nourishing, it is not contaminated, and comes complete with disease-fighting antibodies.

Undoubtedly, extended breastfeeding (extended compared to today's norms) is what our bodies 'expect' to happen....it's in line with our physiology, evolved over many, many thousands of generations.

When things happen that are not in line with our physiology, there is often a physiological price to pay at some point.

kks - I dont think if a baby was "late" it would make any difference to the weaning guidelines as full-term pregnancy is anything from 37-42 weeks so there is quite a variety of the time some women "cook" their babies for....of course babies born before 37 weeks might need supplementing earlier as the baby wont have had enough time to build up a store of nutrients like iron (usually best with medical supplements rather than food afaiaa).

I cannot understand for the life of me why people aren't interested in listening to the research? Why would anyone wean early even if they believe there's only a chance of being harmed, what possible gain is there from weaning 1 or 2 months early? I simply cannot get my head round it. I wish someonen could explain why they'd wean their baby early when it could cause allergies and other problems. I also don't believe that a baby is too hungry to stay on milk because there are more calories in milk that in food anyway and they only eat small amounts of food at first. Both my ds's were and are big babies, ds1 was 18lb 14 at 16 weeks and currently ds2 is about 17lbs at 12 weeks and neither need/ed food before 6 months. I really feel like shaking people when I see them weaning early because there's just no need to risk it.

English Heritage article on human osteology study at Wharram Percy here

Hokay - finally I am back, clutching a well-worn copy of the HIV study looking at exclusive breasfeeding...

The study reference and abstract is here for anyone who wants to have a look.

What these people did was, they recruited lots of mums with newborns in South Africa where the prevalence of HIV is shockingly high. They then monitored these babies very closely from the point of view of how they were fed, and whether they acquired HIV. In the end, they discovered a significant protective effect for 6 months of exclusive bf in determining whether babies became HIV positive.

So, OK, this is very very important for those mums, but not so relevant for mumsnetters, who generally live in places with low HIV rates.

However, like all good studies, some other very interesting facts were thrown up along the way.

eg:

1. The babies who were given solids before 6 months did worse than the babies who were mix-fed with formula and bf. The authors suggest that this is because the proteins in solid food do more damage to the gut wall than the proteins in formula. They refer to another paper discussing this, which I'm trying to get hold of at the moment.

It's interesting because you can see that having breastmilk in itself didn't protect the babies from infection - they needed to be exclusively breastfed to get the full benefit.

2. They achieved fabulous rates of breastfeeding. All the mums in the study had previously said that they wanted to breastfeed (ff mums weren't selected for the study). They were then visited by "infant-feeding counsellors" at home 3-4 times in the first 2 weeks, and every 2 weeks thereafter (to 6 months). The mums were encouraged to choose their method of feeding ie were not being bullied into bf.

In this study, 82% of mums exclusively breastfed for at least 6 weeks, 67% for at least 3 months, and 40% for 6 months. This is just amazing when you think of the kind of poverty they live in - for example, the majority don't have a tap at home and have to fetch their water from elsewhere - so they're not exactly sitting on the sofa bf and watching telly.

So I figure, if they can do it - so can we, as long as we have the right support...

And the distinction between exclusive bf and partial is very suggestive of the 'virgin gut' theory.

well done, welliemum. am very interested in the virgin gut thing, although poor dd was mix-fed from about 10 days...

Yes, but you weaned her at about 6 months didn't you?

For these study babies, being mix-fed to 6 months then weaned was the next best thing to exclusively breastfeeding.

oh i did the best i could wrt her gut under the circumstances, but there's not much denying that formula buggers up the flora in a way that bfing exclusively doesn't. shame. maybe next time.

seriously, does welliemum not get any more attention for her hard work? [round of applause]

i think it's because it's the easter weekend, wellie.

Well done and thanks Welliemum for finding and summarising this study. It is great to see some research that seems to provide real evidence to support all the theory. I will try to read the link you provided. Like Aitch I am sad that this does seem to confirm that DS didn't get the best start, but it is heartening to see that it was worth soldiering on with some breastfeeding for 4.5 months.

From my personal perspective, I do find it interesting that nearly a fifth of the women DIDN'T manage to exclusively breastfeed for 6 weeks, even with all that support.

I'm puzzled by this attitude that babies don't take much by way of food in their first year, that solids don't provide a significant amount (calories, nutrition, etc) in the first year. When dd was 9m, and ds1 was 3y, they were eating the same food, and she was eating two to three times as much as him at each meal. Hardly insignificant! Can't deny that she was having fun though!

i wonder if the point is that they needn't rather than don't, PC? my dd sometimes packed away an adult portion and then had a few days of picking at things, but i'm glad i wasn't stressing when she wasn't eating iykwim because i knew that she was drinking plenty of milk? even in the very early days she could somtiems shock the shit out of me with how much she ate.
i suppose as well you often see it as an argument for early weaning as well... 'it's only a cube of sweet potato etc etc'.

Twinkle, I too was interested in the ones who didn't exclusively bf.

The paper doesn't discuss this, but probably the biggest reason was that all the mothers being studied were HIV positive and they didn't have access to good medical care so many of them would have been quite ill.

As for the babies - many would have been ill too, and some died.

I guess good bf support can only do so much.

ah, i hadn't gathered that the mums were all hiv pos, that makes the protection all the more remarkable, actually. the abstract link didn't work for me.

Fascinating, WM - thanks for that!

Really interesting that solid food made more difference than formula too.

Jodie, I don't get why people wean early given the possible risks. Really don't understand it. It's only a few weeks to wait anyway - unless you're bonkers and wean at a month or somesuch abuse.

in haste - sorry link didn't work - here is the abstract.

They recruited all women who wanted to bf but the main analysis only looked at the HIV pos ones, to see whether their babies developed HIV too, and whether this was related to feeding practice.

more tomorrow...

---
Lancet. 2007 Mar 31;369(9567):1107-16.

Mother-to-child transmission of HIV-1 infection during exclusive breastfeeding in the first 6 months of life: an intervention cohort study.

Coovadia HM, Rollins NC, Bland RM, Little K, Coutsoudis A, Bennish ML, Newell ML.

Centre for HIV/AIDS Networking, University of KwaZulu-Natal, South Africa.

BACKGROUND: Exclusive breastfeeding, though better than other forms of infant feeding and associated with improved child survival, is uncommon. We assessed the HIV-1 transmission risks and survival associated with exclusive breastfeeding and other types of infant feeding.

METHODS: 2722 HIV-infected and uninfected pregnant women attending antenatal clinics in KwaZulu Natal, South Africa (seven rural, one semiurban, and one urban), were enrolled into a non-randomised intervention cohort study. Infant feeding data were obtained every week from mothers, and blood samples from infants were taken monthly at clinics to establish HIV infection status. Kaplan-Meier analyses conditional on exclusive breastfeeding were used to estimate transmission risks at 6 weeks and 22 weeks of age, and Cox's proportional hazard was used to quantify associations with maternal and infant factors.

FINDINGS: 1132 of 1372 (83%) infants born to HIV-infected mothers initiated exclusive breastfeeding from birth. Of 1276 infants with complete feeding data, median duration of cumulative exclusive breastfeeding was 159 days (first quartile [Q1] to third quartile [Q3], 122-174 days). 14.1% (95% CI 12.0-16.4) of exclusively breastfed infants were infected with HIV-1 by age 6 weeks and 19.5% (17.0-22.4) by 6 months; risk was significantly associated with maternal CD4-cell counts below 200 cells per muL (adjusted hazard ratio [HR] 3.79; 2.35-6.12) and birthweight less than 2500 g (1.81, 1.07-3.06). Kaplan-Meier estimated risk of acquisition of infection at 6 months of age was 4.04% (2.29-5.76). Breastfed infants who also received solids were significantly more likely to acquire infection than were exclusively breastfed children (HR 10.87, 1.51-78.00, p=0.018), as were infants who at 12 weeks received both breastmilk and formula milk (1.82, 0.98-3.36, p=0.057). Cumulative 3-month mortality in exclusively breastfed infants was 6.1% (4.74-7.92) versus 15.1% (7.63-28.73) in infants given replacement feeds (HR 2.06, 1.00-4.27, p=0.051).

INTERPRETATION: The association between mixed breastfeeding and increased HIV transmission risk, together with evidence that exclusive breastfeeding can be successfully supported in HIV-infected women, warrant revision of the present UNICEF, WHO, and UNAIDS infant feeding guidelines.

I meant to say also that we need to be cautious about taking the results of this study too far - not that anyone is doing that - but it's always worth bearing in mind. You have to read everything with a cautious attitude.

For example

1. this study only looked at infection with 1 specific type of virus (HIV). It can't answer for all types of infection.

2. this study only reports on the first 6 months of the babies' lives - we can't comment on long term effects of early weaning from this study.

3. the study was conducted in a very poor part of the world where babies are very vulnerable. Possibly, if you did a similar study in an industrialised nation you might find less of a difference, because the babies' general health and their medical care would be better, ie more safety nets.

4. This study only looks at infection transmission and can't shed any light on nutritional aspects of weaning.

That said... a study showing that you can tell the difference between babies weaned before and after 6 months is a big deal. If there is one difference (the one shown in this study) you can bet there will be others.