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Weaning

Find weaning advice from other Mumsnetters on our Weaning forum. Use our child development calendar for more information.

Original poster

Please somebody tell me about the research that shows that weaning before 6 months "may damage your baby".

190 replies

SenoraPostrophe · 14/04/2007 21:18

....only all I can find is the Gill Rapely research, which, as far as I can tell, was based on a small study, centered on chewing not digestion and wasn't longitudinal. I could be wrong as the paper itself isn't online. I did find lots of summaries of it and lots of talk about stone age mothers not having blenders (well no, but they did have teeth).

Is there more to it than this? and if not, why is everybody being quite so aggressive about it?

OP posts:
UCM · 15/04/2007 23:17

So, is it a good thing to give them something to chew on or not??? I was hoping someone would tell me?

SlightlyAngrySlug · 15/04/2007 23:18

It (ML) was def 4m in 2001 when I had DTDs.

Soapbox · 15/04/2007 23:19

A teething ring UCM?

Soapbox · 15/04/2007 23:20

You could get extended mat leave to 6 months though, if you had worked for the same co for more than 2 years iirc. I had 6months+ off with both of mine in 1998 and 2000.

UCM · 15/04/2007 23:21

Ta

welliemum · 15/04/2007 23:22

Many people and organisations were recommending exclusive bf to 6 months in 2000. It was quite a hot topic at the time, because just then, the WHO did their expert review (the one that concluded that 6 months was better than 4-6 months).

It takes a long time for information to filter down though.

Soapbox, just to answer your points:

  1. they weren't testing 6 months vs 4-6 months. They just looked month-by-month up to 8 months without a particular cutoff, which is IMO a stronger way of doing it. HOwever this approach is unlikely to yield a time-limit recommendation, as the effect decreases gradually over time.

  2. Exclusive bf means strictly that - no formula or solids.

The physiology papers on the mechanisms of protection in exclusive breastfeeding that I've been reading seem to suggest that mix-feeding (ie ff plus bf) is more similar to exclusive bf than bf plus solids, and the HIV study I linked to on the other weaning research thread demomnstrated this well, ie solids make more difference to the risk than formula.

shonaspurtle sent me a really interesting article about bf and the gut and immunity which I'll try and write about later today - lots of fascinating stuff.

SlightlyAngrySlug · 15/04/2007 23:23

yeah but people (including me) couldn't afford to do that.

exclusive bf @ 4m wasn't bad for statisticaly purposes (17%)

terramum · 15/04/2007 23:24

DS quite managed fine without food until he was 29 weeks, despite getting teeth when he was 4-5 months old....he just chewed anything else he could find - every toy and book he had, the coffee table, DHs guitar (although I wouldnt recommend that last one - DH was SOOOO not impressed by the teeth marks he has left on the fret board )

terramum · 15/04/2007 23:26

Extended maternity leave isnt always paid though is it so those that have to go back to work for financial reasons wouldnt have been able to stay at home any longer?

Soapbox · 15/04/2007 23:30

Welliesmum - if they give the effect of exclusive breastfeeding by month - what is the incremental increase in number of gastrointestinal infections which could ahve been avoided between months 4 and 6?

Even if it is still 53% (and it is likely to be much lower) of all cases which are avoidable through exclusive breastfeeding, then at 53% of 1.2% times the actual incidence of hospitalisation for gastrointestinal diseases - you are at some very very small number of actual cases which are avoidable.

I've not seen anything yet which looks at weaning age in isolation from breastfeeding/mixed feeding, which is really what might start to be persuasive.

welliemum · 15/04/2007 23:31

The effect was still seen at 5-7 months by the way.

(1.2% of 15890 is still a lot of cases)

What is not persuasive about the study soapbox? What evidence would persuade you?

I'm interested because to me, all the evidence is pointing in the direction of later weaning. There's no data on what actual age would be best to wean, but I wouldn't epect that as all babies are different.

I think the most sensible approach is WHO advice to hold off til at least 6 months, pending further research.

VeniVidiVickiQV · 15/04/2007 23:31

Soapbox, it doesnt mention solids, but the very fact that exclusive b/feeding to six months was indicated to be far better than mixed feeding, and better still than not b/feeding ata ll, surely shows that to have nothing other than b/milk is best for first 6 months?

It could be presumed that the further away from b/milk you move, the more likely to succumb to digestive tract illness, yes?

Soapbox · 15/04/2007 23:36

No - I don't agree QQQVQ. The making up (and lack of hygene) around making up formula would be the most plausible reason for gastrointestinal infection in those age groups. So it is the formula rather than solids which might cause the problem. That would certainly seem logical since the Honduran studies referenced from the WHO research has higher incidences of gastrointestinal infection than the UK study whihc is plausible given less access to clean water etc.

This study tells us nothing about allergic reactions (or at least in the summary) and that will be highly personal to ones own susceptibilities. My DC's were violently allergic to milk, but could quite happily have eaten carrots pureed or otherwise at 4 months without incidence

Soapbox · 15/04/2007 23:37

Oops transposition alert! I did mean VVVQV of course

welliemum · 15/04/2007 23:39

crossposted

Soapbox, any study which talks about exclusive bf is by definition talking about not giving solids, including this study. They saw a protective effect of mixed bf but it was weaker.

I agree, it would be nice to see their figures month-by-month. My suspicion is that they're saving this for a separate paper but I am a cynic.

However if you look at table 3 you can see that the effect of bf continues in the older children.

Not sure why you want to argue against it so strongly?

VeniVidiVickiQV · 15/04/2007 23:41

QQQVQ????

Well, yes, there are other foods that atopic children would not react to and could have, however, there has been several studies that have found that if a child is allergic to one type of food, the more types they are exposed to at an early age, and particularly so if foods are mixed together, they are more likely to react to those foods too.

I think, if we are both being honest, we could both be right or both be wrong in our interpretation of why this is the case.

The fact does remain - exclusive b/feeding, and the less 'alien' and the more sterile products that enter a baby's gut, the better. As such, there is no reason why germs and bacteria could not or would not be a problem when pureeing or give foods as much as making up a bottle of formula badly could do, is there?

welliemum · 15/04/2007 23:44

This report is not about allergy, it's about infection, but quite possibly these children are being studied for allergy as well - it'll be interesting to see.

Allergy and infection are linked, however. As you probably know, the immune system is in balance between protecting against infection vs tolerating harmless stuff like food. This is where the work on gut permeability is so interesting: what you feed a baby affects their gut permeability and that affects their immune responses to infection and food. Still being worked out as far as I can see but the connection is there.

VeniVidiVickiQV · 15/04/2007 23:46

indeed welliemum. I think Soapy and i are covering several issues at once, although I do personally believe that allergies are inextricably linked to this.

Soapbox · 15/04/2007 23:47

No I'm not arguing against it - I'm just baffled as to where the research is that supported the change from 4-6m to 6m.

I'm just rather surprised that it is so scant, tbh. The WHO seem to have changed the guidelines based on little in the way of evidence as far as I can see.

I wanted to find some rationale for the change in policy and I can't seem to find it!

My DC's were both weaned at 4-5months at a time when the guidance was all for weaning around 5 months. They are pretty allergy prone children and I wonder whether early weaning was part of the problem. There seems to be so little research, on the allergy impact especially, that all one is left with seems to be anecdotal evidence.

Soapbox · 15/04/2007 23:50

Sorry that should ahve been 'around the time when weaning was around 4 months'.

In fact they actually held 'weaning' sessions at my local GP surgeries run by the HV's at exactly 4 months - when they handed out lots of free samples of 'muck' which I assume some parents run off home to 'try' with the moment they left the room

welliemum · 15/04/2007 23:52

Soapbox - sorry not having a go with these repeated posts to you - I like discussing these things! - anyway, I mentioned an HIV study a bit further down.

This is very recent, from South Africa, and they compared exclusive bf fo 6 months vs mix bf/ff vs solids ie exactly what you're asking about.

The outcome was HIV transmission and the babies best protected were the ones exclusively bf for 6 months. The ones mix fed with bf and formula were quite a close second.

The ones who had solids were a LONG third ie were much more at risk. So in terms of measuring gut resistance to infection, solids were much more harmful than formula - and you couldn't attribute this to hygiene differences.

I've just found another study from scandinavia looking at risk factors for diabetes and according to the abstract they've found a protective effect for exclusive bf there too - ie autoimmune diease effect - but I haven't seen the whole article so it's too soon to comment.

AitchTwoOh · 15/04/2007 23:52

they still do weaning talks at 4 months, soapy, almost as if the HVs aren't promoting the WHO guidelines...

welliemum · 15/04/2007 23:56

aaargh - I keep crossposting!

WHO have published a big document on their website which sets out the evidence that they examined and their decision process.

They didn't look at evidence of harm in weaning 4-6 months because that wasn't their question. THeir quetion was 'Is breastmilk enough for the first 6 months of life" ,a nd the evidence is clear that yes, it is.

Evidence for harm of early weaning is hard to come by because of the diffculty of setting up believable studies which are also ethical. However, there's starting to be evidence now - this study for example - in very big studies, and the mechanisms for why this should be are very plausible and seem to be well accepted by the experts.

Soapbox · 15/04/2007 23:57

Aitch!

I wonder if they still do sunshine orange flavoured baby rice. A more vile taste one could not imagine - ok so someone had to test them out

Welliesmum - I too am enjoying discussing it - and hope that in trying to drive for more evidence and research I haven't appeared as too sceptical?

I will look at the HIV study tomorrow night if I get a chance. I seemed to choose the hottest day of the year so far to start spring cleaning the children's rooms! Two bin bags of charity shop clothes later... and I am knackered

VeniVidiVickiQV · 15/04/2007 23:58

Ours did the weaning talk at 12 weeks.

I asked the HV why and she said that whilst she recommends not before 6 months ie 26 weeks not 6 x 4 weeks, she knows that people will ignore it and wean anyway, so, she'd rather that they would wean early with some good advice, rather than wean early with no advice.