now this weill set he catamongst the pigeons - WHOS advice is wrong to breastfeed for 6 motnths

[Dogsby]

as is based on developing coutnires

har har har

mine was eating steak and chips

lol at olive
(literally)

OMG - so much to say, so little time.

1. Gillian Harris is a psychologist, and does have a bunch of research and hands on experience with food refusers and so on. She also works for (formula and baby food manufactuerer) Wyeth and is a regular speaker on their child and infant nutrition days.

2. She may have been misquoted in the Times, but giving veg will not impact on a baby's iron status at four to six months. There are no studies which show risk of low iron in babies fed on breastmilk only to six months, apart from one or two papers showing this might be an issue in very poor populations, where the mothers are young and deprived, and very anaemic, and who may not have passed enough iron on to their babies in pg. In the UK, this is not a question that needs to concern us, as far as I can see...we certainly do not need to be panicked into giving solids at four months in case our babies 'run out' at 6 mths and become anaemic. What tosh.

3. Giving veg before six months study (Gillian Harris's work, shows greater acceptability of veg at age 7 years) does not tell us anything about the need for veg at four months, because there was no control group showing the effects of veg at 6 - 7 mths. I suspect what her work showed was the benefits of giving veg early on in weaning (as opposed to bland slop). You'd think as a scientist she would know what she was looking at.

4. WHO studies and others include developed settings as well as developing settings. Worldwide, including US, Canada, Australia and all over Europe, guidance is excl bf to 6 mths. Our babies are no different.

5. No one 'dictates' breastmilk only to 6 mths - the difference in health between babies bf excl to 4 mths and those bf excl to 6 mths is probably fairly small, and the emphasis is not on 'making' women do it, but 'enabling' them to do it and not automatically pushing solids at mothers happily continuing to bf perfectly healthy 4 and 5 month olds....if a baby is happy and healthy and thriving, then solids are a pointless hassle. If the baby is not thriving, and mother is happy to continue to bf excl, then she can be supported to bf more as a way of getting more calories into him

Cochrane review in 2002 suggested the following (search "exclusive breastfeeding" on PubMed):
REVIEWER'S CONCLUSIONS: : We found no objective evidence of a 'weanling's dilemma'. Infants who are exclusively breastfed for six months experience less morbidity from gastrointestinal infection than those who are mixed breastfed as of three or four months, and no deficits have been demonstrated in growth among infants from either developing or developed countries who are exclusively breastfed for six months or longer. Moreover, the mothers of such infants have more prolonged lactational amenorrhea. Although infants should still be managed individually so that insufficient growth or other adverse outcomes are not ignored and appropriate interventions are provided, the available evidence demonstrates no apparent risks in recommending, as a general policy, exclusive breastfeeding for the first six months of life in both developing and developed country settings. Large randomized trials are recommended in both types of setting to rule out small effects on growth and to confirm the reported health benefits of exclusive breastfeeding for six months or beyond.

are they not human in developing countries then? I thought we were the same species.

Can I just ask what MN faux pas I have committed according to the Cod(e)? [confused emoticon]

I've bf my little ones until 6 months exclusively - after this point they kept bf and tried new food but little by little - I was still providing them with more breastmilk than solid food.

My babys thrived on breastmilk and where at the top of the centile charts.

WHat aload of rubbish that the who guidelines apply to just developing countries - what a ill researched article.

There are so many benefits to bf for mum & baby - this wasn't mentioned at all.

Pigleto - my thoughts too.

Weaning according to "race"? I really hope not!

I'd be interested to see how this clinical psychologist answers the open gut theory - that babies' guts are designed to digest milk easily, not solids, and if you give them food too early large particles pass through the open walls of the gut straight into the bloodstream.

Being a psychologist who treats fussy eaters and children on the autistic spectrum still doesn't make you an expert in b/f and weaning, tbh. If she's seeing children and older babies, then maybe she's working back from what she sees in them and deducing stuff about infants.

Interesting what she says about beige food, though, must ask my mother whether she weaned me onto rusks and baby rice. FWIW (not much) ds is not a fussy eater and he was weaned onto fruit and veg.

regardless of the guidelines , research, psychology...can it harm to exclusively breastfeed for 6 months or longer??

Ah, just seen Cochrane review, I'd go with them and not one clinical psychologist, tbh. Esp. one funded by baby food and formula manufacturers!

Very, very interesting new studies showing that delaying cutting the cord after bith gives a significant boost to a baby's iron status which continues right up to six months - so if waiting to cut the cord became standard practise we could stop all this panic about iron stores 'running out'. Seems to me there is very good evidence that they 'run out' because we artificially create low iron to start with with premature cord cutting.
I found it much easier to wait a bit before starting to feed a baby. And in fact, EVERYTHING I have read about blw (which is a bit wanky but pretty much what I ended up doing with my very independent dd) says they should be able to sit up independently, use a pincher grip to pick up food, and be able to chew efficiently and have lost their tongue thrust reflex, all of which happens nearer six than four months in babies.
Also, around the world and in history babies were regularly kept on milk only diets for longer than six months.

Actually I thought this was a confusing article because it started off saying that it was OK to introduce solids at 4 months and then went on to talk about BLW, which wouldn't be suitable for babies much younger than 6 months because they wouldn't have the motor skils / chewing ability etc.

And westerners living and working in developing countries? Which advice should they follow? Not being cheeky - genuinely curous on the distinction between babies.

i fancy steak and chips now

haven't had that since the 1970's, apart from in France

Rube? Like lube?

Aloha how long are you meant to wait before cutting the cord? A matter of minutes or longer? That sounds interesting! Not sure we did wait longer than a couple of minutes...

Blimey Aloha, that was a new one to me.
At first I thought you were being sarcastic!

Quick google confirms your point albeit
mainly with preterms?

I actually cut the cord but can't remember
how long after birth. Or whether it was still
pulsating.

In this context, what would 'birth' mean?
Baby completely out, I presume.

daddyj the point about cord cutting is about whther you have a managed or a natural/physiological "third stage" i.e delivery of placenta.
it is a fairly complicated matter
managed means an injection and controlled cord traction
natural means you don't have an injection and the placenta is delivered by the mother with contractions/effort but it does take longer.
not everyone can have a natural e.g. if they have had their labour induced or augmented.
but the vast mojority of hospitals/midwives do a managed third stage as a matter of course.

this is not a bad explanation from babycentre.com.
hardly anyone these days has a natural third stage in hospital, so they don't get the benefit of hte pulsating cord. there is a middle ground btw.

Whether you have your baby at home or in hospital, you can choose the way the placenta and membranes are delivered. A managed third stage means you have an injection in your thigh just as your baby is being born which causes the uterus to contract strongly and separate from the placenta. This allows the placenta to be delivered quickly. You do not have to push or do anything as the midwife will wait until your uterus is contracted, and then pull gently on the cord to deliver the placenta. The cord will be clamped soon after the baby is born. The advantage of this method is that it is over quickly, usually in five to 10 minutes, and there is little blood loss. The disadvantage is that the oxytocic drugs used may make you feel sick or faint, or give you a headache.

A physiological or natural third stage means that you wait for the placenta to be delivered naturally. This may take up to an hour to happen, though skin-to-skin contact and breastfeeding your baby will help the uterus to start contracting. You need to actively help the delivery of the placenta by pushing, perhaps in the squatting position. Cord clamping is left until after the cord has stopped pulsating, so that the baby gets more oxygenated blood from the placenta. There is usually more blood loss with a physiological third stage, so it is not advisable if you have had any complications of the pregnancy such as anaemia, heavy bleeding or high blood pressure, a twin pregnancy, an induced or very long labour, or an assisted delivery.

Discuss the options with your midwife, and make your wishes clear in your birth plan. If you choose a physiological third stage and it takes longer than you expect, or if you do start to bleed more heavily, your midwife can give you an injection to deliver the placenta at any time

i think it's an interesting article, personally i go along with the thinking that babies know what they're doing so if they're swiping food and eating it they're ready to eat, even if it's before the magic 6 months. pinktulips and wallace's children are examples of this. but the key thing is that they 'make the decision' it seems to me.
don't understand about the veg at 6 months research, though... is that not just another argument against baby rice? surely everyone weans on veggies first, pretty much?

harpsi, if you go for the physio cord thing does that mean that you get more time for bfing? i was rushed onto a ward because they were short on labour suites. might it improve bfing? i had to have an epidural to bring my bp down adn i've always felt dd was sleepy... might that have helped? or hindered? hmmmm...