Advised by consultant to wean

[Lipsticktraces]

Looking for some advice please.

Ftm to 23 week old twins (17 weeks corrected) Both are ebf.

DS is still under the care of NICU and had an appointment this week. Consultant asked me how he is sleeping. I told her that in the last few weeks he’s started waking every 1/2 hours to feed. She advised that I start weaning. I thought they were too young as my HV told me not before five and a half months corrected age, but consultant said that wasn’t right and I could start now.

She advised me to start with baby rice, but I had planned to do BLW. They can’t sit unaided yet though. I tried them with some baby led spread and some hummus on their lips yesterday to see how they reacted. DD clearly not fussed but DS grinning and opening his mouth for food.

Really not sure how to proceed. I wanted to avoid purées and spoon feeding if possible, but I can’t see how they are ready for anything else at this age?

Would really appreciate people’s thoughts

Do they have a baby reclining chair? I put ds in that to feed purees. Or I hold him on my lap and spoon little bits in, he likes to hold the spoon and feed himself, so often I just reload it for him and he does the rest. I wouldn’t worry about hummus. Look into the EAT study. Sesame was one of the allergens that they introduced to babies as young as 3 months. It’s out of date to delay feeding allergens.

Mum of a 26 weeker. My consultant admitted that the research on weaning premature babies is thin bordering on non existent. They are not being weaned for medical reasons are they?
Right so my consultant said wean at 6 months actual. I said why? And she said: well that’s what we advice. Now everything else they advice is evidence based. So she admitted that as a prem baby already on iron supplements iron wasn’t a key issue. And it was really ‘just what we have always recommended.’ And when I said, do you mind if I wait? She said, absolutely go ahead.
I waited till 19 weeks corrected. Bliss says 17 weeks corrected as a MINIMUM btw. I would say it took them till they were 6 months corrected to get a proper hang of it.
The IKEA high chair with the padding is good for weaning prems btw.
Incidentally I did a mix of purées and BLW. At first he was mushing it around but I saw it as fine motor practice. But he got the hang of it quickly enough. So ‘first course’ was finger food. Second course was puréed veg and ‘dessert’ was finger fruits followed by puréed fruit and then as their fine motor skills improve you can cut down on the purées.

Start with one meal. I started with lunch. I always do food first then milk. So give them a few spoons then milk and nap.
I did breakfast next (I have an older child so we have fixed meal times anyway) and finally dinner. I moved to three meals slower than I did with my older kid. Once they are six months corrected you can add yogurt etc to their diet.
For the first purées try carrot, butternut squash, pears, apples, and then slowly a mix. Add green veggies like peas, broccoli and spinach. Then I used to make a soup where I cooked onions in butter. Added some veggies, non salted stock cube, blended it and stored it. I cooked once a week and stored in an ice cube tray. For fruits you can purée apple, pears, bananas, mango, mixed berries etc.

I think you need to clarify with the consultant what the reason is for her recommendation. Is she concerned about low iron levels? This can indeed be an issue for premature babies, but it means that any cereal you give them needs to be fortified (not all are--you need to check the box). It might, in any case, be more efficient to give them iron drops in the meantime. Talk to her and find out what her rationale is.

Whether you decide to wean now or later, bear in mind that a pure BLW approach might not be the best idea, as babies who are premature sometimes have a slower start with motor skills, meaning that it may not be sensible to expect them to self-feed their entire food intake and waiting for them to do so could mean that they do not move onto solid foods quickly enough. You might be better off doing a mixture of parent-led feeding and self-feeding.

My consultant admitted that the research on weaning premature babies is thin bordering on non existent.

There is consistent research that premature babies run a higher risk of iron deficiency:

www.ncbi.nlm.nih.gov/pmc/articles/PMC2657918/

Unlike full term infants, in whom the condition typically occurs during the second half of infancy, preterm infants are at risk for developing iron deficiency during their first 6 postnatal months.

The best solution for dealing with iron deficiency is getting babies to eat iron rich food (e.g. meat, lentils, beans, certain green vegetables, etc). Some baby cereals (including baby rice) are also fortified with iron so while I did not use them with my DD (who was born full-term and has always eaten everything and anything), they may be a feasible option for some babies.

Wow. This consultant does not sound up to date on the research. Avoid baby rice! Wait until they can hold their heads up at least. Don't wean thinking it will help with sleep. Do your own research before proceeding (proper papers) Don't assume consultants know best unless they are a specific infant feeding specialist. I weaned my son too early and it was not great (he had reflux and it made it much, much worse. His gut was just not ready for it.)

Also had premature twins and consultant gave us the same advice - start weani g at six months actual rather than corrected age and use purées. It worked for us! They were pretty slow at eating more than a spoonful of purée but once they got the hang of it there was no stopping them. We introduced finger food later on and it worked really well.

I would listen to your consultant.

My baby was on a fairly high dose of Sytron so iron deficiency was really not an issue.

Oh and I found the Annabelle Karmel book on purées really useful. Loads of secondhand copies on amazon.

DD was born at 28 weeks and noticeably came on in leaps and bounds when weaned. She really needed that boost, in hindsight.
Follow the consultants advice.
BLW is just a name. If you give what your baby needs, that IS baby-led.

That iron deficiency article does NOT once mention early weaning as a solution. In fact it suggests iron supplementation up to 12-15 months of age. I just read the whole article and there is literally no mention of early weaning for iron deficiency.

I quoted the article to highlight a very real risk of iron deficiency. Of course, there are different ways of dealing with it. One is iron supplementation, introduction to solids is another.

The problem with iron supplementation is that it is more likely to lead to iron overload which is equally bad. I personally always prefer a "natural" solution if it might be effective.

Here are a few other interesting posts on introducing solids. They include references to the current research:

scienceofmom.com/2015/05/14/starting-solids-4-months-6-months-or-somewhere-in-between/
scienceofmom.com/2016/07/18/the-eat-study-more-food-for-thought-on-earlier-introduction-of-solids-to-prevent-food-allergy/
expectingscience.com/2014/11/07/when-is-it-best-to-introduce-solids/

I weaned DD at 17 weeks. It was a conscious / well researched decision and my primary motivation was to reduce risk of allergies. This consideration is less relevant for OP but if her DS is not getting iron supplements, I would go with the consultant's recommendation and start introducing solid food.

The iron overload in that article refers to the early weeks after birth when kids who have ROP and BPD are often given enteral iron. NOT related to weaning. That enteral iron is not the supplemental iron given at discharge.

Why should a baby be early weaned for iron IF the baby is already on iron? Shouldn’t it then cause this iron overload you are so concerned about? With respect having a full term baby is NOTHING like having a premature baby. Most of ours have undergone plenty of blood tests, ABGs and what not to determine quite precisely how much supplementation is needed. None of this is related to early weaning which is seen as developmental (as I confirmed with my consultant).
I mean 17 weeks for my child would have had him at what 5lbs? And really not at a place where weaning was recommended. Even at 17 weeks corrected he was much smaller than the average 17 weeker.

My son was under a consultant due to CMPI. I saw her when he was 4 months and she told him to wean him. I assumed it was due to the CMPI, based on my son himself and as she was a specialist I took her advice.

I saw her a month or two later and she asked how the weaning had gone, and then told me she “never believed in them changing it to 6 months, in her opinion it was better at 4 months”. I was shocked and upset. The advice wasn’t anything to do with my baby, but just her not liking that the advice had changed. And I’d blindly followed her because she was a consultant.

Why should a baby be early weaned for iron IF the baby is already on iron? Shouldn’t it then cause this iron overload you are so concerned about?

I have read all OP's posts and I have not seen her mentioning that her twins are on iron. I appreciate your LO is/was but OP's situation is different. I would not have weaned early in your case. I definitely would have in OP's.

Well. The OP also said the only reason the consultant recommended weaning was for better sleep. And also recommended baby rice. There was literally no mention of iron.

Neither of mine would touch baby rice. Quite useful.to thicken puree with though. I agree with above that blw harder with prem babies. Nothing wrong with a spoon though. You will find occasions where spoon feeding very useful.e.g. on a plane, mil new sofa, where no high chair is to be found (or is filthy) - just examples

Actually, the most recent and comprehensive research shows that babies who start solids early have fewer "serious sleep problems" and show "small but significant improvements in their sleep characteristics":

expectingscience.com/2018/07/11/introducing-solids-and-baby-sleep-yep-early-solids-improve-baby-sleep-after-all/
jamanetwork.com/journals/jamapediatrics/fullarticle/2686726

There are more calories in milk than any food, volume for volume, which is why there is the saying "food is for fun until one" - food should be an additional taster at first, and the baby should be getting their full calorific requirement from their milk. Then they gradually cut down on milk as they take bigger meals.

I would take the advice.
It’s hard to know what’s best, I had 4 babies In 16 yrs and the recommendations were different for all of them.
I started with puréed food not rice, used Annabelle Karamel and did some BLW( before it was called that) at meals where it suited.
My preterm son is the best eater, he got puréed food until he could sit then a mix of everything.
Food is fun and fuel for babies don’t worry too much about it.

I wouid follow the consultant's recommendations.

And scour secind hand bookshops for the editions of Annabelle Karmel's baby/toddle feeding books from before the weaning guidelines changed (about 2003), or ask parents of teenagers if they still have a old copy around somewhere.

There are more calories in milk than any food, volume for volume

I don't think this is true at all.

breastfeedingwithoutbs.blogspot.com/2012/06/bullshitometer-breastmilk-has-more.html