Okay all you fabulous mumsnetters - listen to this advice on weaning.

[incognitoHV]

Name changing again....

Thougt you might be interested in the latest guidelines I have been sent by my employers regarding the nutrition of children aged 0-5. Here's what it has to say on the subject of weaning....

"The Department of Health have clarified that six months (26 weeks) is the recommended age for introduction of solid food for all infants, both formula fed and breastfed.
Occasionally some parents may wish to wean earlier than six months. Should they wish to do this, four months (17 weeks) should be regarded as the earliest age at which solids should be introduced. The DOH weaning guide states 20 weeks is the earliest age to wean but no references as to how this age was arrived at could be found."

So - now - er - let me see if I've got this right. I advise 26 weeks but I could also justify 17 weeks if a Mum really wants to wean - or should that be 20 weeks? Clear as mud I'd say. So next time your HV gives you crap advice regarding weaning - this is probably why - nobody seems to have a bloody clue.
As a Mum who used BLW for my DS (incidently the guidelines do not mention BLW - perhaps they've never heard of it) I'll carry on talking to parents about that and keep pushing the six month advice - but what's the point really if the DOH is still saying 20 weeks and my Trust 17 weeks (all easily discovered via the internet).
Oh crap - I don't know what I'm talking about anymore.

I know what a rant this is turning into but honestly I really do despair at times.

two things which are confusing. First is the ever changing guidlines and second is the conflicting information between health professionals. wish they would just give us the "facts" in so far as they know them and then encourage us make up our own minds knowing what we do about our los.

My understanding is that the research on the adverse effects of early weanings is based on those weaning around 12-16 weeks and that the adverse effects of v. late weaning is based around those fed soley on milk well into the second 6 months. Feel not much is actually known about the optimal dates between those extremes.

so are we to think that maybe depending on the lo etc, that anytime between 4 and 6 months is ok, earlier is bad, later isn't so bad, but much later could cause problems? As a general guide?

Kisidee - Thanks for the leaflet. I can see where the confusion incognitiohv talks about comes from. You should wait until 26 weeks unless your family doesn't have a history of allergies and then 17 weeks is OK. If I had a baby who was hungary and had started to wake up at night again I think I might be tempted by point 5 on 'When to Start' to begin solids at 17wks/4mths too. (Never an issue for me though - by boys didn't sleep through the night until 10mths for and 8mths).

Also I am now not sure where I got the idea of when to wean DS2 in 2003 as I understood at that time the guideline was 6mths. Maybe I picked it up from reading around. It might explain why my HV was a bit vague when I asked her about the change at the time. Mind you she was lovely but a bit vague on most things.

callmeovercautious - I remember a similar explanation when DS1 was starting solids following the 4mth guidelines. I understand that research moves on and the professionals understand more but to the lay person the explanation sounds the same.

witchandchips - good point - that is another thing that bothers me. When the guideline was 4mths it was said to be important that you had moved on to a wider range of foods and textures by 6mths as otherwise the baby would have problems developing his palette from a taste and an anatomical point of view. If you don't start until 6mths with any solids where does that leave this guideline?

It seems to me that the guidelines will be a bone of contention until

• the leaflets are less ambiguous - they are the first line of info for most mothers at home with nobody to ask.
• mothers who were given 4mths as a guidelines first time around have stopped having babies as there seems to be be no reason to chose the new guideline if they had no problems first time around (although as a worrier I followed the guidelines even though they had changed but many won't). -Health visitors who have spent all their working lives giving out one set of advice without it seemingly causing any harm have accepted the changed or moved on and retired.

I too looked up my old baby book from 1966 (I really need to declutter) and it starts off by saying that mother's may be surprised to learn that until comparatively recently (to 1966 obviously) babies where not weaned until 8 - 9 months and for mothers not to be swayed by what their grandmothers say when they begin weaning at 4mths!

Sorry this got a bit long but everybody is making very interesting points.

i think the problem is that no one is prepared to say "we don't really know". Health visitors want to be clear and firm (and to be fair worried parents expect them to be so) and given that there is no clear answer we are going to get conflicting advice.

"that is another thing that bothers me. When the guideline was 4mths it was said to be important that you had moved on to a wider range of foods and textures by 6mths as otherwise the baby would have problems developing his palette from a taste and an anatomical point of view. If you don't start until 6mths with any solids where does that leave this guideline? "

developing a taste for different things and the anatomical point are misnomers in my understanding.

babies put all sorts in their mouths and chew on which introduces them to textures - most if not all are inedible at 4 months (lol). Breastfeeding and formula feeding provides all the jaw and head develoment they need early days anyway. How much chewing of mush does a 4 or 5 month old really does? They get plenty from chewing on toys and old shoes.

And have you heard of any adults anywhere who has never moved on to solids because they weren't weaned 'in time' whatever that may mean?

I think what the leaflet says is that all health visitors should advise parents to wait to 26 wks (or thereabouts, as some parents are more anxious than others to get on with weaning - it always seems like boring and work to me)

However, the DoH recognises taht some parents are keen to start earlier so they should urge parents not to start before 17 wks. So to me, it is saying that 17 wks is OK but don't push that. But only say that to parents who are champing at the bit to put a spoon into a baby's mouth.

I was heartened to see that my local surestart is pushing 26 wks to all parents whether or not they've had kids before.

kisidee - all I was saying was that there is a less relax approach if weaning started at 26 weeks if you then have to immediately move on to lumpy food.

It does make a difference if a child is not fed the proper consistency. This an extreme case but my BIL/SIL have adopted 2 children taken away from their birth mother for being an alcoholic. She badly neglected the little boy, and he wasn't wean, just existed on milk (supplemented with cola) for the first year of his life until taken into care It has taken 3 years to sort out the child's eating and speech. He has all sorts of problems as the appropriate muscles weren't being used quite apart from what his diet did to him. He found chewing really hard work and often gagged on food and only now is he beginning to speak in sentences aftre speech therapy. No he won't be an adult who can't eat solids but that doesn't mean that it can't cause problems. It is not uncommon to hear stories of babies who have been fed puree for too long who then don't take to lumpier food. I have a friend who was affected by this.

To be fair the leaflet says you can give babies solids from 17wks and not before. Given the history of the guidelines on weaning I personally think that this should not even have been mentioned. If a HV wants to discuss that possibility with a parent when the need arises in a paricular set of circumstances then great, go ahead. Every baby is different. But I think, like others seem to, that this leaflet is just confusing to the average mother.

I don't want to sound like I am sticking up for the 4mth guideline over the 6 mth one. I followed the recommendations with both my children, even though they were different for each. What I don't understand is why there was the change? Callmeovercautious points out that the research into the digestion of small babies warrants the change but the average mother won't understand or even be that interested. She will want a guideline that is clear cut and simple to follow. I don't think that the DofH has achieved that with the leaflet just because of the inclusion of that paragraph that mentions 17 weeks.

When I had my new dd (March) was told by midwife that the guidelines were going to change back to 4m!

Hmm, I am breast feeding a 5 month old (3rd child), and he has had supplementary baby slime for a couple of weeks. He particularly likes banana and apple. Since the solids, he has been sleeping through the night and I am no longer depressed. Perhaps the increase in PND is a result of mothers slogging themselves into the ground trying to do too much AND breast feed a huge baby (mine is large!) just because some dodgy research shows that babies in some countries do fine without solids until 6 months.
Having tried to look at the original studies (it all seems very poorly referenced) it appears that a lot of the "exclusively breast fed" babies got tea or similar from a few weeks old. So Bs to the lot of it.
DS1 and DD1 (it this the right terminology or should it be DD2??) were weaned earlier. They all slept through once on solids, for which there is no research evidence - "there is no evidence that introducing solids has any impact on babies sleeping through" (so says La Leche league). Well, it worked for me.
Actually, no 3 is much harder to get to eat things - I think I have started too late and he already has opinions about what he wants.
I reckon mums should do what is right for their child, and it would be really nice if Health Visitors would give advice based on need rather than censoring knackered mums for not toeing whichever party line it is this week. It will only go and change again in any case.
Sorry for the rant, but it all makes me so angry.

Oh, and I don't sterilise any food things but still sterilise breast pump and bottles if he gets one as they are so difficult to get clean.
What is the point in sterilising when he sticks grubby toys in his mouth, along with his siblings fingers, noses, tongues...... and anyway, too much cleanliness is supposed to cause asthma isn't it??

I have a 5 month old and would like to start giving her some baby rice. I am a a bit confused by definitions when you say you weaned at 5 months do you mean stopped bfeeding altogether, or just started solids. My books say babies stgill have to get breast milk for up to a year.

Yes, all the weaning advice/definitions are a bit loose aren't they?
As a breast-feeding mum, I think of weaning as adding in solids, ie supplementary feeding, and, like you, I will carry on BFing to around a year old.
Good luck

My ds was born in 1999 and weighed in at 10 2oz. I bf him exclusively, but by the time he was 16 weeks I was showing symtoms of exhaustion. The hv's advice? Start him on solids immediately. This I did, although I continued to bf as well & although some things upset his stomach, I think it was a commonsense, pragmatic approach - & I stopped feeling so wrecked.

Maybe the guidelines should say start solids any time between 17weeks and 26 weeks but it is best to leave it as long as possible, especially with a family history of allergies. There could be a window of readiness in which solids become acceptable but it should be stressed that starting earlier than 17 weeks and leaving it later than 26 weeks is definitely not advisable. This allows for health professionals and mothers to use some common sense.

I just don't think the guidelines are very well worded and if even midwifes are saying it is 4mths again, regardless of whether it is or not, it just means that there is confusion everywhere and some babies are inevitably going to suffer.

To be fair I think that the later limit is necessary. When I weaned my first in 2000 there were mother's who were starting solids at 13 or 14 weeks because they thought that was close enough to 17 weeks but I wouldn't have thought that is particularly healthy. But then what do I know - as I keep saying the research and the reasoning don't appear to be clear to anybody!

Frazz - yes I think you got the terminology correct (talking of confusing guidlines )
Mumonthemove - By weaning most people mean starting to introduce solid foods gradually. As you say Milk is their main souce of food until 1 year. If you are still BFing you may find www.kellymom.com interesting. It is a BF site which I wish I had found before DD arrived. It has good articles and is fully referenced if you want to understand the research behind their recommendations.

an all round better leaflet from Northern Ireland neither leaflet says it they recommend weaning between 17 and 26 wks. (see pg 22) these things are carefully worded. read the bits in bold carefully.

Kisidee - The NI leaflet was a much better leaflet. I still find the other one ambiguous.

The paragraph that ruins it all for me in the DofH leaflet is this one.

"Solid foods should not be introduced before the end of your baby?s fourth month (at 17 weeks). If you decide to introduce your baby to solid foods before six months there are many foods that should be avoided."

Surely it should say don't introduce solids before 26weeks and leave it at that. Why mention the possibility from 17 weeks at all?

The NI leaflet doesn't do this in such stark terms. It only mentions 17 weeks when explaining the change in guidelines which is exactly where I came into this thread. Why did the guideline change?

It makes 17wk guidelines sound like a negative thing by saying if you chose not to follow advice and introduce solid food at 17 weeks. Less ambiguous tone.

To my mind the DofH gives you the opportunity to argue for 17 weeks, the NI one doesn't.

but my reading of the research is that there is no new evidence base for 26 weeks, just more evidence that weaning before 17 weeks is dangerours and more evidence that before 26 weeks solid foods are not necesarry and do not make babies more "settled". The NI leaflet is clearer as takes more of a line on things but i am not sure it is better as it indicates that weaning before 26 weeks is bad (rather than not good) ifyswim

that's how i understand it, witchandchips. before 17 weeks = bad. between 17 and 26 weeks = unnecessary. after 26 weeks = get started.

that's where i do feel the BLW thing is good. you can offer the baby food from the day it's born but by picking it up and eating it, the child demonstrates readiness. by and large that happens at 6 months, but sometimes before and sometimes after.

am a bit at the woolliness of the HV guidelines, you'd think they'd be a lot more explicit so that the HVs have something to go on.

lol, btw when i say 'bad' i mean 'not ideal, but if it's for reflux or some other medical thingybob then game might be a bogey'.

Aitch - that's exactly what the guidelines should be saying imo but they don't and when you lay it out like that it seems much clearer to me that it is better to wait for 26 weeks.

witchandchips - I wish there was something with more discussion of what actually happens at 26weeks that makes it more suitable than earlier to wean and if more research has been done to lay it out. You have to trust mother's to have a brain and explain the process. Those that aren't interested won't read it but those who are might be more convinced if they knew the details.

I read an interesting discussion with a lady called Gill Rapley who is deputy director of Unicef Baby Friendly Initiative. She was really pushing 26 weeks and BLW but even she admitted that they don't really know at what age milk is not enough for a baby. If you do baby led weaning from birth some babies will start solids before the magical 26 weeks although most probably won't but nobody knows for sure. They haven't done a large enough study of this to know.

It's crazy really, because other things I've read say that if you leave it much later than 26 weeks it may be difficult to get your baby to accept solids at all.

I personally decided to wait until as near to 26 weeks as I could. We eventually started at almost 25 weeks because DS was just getting so excited watching us eat, and seemed on occasion to be bored with his bottles. As he is not 26 weeks until Tuesday, for the first week or so I've just introduced 'tasters' so he gets used to the new flavours and textures. He took to baby rice straight away and it only took him a couple of spoonfuls to work out how to swallow it. I gave him some pear puree yesterday and he ate the lot, although he screwed his face up at each mouthful. Today when I gave him the pear again he wolfed it down and wanted more. Just needed to get used to the new flavour and texture.

Once he reaches 26 weeks I'll start introducing new things every couple of days, and start increasing the amounts of solids and gradually cut down on his milk (although obviously he'll still need a certain amount per day up to a year). BLW sounds great if you have a fussy eater - am not doing it at the moment but if problems arise later on I might give it a go.

i don't know what you mean about fussy eaters and BLW, do you mean about spoons? certainly i've noticed on my blog we get quite a lot of people who come to BLW because of spoon strikes.

re; the reasons. i think from what i've read (i have no medical training) that the idea is that at some point after 17 weeks-ish this open gut thing begins to close. the problem is that it may happen at 18 weeks or at 25 weeks and without an endoscope you don't really know.

so my understanding is that the guideline is set at 6 months to protect the maximum amount of babies, iykwim, but of course the individual baby may have been 'ready' for a while. and that's why i like BLW, as i personally subscribe to the logic that if the baby is developed to the extent that it can pick food up and eat it with its fingers then it follows that it will also be developed internally. but that is absolutely just a theory, i should stress.

I breastfed dd til she was 10 months, weaned her to solids at 6 months and didn't give her egg til over a year. Also did not eat peanuts in pregnancy as their is a history of allergies in dh's families. Therefore following all the guidelines I was given BUT dd has eczema and an egg allergy so it didn't seem to make any difference.