Interesting talk today from a Paeds allergist re weaning ,allergies etc.

[LaDiDaDi]

Was at a talk from Prof John Warner today where he was talking about allergies.

He suggested that an overlap period between breastfeeding and weaning was more important than exclusive breastfeeding to 6 months then weaning. He also suggested that the guidance regarding what pregnant women should eat during pregnancy may be changed and that the evidence behind the idea of slow weaning, ie waiting before introducing certain foods that are thought to be more allergenic eg kiwi, was minimal at best. He thinks that soon pregnant women with a personal or family history of allergy will be told not to avoid allergenic type foods unless they are specifically allergic to it.

It was very interesting and I wanted to tell mumsnetters about it. Wasn't sure where to post but thought here was as good a place as any.

Not being rude about paediatricians, some of my best friends etc etc, but they don't have specific training about weaning any more than they do about breastfeeding.

So if a paediatrician gave me advice about weaning, I'd ask them (nicely!) where they got the information from, as a way of finding out whether this is something they've read and thought about, or whether they're simply reflecting standard opinions or their experience of weaning their own children (I expect it would be the latter in a lot of cases).

I'd also be sceptical of anyone making very firm statements about weaning age and allergy because there aren't clear enough answers in the published literature to justify that.

The literature on weaning and allergy is very contradictory and the study designs are weak. Not because the researchers are thick, just because for practical reasons it's a very difficult topic to investigate.

Still wittering away to myself....

The key review document is here if anyone wants a read. (Pediatrics is the journal of the American Academy of Pediatrics.)

As regards weaning age and research, they conclude "In summary, the evidence from these conflicting studies, in balance, does not allow one to conclude that there is a strong relationship between the timing of the introduction of complementary foods and development of atopic disease."

They also say, "There is also little evidence that delaying the timing of the introduction of complementary foods beyond 4 to 6 months of age prevents the occurrence of atopic disease."

I think it's also important not to read more into their statements than is there. The document is a miracle of careful writing - they're absolutely meticulous about not stretching conclusions.

So what they're saying is that delaying weaning isn't going to stop your child from developing allergies. They're not saying that weaning later will increase your child's risk of allergy - there has been one study suggesting a risk of wheat allergy with later introduction of wheat but this was a small study and it seems the jury is still out.

They're also not recommending weaning at 4-6 months - the American Academy of Pediatrics recommendation of exclusive breastfeeding to 6 months still stands.

Real minefield of a research topic - rather them than me....

By CoteDAzur on Thu 06-Mar-08 16:54:54
I didn't say "first teeth".

Sorry CoteDAzur, I didn't mean to deliberately misunderstand you. I was confused by your earlier post where you did actually refer to first teeth:

By CoteDAzur on Thu 06-Mar-08 12:39:07
I don't know about 'baby led weaning' but didn't dare give DD solids at 6 months, as she got her first teeth at 9 months. Maybe next time I will be less precious about my baby choking on solids she can't chew, but I doubt it.

But are teeth all that important for solids? Isn't it more about learning to move food from the front to the back, and then swallowing?

I have this mental image of elderly relatives managing fine without any teeth.

I didn't say it was a nice mental image, mind

No need for teeth imo, the gums are sharp enough with all those teeth under the surface. I didn't do blw as such, but my toothless dd was demolishing double thickness breadsticks at 7mo, so it can be done.

Having said that there are some old fashioned paeds here that insist on purees only if the teeth haven't come through. And I agree with you re most paediatricians knowing very little about bfeeding, weaning and nutrition in general, we've changed 3 and I've heard different camped up in the air theories from each. At least my dd's current one lets me decide what to feed her as she can see she is happy and healthy and hardly ever darkens her doorway as is rarely ill.

oops, I appear to have kicked off a debate about teeth and chewing. I don't think the emergence of teeth make any difference to ability to 'chew' stuff, the teeth are there under the gums doing a pretty good job anyway. No sign of teeth in babycarrot's cakehole (relief as I'm still bf) but she is managing to do well with sirloin steak.

I know some people (not you Cote!) believe that purees are essential until first teeth arrive, and I was making the point that incisors wouldn't help anyway as you don't chew with them. (well, I don't)

Perhaps some babies just can't deal with lumps until they are ready to - don't know? Is there any research suggesting that starting with purees makes it harder for a baby to accept lumps and chewing?

there's precious little research into weaning techniques, vlc, it all appears to be received wisdom. apart from blw, there's a little bit of qualitative research into that. and the thousands and thousands of people who come to my blog, none of whom has reported a fatality i am Very glad to say.