Any advice on weaning a 5 month old? (specific reasons for this)

[CucumberNova]

Hi,
So I know the advice is wait until they are 6 months old, but with the consent of the health visitors we are starting to wean our DD at five months. There are specific reasons for this, she's always been difficult to feed and we are trialling a cows milk allergy formula to treat her awful reflux and discomfort. It's possible she just doesn't like milk too much and refuses some milk feeds during the day. As she was still screaming hungry, we started her on basic baby rice made with formula (with a bit of fruit puree as she wouldn't eat the baby rice on its own) and the health visitor on Tuesday said we can start introducing vegetable purees.
I wanted to do BLW but because she's not 6 months yet, I'm sticking to purees at the moment.
I just wanted some advice though because I'm not sure how to manage her milk feeds now and how much solids she should have, as all the guidance I have is for a 6 month old. If she has some solids for lunch does she need all her bottles? She has never drank as much as the tin suggests for her age. She happily has some lunch but now I'm wondering when do I start including a second meal?
For some background, she was combi BF/bottle fed until 4 months until she refused BF. Also, she seems ready for solids as she can sit in her high chair holding her head very well, opens her mouth for spoons, sometimes takes the spoon and tries to feed herself, and generally gets really excited when she sees it coming (which is just so cute).
Anyway, any advice is appreciated, thank you

Oh dear. A health visitor is not qualified to tell you it’s okay to wean at 6 months.

HV are not qualified to advise on this. If you are having real issues with weight gain a paediatrician may advise early weaning, but even then it's unusual.

maybe i should have said, I'm not completely weaning her - i'm giving her as much milk as she will drink but she refuses milk feeds but is still hungry so I need to give her something. doctors are aware!

I would stick to one meal until she is 6 months at least and try to keep her milk feeds up as much as possible. There is emerging research about the value of weaning pre 6 months for babies prone to allergies. Veg puree etc won't fill her up as much as milk though.

Is she on Neocate?

Oh and baby rice before bed may help with the reflux, there's also research on the usefulness of weaning for reflux.

My son had quite severe reflux and CMPA. Unfortunately weaning didn't help and actually many foods (fruit and veg) made it worse so weaning wasn't easy. My son was medicated which helped ease the discomfort but reflux sometimes just needs time and it did eventually pass as he grew. It was gone by the time he was one.

Thank you - yes I'm offering her milk before and after. I will try and find some of that research, thank you

No I'm not sure what that is, sorry. She tried a formula thickener and then Gaviscon which didnt help. We've just tried adaptil pepto 1 but she still has symptoms so we're trying a new formula now.

I know 'what we used to in the old days' isn't always a good answer (see car-seats) but only 14 years ago it was totally normal to wean on fruit, veg and baby rice from 4 months, introducing cheese and meat from 6 months. Everyone did it, the vast majority with no ill-effects.

I understand why you're doing it @CucumberNova , it's often recommended for refluxy cmpa baby's. My son had it though we didn't wean til 6 months, but the baby still needs most of their nutrition from milk for a good while longer so the first month is exploratory, starting with a mouthful at first then building up, of purees of a single ingredient to ensure any allergic reactions are traceable, and then mixing and graduating up to more textures. Some foods react badly with cmpa baby, tomatoes and onions for example often set it off with the acidity. They won't get a majority of nutrition from food and dropping milk feeds for a good while yet.

I never did baby led as you start with purees and they're too little for spoons etc, and he was a tricky bugger at times so I wanted to ensure I knew he was getting as much nutrition as possible.

Baby rice has no benefits to a baby. Imo it's polyfilla not babyfiller...

thank you! I'm so worried about making the reflux worse. It's so hard seeing them squirm and vomit and cry all day isn't it. And she absolutely wants to eat. Thankfully she will drink morning and evening bottles, its mainly mid day she refuses

i got an organic one and i make it with her formula milk

What have they tried for the reflux so far? Have they tried omeprazole etc?
Gaviscon usually just seems to cause constipation but does help
some. I’m confused as to why a Hv is saying to give food, weaning with bits of puree and rice doesn’t help reflux. Baby rice is horrible and has no nutritional value so probably good she wasn’t keen :) yes she should have her normal milk still as her intake at this age should be zero or tiny if you are doing it early. Even food at 6 months is mainly about learning textures, flavours, hand eye coordination /and starting to get some iron from food. Babies don’t tend to drop milk until at least couple of months or more later. If you think about it most first foods that babies have are very low in calories. So yes you can give her milk as usual.
Is she in pain from the reflux or weight gain issues etc?

Does being organic take the arsenic out of it? I thought baby rice was no longer recommended for this reason. I'm surprised a health visitor ok'd it.

It was 6 months for weaning 22 years ago @Runnersandtoms - it changed between 2 of mine although when I was born it was 3 months!

@CucumberNova with my son we'd got it under control by weaning stage thankfully as he had severe silent reflux so was on omeprazole, then found it was due to cmpa so he was on aptamil pepti syneo and it was the flavour he didn't like which made milk feeds a trial! It was horrendous when we didn't know why he was so upset as a newbie, everyone said colic but we knew it wasn't, I took him to A&E he was that bad, screamed in pain if he wasn't asleep. He's 18 mpnths now and eating yoghurt though failed cheese on the milk ladder, and when he turned one he went on oat milk which he loved and drank with gusto.
At 5 months and for a long while milk is the way baby's absorb nutrients best though, so it might be good to find a formula that may work better, a friend of mine was told by gp to add a drop of alcohol free vanilla essence in to improve the taste for her baby as he was dropping centiles swiftly.

it's frustrating because i started her on carrot puree as i thought it was more nutritional but HV said to do baby rice instead because its kinder on her stomach! but I might make porridge instead now as people have said baby rice isn't great for them. also veggie purees.
they never offered us omeprazole, they tried a thickener then gaviscon but she was still sick and got constipation. im assuming the pain is reflux or lactose intolerance! fortunately her weight is ok now but she dropped to 2nd centile at one point

that sounds like it was really tough. we've seen a lot of gp's and we've struggled to get help. out little one is very obviously uncomfortable a lot of time and cries a lot and vomits throughout the day but we persevere with milk as much as possible. hopefully this new formula will do the trick

@CucumberNova if she's still suffering from symptoms of reflux then omeprazole is ehat worked for us, gaviscon is the first on their ladder to offer and it does constipate. Because I went to the actual hospital admissions a new mum not knowing what was happening and was seen by paediatrics I went straight to omeprazole, it takes the acidity out of the reflux and stops it hurting them. Might be worth pushing for it and the association with pain and feeding won't be as strong.

@CucumberNova it's something not all GPS want to prescribe as it is a PPI but as long as she's on the right dose for her weight, they're weaned off it eventually and we had no issues weaning our son off it at 11 months. Feels like years ago those days of doses and mixing formula etc, it will for you too one day promise!

When my DCs were babies, the guidance was four months.

They started on baby rice and baby oatmeal, then moved on to purees. I made my own by boiling and/ or blending veg and fruit and putting it in the blender, then freezing in ice cube trays. They would have one cube with the baby cereal to start.

They also had mashed bananas, but these were prepared fresh.

I added no sugar or salt to any of the fruits or veg I prepared.

The fruits I used were stewed apple, stewed plums, stewed pears, blueberries (just blended, not cooked), avocados (mashed), and mangoes (just blended).
Veg - peas, broccoli, spinach, carrots, parsnips, and sweet potatoes.

They all had CM issues, but they tolerated Greek yogurt well (unsweetened or with unsweetened pureed fruit mixed in).

Some foods went down well, and some didn't.

They graduated to scrambled eggs and very finely cut up fruits and cooked veg by around 6 months. Also bagels, a little peanut butter spread very thinly on toast, white potatoes mashed or mixed with unsalted bone broth. They could manage plain cheerios, and two of the five DCs tolerated little bits of cheddar.

It gets them used to the texture and the mechanics of swallowing something more solid than milk.

I live in the US where all baby cereals are fortified, so there is a nutritional value.

Follow the advice the doctors and hv are giving.

I weaned my oldest at 4 months as that was the advice that year (the next year it changed to 6 months). Started on veg purées, then some fruit ones, baby porridge in the morning gradually increased what she was having. Kept milk intake the same. BLW wasn’t a thing then, she was always a fantastic eater. My next two had cmpa and reflux and were on dairy free formula followed same feeding plan but quickly moved from purée to mashed