A rambling OP about discussing risk and why risk is not destiny. And a couple of rude comments about Irish weather.

[welliemum]

OK. If I go out today without my umbrella, I?ve increased my risk of getting wet in the rain. But risk is not destiny. Umbrella or not, if it doesn?t rain, I won?t get wet.

Why is this important? Because if research suggests that doing X increases the risk of Y, the researchers aren't in their wildest dreams suggesting that X always causes Y, any more than I?m suggesting that going out without an umbrella always causes you to get wet (unless you live in Ireland, in which case, fair enough ).

So?.

?.If I point out to another mother that going out without an umbrella increases the risk of getting wet I'm NOT saying ?you will cause water damage to your child you evil mother?, I?m saying, well, that has been shown to increase the risk of getting wet. It's a fact about risk, not a prediction for the future of that child.

?If I read the research about umbrellas and rain and decide to disregard it, fair enough, my choice. But I need to think about why I?m disregarding it. The research was probably conducted on people just like me. Do I truly believe it won?t apply to me? Am I somehow different from the rest of the human race in having special protection from the rain? Or am I using that well known (but sadly useless) protective mechanism of ?it could never happen to me??

... The risk of getting wet is related to a physical law of nature, it wasn't made up by a politician. It doesn't make the blindest bit of difference whether or not the government advises me to carry an umbrella. The underlying risk is whatever it is.

?. If I went out yesterday without an umbrella and didn?t get wet, this is not really rock solid proof that the research is all rubbish. Maybe it just didn?t rain. Because after all, most of us don?t live in a climate with a 100% daily risk of rain. Except you lot in Ireland.

Seriously, I think there are some big mistakes being made in the way risk is discussed here, and it's not just academic, it's causing a lot of bad feeling.

The research on weaning is mostly pretty rubbish - not because the researchers are rubbish, but because it's a very very difficult topic to research. A lot of the findings are fairly tentative. That doesn't make them wrong. A lot of the risks mentioned are rare. That doesn't make them irrelevant. But most of all, risk is not destiny, and I'm uncomfortable about the way the "weaning debate" is polarising on here into some rather dogmatic camps.

It's not a simple issue, any more than predicting the weather is a simple issue.

Yes, think that's well put, slim - but then no-one's going to say that they "shove food down their throats", so it's a bit open to interpretation. It's why I liked BLW - was totally up to dd what she did, so I felt less responsible!

The other thing that winds me up about the public perception of risk is that people are often unable to differentiate between the risks of something happening, and the consequences. When I worked on a public inquiry into the possible building of a new nuclear power station back in the late 80s, much of the evidence submitted to the inspector was along the lines of 'an incident along the lines of Chernobyl would be so devestating, the risks are too great'. Whilst you might agree that the consquences of an incident were terrible, that didn't make it any more likely to happen.

I had a 'clever' 4 month old. At 4 months (and she is 18 now so she was in guidelines then) she was sitting up independently, rolling and commando crawling, she crawled at 5 months and cruised at 6 (didn't walk til 11 months)

She grabbed, sucked/chewed food from us and swallowed, in a week she was on 3 meals a day, with pudding and snacks and drinking from a cup. She went on to fingerfoods/chopped foods in a few weeks and was eating with a fork 6 months. She was physically very advanced (she's very average now, everyone caught her up lol)She has no allergies, asthma etc and was also on ff from 6 weeks

Another one of mine (also in the from 4 months guidelines) was very happy with milk alone, exbf and I weaned at 7 months. He didnt sit up independantly til 10 months, walked at 18 months etc he was born after the forward one. He has had severe asthma, was in hospital for it at 3 months and regularly since, and is allergic to anything with fur, nickel and bad hayfever. I'm glad he wasn't weaned at 4 months as maybe his problems would could have been blamed on that

i have only seen this subject argued so heavily on mumsnet.

I have a problem that the risk is made up from different places (and I know I'm repeating myself but I'm always ignored lol) Person A mentioned one lot of research like the WHO (waiting until 6 months isn't harmful, early weaning not desirable, best to hold off, never before 17 weeks), then person B mentioned advice from somewhere like kellymom (the virgin/leaky gut), then person C talks like both as coming from the same place, often saying the WHO also says leaky gut, then everyone comes along and quotes C.

If you read from WHO, they are talking mainly about under delevoped countries but do say, it won't hurt people in developed countries to wait, which gives a global strategy (ie not needing 2 sets of guidelines) Also, if you read, it says at 6 months a child needs 600 ish calories a day, at 9-11 months 700 calories. That says to me, they need more than a few tastes of solid food at 6 months, which throws out the saying food is for fun until 1.

I don't understand why the WHO is quoted so often for weaning but rarely about bf until 2 years

Kell

oops don't know where the kell came from

It is not just about feeding babies this confusion affects almost every imaginable topic on MN, in RL, in the media etc. For example, you see it on the threads about car seats, especially the rear-facing ones for stage 2 and 3. We have little money to spare and rarely use our car - but I have felt really upset that I can't afford one of those posh rear facing car seats. Though I know that rationally, the risk of regular car journeys in an expensive state-of-the-art car seat is probably much higher than the risks of an occasional trip with no car seat at all (not that I do that before I get flamed!).

There was one memorable thread where an MNer asked if it would be okay, as a one off, for her DH to leave their baby asleep in his cot while nipping out to pick her up from the train station, it was only a ten minute walk, her DH felt that it was not safe for her to do it alone late at night. There were lots of outraged posts about how they shouldn't take the risk of abduction or sudden inferno and should instead wake the baby and bring him in the car. I think Madeleine McCann was invoked, and it made me wonder if people believe that if they do everything in the correct way, no harm will come to their little ones. I don't believe that to be the case, we take risks every day from the moment our babies are concieved - each of us decides what approach is acceptable based on imperfect information. We manage risks as best we can but we never eliminate them. I really hate the suggestions that suspected risks of early weaning, or formula feeding, or anything else should not be mentioned for fear of upsetting anyone who went down that route. New parents like myself need as rational a basis as possible for our decisions.

I love your analogy welliemum, right down to the bit about the Irish weather

annd very much agree with; misinterpretation of risk has been my bugbear for several years (I should get out more )

Good discussion, thanks, WM.

Were you really and truly 'flamed', MrsMattie?? For giving solids at 5 mths and not 6 mths?? Where is this thread?

I agree with WM - 4 mths, 5 mths and 6 mths are dates on a calendar and when talking about individual babies, it's far more accurate to talk about stages of development. But when it comes to a public health document, or govt policy, or world health guidance, the convention is to give quite prescriptive statements, and in this case, because the research has looked at outcomes and has had to measure these against actual dates (because if you are going to crunch numbers, it helps to have numbers to crunch...), we end up talking in terms of 'after four months' and 'after six months'. It just so happens that the 'stage' of development when most babies start to benefit from something alongside milk is indeed about 6 mths.

I am bemused when people count down the days to 6 mths, to be honest....some babies will truly not get much out of solid foods until rather later than this, and that's ok too, but there are posts on mumsnet from mothers of babies who hardly take anything at 6 mths 1 weeks, and they are really worried.

Habs, I had the same feeling about BLW: because it was up to the baby, it took a lot of the responsibility from me. And since I didn't feel at all comfortable about controlling when and how much my children should eat - how would I know what was best? - I was very happy not to take on that worry.

Orm's point about consequences is a really good one, and I agree with upwind that there's no zero-risk option when you're a parent. It's always going to be balancing risk.

Another thing that's been bothering me a bit about weaning discussions recently is the role of exclusive breastfeeding.

This is the other side of the coin of weaning - or would be, if so many people didn't mix-feed - in the sense that you stop ebf in order to introduce food.

So are we talking about the risks of giving food, or the risks of stopping ebf?

I'm saying this because current research (I'll come back later with some links) seems to suggest that the duration of ebf (before introducing formula) can be enormously influential on health outcomes. This is hard to discuss on MN because people get defensive about formula, and sometimes I feel it's like the elephant in the corner of the room during weaning debates.

The WHO review showed (IMO) pretty convincingly that ebf is good nutrition to at least 6 months. But the evidence about when solids can be harmful is very contradicatory (except very early, where the risks are clear). I wonder if we'd get better answers about weaning by paying more attention to ebf. But that's uncomfortable thinking for the vast majority who don't ebf.

I've had similar thoughts, wellie - the only large scale weaning research I found were the Cochrane reviews, and they didn't distinguish between giving formula or solid food in their dicussion of gastro-intestinal problems linked to non-ebf. But as you've said, it's an extra-ordinarily emotive issue, and so it's easier to focus on the solid food issue, as that's a more obvious matter of choice.

Agree with welliemum and tiktok (surprise, surprise ). FWIW, I started weaning both mine at 6.5 months, in a vaguely BLW way, but ds2 in particular really wasn't ready until much closer to 8 months.

WM, I would assume it's a bit of an interaction - risks are associated with intoduction of solids (before a certain point and on a sliding scale) and with stopping ebf, and those risks probably sort of 'complement' one another iyswim. Possibly avoiding early weaning is even more important for ff babies, for that reason.

One more thing and then I really must stop talking to myself!

I think people don't always realise that when you're talking about biological systems, risk generally looks like a curve, rather than an on/off switch.

Specifically in weaning debates, people who wean before 6 months will point to the lack of evidence of harm in weaning between 4-6 months to justify weaning at 4 months or so.

But we know that weaning before 3-4 months carries very significant risks for some babies. And here's the point about the curve - it would be very odd if the clear risks of early weaning suddenly switched off at 4 months for every single baby. Unless weaning risk is different from any other health risk, there will be babies towards one side of the curve who are still at risk of those things after 4 months - and no-one knows who they are.

There may even be babies who are still at risk at 7 months - but as practically no-one in developing countries weans at that age, it wouldn't show up in a study.

wellie, without giving too much away, what's your professional background? I just think that what you write and know is v. interesting, and wonder if it's a personal or professional thing?

oh wellie I thnk I love you

i think dr jack newman actually recommends giving a baby food in preference to exc formula if there's only a month or two in it, because yer carrot is less processed etc.

thank god for BLW is all i can say, i just felt like i side-stepped all this angst. dd grabbed a peach off me at 5 months and three weeks and we didn't look back from that. she genuinely didn't need anything other than her formula until then, so we didn't have 'when to wean' to deal with.

i do find the 'my wee man is on five rusks and a carton of fromage frais and he's only 12 weeks' stuff on other sites completely baffling, though. you never see that here, and i think it's cos by and large on MN there's not that competitive thing. if anything, i'm competitively lazy.

helloooo! how are dds?

wellie, common sense indicates that curve thingy, just as you describe....not a switch. Trouble is, research and guidance tends to result in a 'sudden' date on the calendar, like 3 mths, 4 mths and so on, which is inevitable, but is no more than an artefact of data gathering and reporting.

This is a fab thread, btw, wellie. Many thanks.

the interesting thing about risk though is that it only really makes sense at population level.

so for example the risk factors you get at the 12 week OSCAR - if you get 1:250 risk of Down's Syndrome, then, yes, out of 250 people who have that risk factor, one will have a baby with Down's Syndrome.

But for each individual in that 250, it's a binary issue - yes/no, black/white, Down's/No Down's. Your baby doesn't have 1/250th of Down's, it either has it or it doesn't.

So when you talk about the risks of weaning early, people inevitably boil that down to the individual level with 'I was weaned at 12 weeks and I was fine'.

Individuals don't understand population risk factors very well, because they think as individuals.

Does that make sense?

Aitch, I think you're right about Dr Jack N, and I am drawn to agree with him on this, but I am probably less informed by research than by my simple preference for something that is not produced by companies which have a vested interest in telling me my baby 'needs' their product. I am pretty sure the Carrot Farmers Guild have no plans to advertise their product with some spurious Carrot-o-fortis special additive, or to pay celebs a fortune to be pictured giving carrots to their kids...

totally. like when people are weighing up the 1% risk of an amnio... it's 50/50 cos it's going to happen or it isn't. but that doesn't mean that person will tell others in a breezy manner 'didn't do my kid any harm, so extrapolate away'.

Yes, but, Hell.......there is a spectrum of food intolerance and allergy though, is there not? For example, anaphylactic shock, where someone dies if they touch a nut is at one end of it, and at the other, we have someone who gets a bit of a tummy pain if they eat too much full fat cheese, with all sorts of rashes, spots, diarrohoea and constipation in the middle! Not to mention different conditions like inflammatory bowel disease, metabolic disorders, atopy, IBS and so on.

oh yes. also true,
feeding relentess...

Quite so - and that's because the risk of amnio is so definite and so absolute.

Whereas the risks of early weaning are difficult to isolate - got eczema? could be weaning too early, or it could be hereditary, or environmental. who can say for sure? the only level at which it makes sense is at population level, where you can say 'there appears to a significantly increased risk of problems associated with early weaning'.

Sorry tiktok cross posts! but I think that the spectrum aspect does add to the inability to think at population level, iyswim.