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.

Actually, I think I love all of you

Yes, but sometimes people talk about risk, or a spectrum of risk, or whatever, when there is no evidence for any risk whatsoever. Eg there is no evidence for any risk at all when giving solids at four months.

and really, you cannot talk in this quasi-scientific sense about risk, then throw out meaningless phrases like 'early weaning' - what does this mean? Where is the evidence of risk?

It is binary for downs etc in the sense of the actuality being yes/no, but it is not 50/50. The probability of downs for the baby in any individual pregnancy can be adjusted according to personal information like the mother's age, and blood test results. I think individuals don't understand population risk factors very well because they have not been taught to understand them and the media don't help.

Where there are many possible contributory risk factors it gets even more difficult to establish causality - this happens especially in disorders that show themselves in later life.

Eek, I really, really have to go, and I'm so enjoying this discussion.

Habs, I don't want to say too much about my professional background becuase I've had a slightly unusual career path which would instantly i.d. me to anyone who even vaguely knows me, but I do want to stress that I'm not an expert in weaning or anything, it's nothing to do with my job.

I have research training and when deciding when to wean dd1 I got impatient with the poor quality info available and started reading the original literature. Then I got hooked! It's such a complex topic and so hard to research - I find I want to keep reading and discussing the issues becaue theres' so much to discuss - it's not cut-and-dried and won't be for a long time.

Then there's the fact that in about 6 months and 2 weeks I may be weaning DC3.... so it's all very topical for me.

www.mumsnet.com/Talk/weaning/636032-The-research-links-from-the-AIBU-thread-weaning-at-6 is worth reading - interesting collection of links and research from waitingtobloom.

risk increases if you have no allergies and give solids before 10 weeks, or if you do and give solids before 17 weeks
This doesn't mean that it is possible that holding off for six/seven/12 months isn't even safer, but we don't right now have the evidence.

welliemum? are you pg?? Did I know this??? Geez, first Aitch, then you

I knew...

some studies show no link

You see, while of course going out without an umbrella increases your risk of getting wet if there is any possibility of rain, this is a very different discussion, and far more complex. If rain doesn't exist, then the umbrella is pointless.
As it happens, if I came from a family with allergies, I might well decide that despite the contradictory advice, I might decide to act as if there was a risk, but that doesn't mean there definitely is.

OOh, I should not have opened this when I am running on 4 hours sleep....but I do see your point, and well made, shall read it again when brain kicks in after coffee tomorrow though...

Just the research background thing was what I'd guessed, wellie - had you down as sciencey-research, which was as detailed as I wanted!

Do you like my seasonal name change?

what a clever and well thought out discussion this is

I wish I'd had it to hand this morning when discussing risks associated with my VBAC with my consultant as the actual topic aside, the risks are similarly quantifiable (or not as the case may be).

The key word in all of this - bearing in mind the key word here is risk is:

Is it reasonably practicable?

What other factors are in play?

Personally I risk assess for a living, hence I am a cautious individual and I choose to follow all the current advice once I have researched it myself.

I am however using a brain trained in the assessment of risk factors, I can't get away from it, it is in my nature.

The majority of the population do not think like me. The majority do not have the same risk factors as me and also (unfortunately) many are not as informed as me. That is a fact, not meant to be judgemental - I do not live anyone elses lives.

Sorry mis-edited that first line - I guess you know what I meant Should have said - "the key phrase" is reasonably pracicable.

Oh, I do like this thread.

There's also something funny in the way we assess the risk of doing something against the risk of not doing it - as if there's more moral responsibility attached to, for instance, making the active decision to take an umbrella with you than leaving it behind. Along the lines of 'If I get wet, it will be bad luck/down to God or Mother Nature. If I take an umbrella I've made a conscious decision so it's all down to me'.

Btw, I grew up in Yorkshire... didn't even own an umbrella until I left home. No effing point. Wind would just blow it inside out (or take your hat off). If it rained, we got soaking wet, no way round it!

My school uniform included a duffel coat, which my mother made me wear, and I would STILL get soaked if it rained on the way home. We can put a man on the moon, coat our saucepans in teflon, make duffel coats so thick small children are rendered incapable of movement but there is no force on earth that can protect you against the Yorkshire weather.

I read an entire weaning thread. And enjoyed it.

Yes, the moral thing is interesting isn't it. I think you see it especially with vaccine debates - we all seem to have this intuitive feeling that there's a difference between
a) vaccinating your child and experiencing a vaccination side effect vs
b) not vaccinating your child and experiencing a disease side effect.
... and our perception of where the "blame" or "guilt" might lie will inform our decision to vaccinate or not.

I'm LOL a bit at tiktok's assertion that a risk curve is common sense - tiktok, you've so much more common sense than anyone else, of course you would think that!

mabanana, I agree that it's important to define what "rain" means in any discussion about risk. I think I just said this recently on another thread, but IMO it's not terribly useful to talk about allergy risks and weaning. Allergy is too complex and too poorly understood to reduce down to weaning age. It doesn't surprise me that the evidence on allergy is very contradictory.

For example there's the fact that some individuals (my children! have such a strong genetic risk of allergy that there's probably not a heck of a lot anyone can do about it - sort of like Edam's example of living in Yorkshire. There just isn't a duffel coat thick enough.

One type of "rain" that I think deserves a lot more consideration in weaning discussions is the role of breastfeeding and weaning and gut flora in programming gut immunity.

The studies I've read have often been done in animals so the evidence is fairly oblique, but there are a lot of them, and taken together with work on the "programming hypothesis" of early life influences on adult disease in humans, they seem to point very convincingly to a potential role of gut immunity in a lot of conditions found in later life.

Broadly, the immune system is hugely complicated and has to be very finely balanced. If it goes out of balance, there are different types of effect - allergy is one example, and so is infection and autoimmune disease. As a BIG generalisation, those risks are often complementary so the safer you are from one risk, the more vulnerable you are to another.

So I think it would be rash to say that because weaning doesn't affect allergy risk beyond the early weeks, that we could randomly wean our children at any age and it would have no influence on their health. There seems to be a lot more going on than just allergy and my feeling is that we should be farily cautious.

It looks increasingly likely that how we feed our children early on could be terribly important - the frustrating thing is that there aren't a lot of pointers as to how the risk works, ie information we can use to make practical decisions about our own children.

Sorry, written another essay and I've ignored so many other good points on this thread!

I've enjoyed this thread! I have an umbrella in my handbag all the time but at the moment I'm getting wet because a. I don't have a free hand to hold the umbrella because I'm on crutches and b. I don't have a proper coat because I only have a short fleece that fits over my bump!

LackaDAISYcal I had a discussion with an obstetrician where she explained at this stage the risk of VBAC (with my inverse T scar) was low enough that it was better for baby if I delivered her naturally. I had two obstetricians one at each hospital say vaginal would be better, one explained it in better detail though. I know that the risk with my scar of rupture anyway is greater than 0.3% (risk of rupture on a standard scar) and lower than 2% (risk of rupture on a classic scar) but no one knows the true figure because of the rarity of the scar and it being even rarer for someone with it to VBAC. Two days later another obstetrician came to see me, he asked what the plan was, we told him and he said "You understand you're at higher risk of rupture you still want to do that" he was so blunt I was a little stunned!

where umbrellas are concerned mine works the opposite way, you can guarentee, the days I rembember the umbrella it stays dry, when I forget, it pisses down, that is the law of sod

It's fascinating how risk works at an individual level. Dh is a classic atopic person - allergic to fur, feathers, pollen, asthmatic, has eczema, everything bar food allergies. Yet he's the only such person in his family - everyone else is fine, not even hayfever.

I was determined to b/f ds just to give him the best possible chance of avoiding everything dh has. And touch wood, bar some nasty infant eczema that has cleared up, he's fine. I feel VERY lucky because I know b/f is no guarantee.