Evidence against early weaning

[floozles]

Just wondering if anyone can point me to the evidence for not weaning until 6 months (am looking into it as planning to start solids for DD at 22 weeks). I've read through the Optimal Duration for Exclusive Breastfeeding:A Systematic Review published by the WHO and am left scratching my head. As far as I can ascertain, the review was carried out predominantly to see if there was any evidence of harm in recommending exclusive breastfeeding until 6 months in developing countries, in terms of reduced weight gain & poor iron status.

There is evidence of reduced GI infections in babies exclusively breastfed for 3 months vs 6 months in a study from Belarusse, and reduced eczema in the Belarusse study and a study from Finland which looked at children of atopic parents only.

The summary states that 'Besides their reduced morbidity due to gastrointestinal infection, infants breastfed exclusively for 6 or more months had no observable deficits in growth, and their mothers were more likely to remain amenorrheic for 6 months postpartum. No benefits of introducing complementary foods between 4 and 6 months have been demonstrated, with the exception
of improved iron status in one developing country setting (Honduras).'

I can see how exclusive breastfeeding till 6 months is ideal in developing countries where you don't really want your baby getting d&v, and prolonged amenorrhoea is useful in terms of birth control. I can't see from this any real evidence that giving my daughter a daily spoonful of apple puree from 22 weeks will harm her.

Just wondering if there's more up-to-date evidence that I've yet to come across.

[Ducks head below parapet...]

"Decided on 22 weeks coz it's half-term, and we've finished the course of swimming lessons - just in case it causes nappy havoc"

I personally would wait if that is the only reason for weaning earlier than the guidelines.

Yes I agree with B&J but don't agree that all babies are fine on just milk until they are 6mo. If my baby started feeding every 3hrs during the night after previously sleeping through then I would wean cos to me that says my baby is hungry and bm is not enough. My babies started feeding every hour which to me said they were hungry. Before that I was adament I would wait till 6mo.

If milk is more calorific than food and food doesn't help a baby sleep, then how does goodnight milk work? It has got cereal in to make it more calorific and heavier and thousands of mums will testify that it does help their baby sleep.

Prolonging amenorrhoea is not just beneficial for women in developing countries. It is also one of the factors which reduce the risk of many female cancers, particularly breast cancer, which is of course far more a disease of the West. I think that was one of the factors behind the WHO making its six month recommendation.

but why is it the be-all-and-end-all to make the baby sleep?

neenz - there is no evidence that 'good night'milk helps a baby sleep through, and even the manufacturers do not make this claim (because they cannot back it up) and merely use branding to make you think it helps! Putting stars and moons on a packet and using a name with 'night' in, is all marketing.

Of course some babies (thousands???? How do you know?!) will sleep after having this cereal-thickened gloop, but it could be coincidence as plenty of babies change their sleeping habits anyway as they grow.

Personally I think the old advice 4-6 months makes more sense. Not every baby is ready to do the same thing at the same time. You wouldn't expect every baby to start sitting/rolling/crawling/walking at exactly x amount of weeks, so why is it so different with weaning. My ds was soooo ready for solids at 4 months, he was not having a growth spurt, I knew what they were like and 2 weeks of almost continuous feeding after sleeping through was not normal, it settled as soon as I introduced solids. Don't shoot me for doing that either, because he's 7 and back then the advice was 4-6 months!
My dd was completely satisfied with bf until 6 months, or would have been if it wasn't for the fact that I had to go back to work when she was 5.5m and she refused the bottle of EBM. After 5 days of totally no nutrition between 9 and 4 I made the decision to start on solids, which she would accept from other carers.
My mum keeps telling me I was weaned at 6 weeks on tomato, now that's early!

Here's what SACN say about 'good night' milks (among other observations)

"The Committee has not identified published evidence that the use of any follow-
on formula offers any nutritional or health advantage over the use of infant
formula among infants artificially fed. Moreover it has not identified any scientific
evidence that either ?Good Night? milk product offers advantage over the use of
currently available follow-on formula or infant formula. Specifically the
Committee are unaware of published scientific evidence to support the
statements made about ?settling the baby for the night?, or being ?gentler on the
baby?s tummy?. "

www.sacn.gov.uk/reports_position_statements/position_statements/sacn_statement_on_good_night_milks_- november2008.html

I'd rather suffer waking in the night than risk my babies future health.
If he'd been showing the real signs of readiness, eg. being able to sit up and feed himself, then I'd have offered him some food earlier.
Waking up and watching me eat are signs of being a baby. He watches me cook too, I'm not handing him the carving knife.

Neenz - cereal has a lower gram for gram calorie content than milk, so a hungry baby/goodnight milk would be less calorific than bm/normal formula. I think the theory is that it takes longer to digest and therefore delays hunger pangs - much the same principle as the "Shape" yoghurts which contain odd stuff to make you feel fuller. These are diet yoghurts which are intended to get you eating less - fewer calories.

So, in theory, if a baby starts feeding more, you might consider that it needs more calories, which are most quickly and easily obtained from milk than anything else.

That all said - I can very well imagine that if you have twins getting more sleep through the night is a much bigger deal than if you have a singleton. And you may well look to things which you think might assist that - a pragmatic approach, really, and I can imagine that breastfeeding twins must be pretty busy work.

However, as tiktok says, I don't think there's any evidence that shows babies sleeping better after hungry baby milk that can't be just as easily ascribed to a coincidental developmental change.

I think what I'm trying to say is that obviously it's up to you to try to work out a pragmatic solution that suits your children and you, but that in itself doesn't disprove the research that has been done.

While it's not the be-all-and-end-all if a baby doesn't sleep, it's certainly a more pleasant life if everyone is well rested, and starting solids can help babies sleep longer.

Clara, I'm pretty sure there's no research evidence for that, tbh. It may happen co-incidentally, but you may also get an equal number of people (like me, for example) whose baby slept just fine until they were weaned .

it's certainly a more pleasant life not to have coeliac disease, crohn's disease, ezcema or allergies.

(of course early weaning has not proved to have all of these effects but I would not take the risk just for the chance of a month of sleeping a bit more)

Not terribly relevant, but I found this Laughter elevates melatonin levels in bm - they argue it may reduce eczema risk! I'd like prescription comedy DVDs, please.

Wow Habbibu that's incredible.

Just one study, so Lord knows how concrete it is, but I do love the idea. "No, darling, I have to watch the Mighty Boosh. The baby will get eczema if I don't". I reckon comedy DVDs are a pretty essential part of early parenthood anyway.

actually I watched 4 series of the US office while BFing through the night in the early days - wonderful to know that that might have made DS's skin so soft(I have eczema but he doesn't!).

Just a couple of things really although I could write a tome.

A baby waking in the night is not a sign that 'bm is not enough' but probably a sign that they are not getting enough bm. Allowing your baby to feed more frequently will tell your body that the baby needs your bm adapt to its changing needs. Introducing solids because of some unproven link between night waking and readiness for weaning can upset such a clever process.

I cannot stress enough that anecdotal evidence is of no use against scientific research. Just because you did x and y didn't happen then it does not mean that x is appropriate or recommended behaviour.

I want Red Dwarf and Blackadder DVDs and Eddie Izzard in my front room please. For medicinal purposes.

I agree that my babies slept LESS well for a few months after they were weaned. None of them were weaned until 6 months and they were all sleeping 8-9 hours at night whilst having breastmilk only.

LOVE the laughter research!!

It's also true that milk is more calorific than any solids you're likely to give your baby (unless perhaps you start them off on Mars bars ) so they're more likely to sleep better on milk alone.

cmotdibbler: ta for the ref, however this study (like others mentioned) looks at cessation of breastfeeding, not introduction of solids early vs late. The 'partially breastfed' group included babies who were on formula as well as those who were on solids, so this will confound the results to some extent as it is known that breastfeeding rather than formula feeding is protective against GI & respiratory infections. They say that the protective effect of breastfeeding is lost soon after the cessation of breastfeeding. However, I don't see DD greatly reducing the amount of breastmilk she'll be getting in the first few weeks of weaning, so she'll probably be around 6 months by the time the amount of breastmilk she takes goes down IYKWIM. And I plan to still give her EBM/breastfeeds until she's a year. I don't see from this study any evidence that giving a small amount of solid food, in addition to breastfeeding would do any harm. And no, I wouldn't let her drive the car, her sense of direction's terrible

Have to say, I'm with welliemum on the interpretation of risk, and the lack of good evidence on risks of weaning. Obviously it's not something that you can eithically produce sound research on; like I said originally, the WHO paper doesn't do it for me, and I was wondering if anyone had come across any other evidence regarding harm caused by introduction of solids at under 6 months, as opposed to the evidence for exclusive breastfeeding (of which I realise there is quite a lot) - they are two seperate issues as I see it (as minimarmite said). As I don't anticipate her milk feeds reducing that much intially, I don't think the amount of milk will decrease particularly, so she'll still be getting all that lovely IgA & calories (excuse for me to eat those mars bars, not her!)etc.

And I don't anticipate starting solids will help her sleep more either, sadly.

But I still don't understand why you would want to give solid foods before six months?! There is absolutely nothing to say that weaning BEFORE 6 months is better for the baby, whereas there is lots to say that waiting til 6 months MIGHT be better.
So if you don't see any benefits to weaning early (like better sleeping) why not wait until 6 months?
I completely agree that it is unlikely to harm the baby to wean a bit earlier - I just can't really understand the logic in wanting to!

I think you are right and that there is no concrete evidence, just like there is no evidence that eating peanuts in pregnancy will lead to peanut allergies in the child, or that refraining from eating peanuts will protect the child. The govt changed the advice on peanuts 10 years ago to see if it had an effect on allergies. It didn't. www.dailymail.co.uk/health/article-482750/Pregnant-women-told-eat-peanuts-protect-babies-allergies.h tml

It wouldn;t surpise me if the current advice to wean at 6m is just another experiment by the govt to see if it will reduce allergies. I have certainly heard rumours that the advice might be changed back to 4-6mths. And i find the 6m mantra on MN really irritating.

BTW I have never used goodnight milk or any other formula as a drink, so could not say whether it helps a baby sleep. It wouldn't surprise me if it did tho.

My babies' sleep got worse six weeks after starting weaning, which I think was down to the digestion getting used to food and also because at first the amounts they take in are very small. They started sleeping through again at 8m (only after sleep training tho). At that age they know more about crying/food/cuddles association so they may wake in the night for all sorts of reasons.

I didn't think the 6 month thing was about allergies at all - I thought it was about the protective effects of excl. breastfeeding against gastro-intestinal problems, etc - at least, that's what I've gathered from the Cochrane review and other research.

neenz - I've heard no rumours to that effect other than on MN, and I'm pretty sure that tiktok hadn't come across them either, and she tends to be more up to speed than most on these things. If you chose to wean early, then fine, but I don't think the MN mantra (which is pretty much the DoH mantra, if you want to put it like that) is anything to get particularly riled about - if you can justify your choices to yourself, then on you go. If people wish to promote current advice, then, again, that's up to them, surely?

Neenztwinz - I do find the peanut thing annoying - but that's because I like crunchy nut cornflakes and resented being told not to have them when pregnant!
I don't see how the 6 month thing is annoying though when it's no trouble or scrifice to wait until 6 months. If solids helped a baby sleep better or made them more settled I could understand it completely - but what are the benefits to weaning earlier? (I'm genuinely interested!)