Whats the deal with weaning these days then?

[mosschops30]

I spoke to the HV today and she said no need to wait til 6 months because at 6 months I should be introducing protiens, so she said to start now (5 months) with baby rice and veg purees.

Whats the rules now?

Still 6 months afaik. I wouldn't take advice from a HV about weaning, find somebidy who knows

where boo??

I was going to wait, see no need to wean him because he sleeps through and is a happy baby.
She said you only have to wait til 6 months if theyre bf and ds2 is ff

hi, mosschops, that sounds a bit odd, i thought that it was the other way round - babies natural stock of iron runs out at around 6 months and they don't get it in breastmilk, but formula is fortified with it - so surely that means its even less likely that you need to wean your baby yet?

Gah, my health visitor said this as well. There is actually some kind of research which basically said there was no benefit to waiting until 6 months with FF babies because they had already had cow's milk protein introduced. I can't see any harm in waiting though, either.

Have you thought about doing BLW? I always think that this is a good plan if starting before 6 months.

LaTour, there is iron in breastmilk, it is in small quantities but is very easily absorbed.

BB - aha, wasn't 100% so thanks for letting me know - makes me feel a bit better actually as DS is 6mo 2 wks and despite various attempts at offering him food, he's just not interested and i was beginning to worry about thehole iron thing as he is excl bf still - tis bloody exhausting too as he's a proper porker, and prefers eating at night when its quiet...

bertie can you give me a heads up on BLW? It wasnt around when I was doing dd or ds1 (or if it was i wasnt aware of it)

Iron doesn't suddenly run out overnight, either - so even if their stocks are starting to run a bit low I expect you have a few weeks/months to get them onto solids

Sorry, hit post too soon. If you are interested in BLW, Gill Rapley has reently published a book (I got it from my local library) - or google it:there are millions of blogs and websites dedicated.
I tried to wean DD1 onto purees but she wasn't interested and only ever liked fingerfoods (apart fro a revolting spinach sludge) - BLW by default. DD2 I went straight to BLW and it is so easy! Definitely know what I'll be doing with DD3 - and has the advantage, if you are not sure, of reassuring that you are not giving solids before your baby is ready.
Even the NHS/DOH websites give "being able to sit up", "able to grab and reach accurately" and "putting things in their own mouths" as the signs a baby needs weaning; perhaps your HV should read her own literature.

Also (sorry, I am turning into one of those peope who comes stomping back into the room saying and another thing!) you might ask her what exactly is so good about baby rice?

There is a lot of new evidence that weaning should be between 4 and 6 months at the latest. Your HV is more upto date than the NHS guidelines.
The US has just changed it's guidelines back to 4-6 months because of the rise in allergies and many other european countries advice 4-6 months

ESPGHAN Medical Position Paper

Infant Feeding and Allergy Prevention

EAT Study

introduction of solids allergy research

www.babyledweaning.com is a good starting point, as is the book Baby Led Weaning by Gill Rapley.

(Sorry it took me a while to come back!)

bruffin, while I'm open to new research, not sure your links are that supportive of change. The ESPGHSAN paper still says that

"On the basis of available data, the Committee considers that exclusive or full breast-feeding for around 6 months is a desirable goal" and the EAT study is ongoing and has yet to report. The Finnish article is interesting, but is a single study, and it seemed that only reactions to oats and potatoes were affected by introduction after 4mo. The median duration of breastfeeding was also quite low. I'd rather see more reviews - something by Cochrane - on new research, before assuming that guidelines should be changed.

you have missed this

"Complementary feeding (ie, solid foods and liquids
other than breast milk or infant formula and follow-on formula)
should not be introduced before 17 weeks and not later than 26 weeks"

It was enough to support change for the AAP

It's still one small study, isn't it - so, while I agree it is interesting, I'm sticking to my "middle of the first year" (rather than 6 months to the day) approach, and letting her decide when she is ready and able.
Is it all exclusively about allergies?

No it's not one small study, its a medical position paper by European and North American Peadiatric Gaestentologists, herpatologists and nutricianists.It covers many studies.

My DS had silent reflux and we were very fortunate to have him seen by two doctors - one a gastro-paed (at the Portland) and the other a paed dietician (Harley Street). (I only mention where they work as an indication that they are highly regarded in their field). They showed me the ESPHGAN paper and talked me through it - I was reluctant to wean early and was nervous about introducing protein before 6 months, especially because of (IMO, misleading) government campaigns such as, "food is fun till one".

They basically said exactly what the OP's HV said. Weaning needs to start at 4-5 months with simple foods so that BY 6 months there is substantial protein in the diet. The protein is essential for their growth and brain development (protein from BF, FF and vegetable sources does not contain complete amino acids, so lentils are not sufficient!). Additionally most iron reserves have depleted by 6 months (not overnight, but gradually from about 4/5 months) so iron needs to be supplemented by food (again, milk contains iron that is difficult to absorb).

Ironically, most mothers who weaned post-6 months raise the issue of allergies, when the research now indicates that it is the late introduction of food which causes them!

However, it is such a contentious debate (a bit like the BF/FF one) because it is hugely emotive. But certainly the doctors I saw were really hoping that government guidelines would change. Maybe now they are starting to?!

Oh so it is - sorry I've been up for 2 nights with a teething baby and am not at my sharpest!
Am really interested in this. It's not all about the allergies though, is it; what is your (general "you", to everybody) opinion on the baby being ready to feed herself meaning she is ready for solids? E.g. my DD2 swiped a floret of cauli from my plate at 5 1/2 months and ate it - which I took as an indicator that she was ready for weaning! I hadn't waited until then because of any particular worries about allergies (though of course the fact that we are all told to wean at 6 months was in my mind), but because she had seemed perfectly content on breastmilk and it hadn't really crossed my mind that she needed anything else.

Boogeek - I think that is where part of the confusion lies - exclusive breastfeeding for the first 6 months has been so heavily promoted, as has the slogan, "food is fun till one", that many mums have understandably felt that it is in their best interests of their child to leave the introduction of food till as late as possible. The nutritional importance/benefits of weaning have been sidelined and poorly explained to mothers.

frazzles, were they therefore saying that you couldn't raise children on vegan diets?

Not sure that having private practice makes you any more eminent as a doctor/researcher, tbh.

Bruffin, I didn't miss it, but - exclusive bf-ing for 6 mo as a desirable goal suggests that the ESPGHSAN still supports starting at 26 weeks (for bf babies), while saying no earlier than 17. That sounds much like current NHS guidelines to me.

Habbibu - yes, they are saying that you shouldn't raise children on a vegan diet, for exactly those reasons. I have 2 vegan friends who both take supplements because vegan diets are insufficient in all nutrients.

FWIW, both doctors also practise in the NHS!! I was just fortunate enough to be able to see them straight away in their PP, rather than wait on the NHS.

No, I guessed they'd also be NHS - just meant that I set more store by that than private practice in terms of research, etc - it;s not what pp is about, after all.

Not vegan, just curious - what about vegetarian?

I'm not sure it's quite the big issue - it kind of depends on how you wean and what you assume a baby is capable of at 6 mo - I weaned both of mine straight on to what we were having at 6 mo, so protein etc straight away, no careful introduction of one taste at a time. they self fed and ate lots very quickly. If at 6 mo you start to wean as you would a 4mo, then I guess that would be different. The ESPetc paper had quite low expectations of the self-feeding abilities of 6 mo, I thought.

OK I am still pondering this. Surely the children with allergies who are older than about 6 or 7 were weaned around 4 months (assuming parents followed the guidelines of the time) not at 6 months?

I don't think vegetarian is ideal either tbh - as I mentioned earlier, I understand that vegetable proteins do not contain complete amino acids. I am sure it is possible to boost the diet with supplements, but personally I would rather avoid although I appreciate it must be difficult to prepare food for your child if you don't eat it yourself!

I agree that how you wean is also important. There are endless threads on here about milk being the most important nutrition till one, when this simply is not the case. I also understand the perceived benefits of just BLW, but the reality is that many babies can't self-feed sufficient amounts of food at this age and tend to play with it. Perhaps, therefore, there needs to be sensible guidance that encourages feeding puree (for nutritional benefits) in conjunction with BLW to encourage self feeding?

Well, perhaps neither should be pushed - I have 2 major spoon-refusers, so feeding puree would have bene nigh on impossible; but to watch your child and respond accordingly - it's a population-level risk, after all, and if a child is eating well by self-feeding, why should you have to try to feed puree? At the very least "puree" is unecessary at 6mo - they'll cope with mashed food just fine, and with more rapid introduction of different tastes, textures, etc.

Milk is probably still the key source of (say) calories etc well through the weaning process - problem is "most important nutrition" is open to interpretation and definition.

There are whole cultures that are vegetarian, and whole cultures that survive almost exclusively on meat - it seems odd to write off these as being somehow nutritionally deficient; while I don't dispute what your doctors said, i'd be interested more in what a big meta-analysis by something like the Cochrane collaboration came up with.

boogeek - not sure how long the guidelines have been 6mo, but there's also a variation between what guidelines were and what people did - the latter is key, as the former is meaningless if no-one actually adhered to them.