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?

shocking grammar! apologies.

I too had a spoon-refuser, but my point is that there are some mums who have taken guidelines and catchphrases very literally and are giving their 10mo (say) a mostly milk diet, supplemented with a few toast soldiers and carrot sticks thinking that it is a sufficient diet...

I don't know the answer to your suggestion about vegetarian cultures, but yes, perhaps their nutrition is deficient? I would be interested to know.

American dietetic assoc are ok with it

And ESPGHSAN happy with vegetarian but not vegan

Yes but my point was that (given how many people wean at 4 months now the guidelines are 6) I would be hugely surprised if a large proportion of the population weren't weaning until 6 months when the guidelines were 4 - they'd be likely to do it even more early. So blaming allergies on late introduction of solids doesn't make that much sense. But I think I need to go to bed
(Vegetarians need to be careful to combine protein sources as there are very few vegetable sources of all amino acids - though i believe quinoa is one of the few. But as long as they eat, say, rice and beans, or cheese and beans, or lentils with yogurt (!) then they will get all the essential aas.)

I think I was agreeing with you, boo! I think wwhat I was saying was that even if the guidelines were 6 for ages, most people, as you say, prob didn't do that.

Ah sorry. I don't know if I am coming or going today (but mostly I am on here...)

No problem. I'm not doing v well on the articulacy stuff today.

Boo the reason for the EAT study is the rise in allergies is coincidental with a 2/3 reduction of early weaning. Allergies always existed but just looking on MN there seem to be so many more babies now with allergies.

bruffin, you say the AAP has just changed its guidance from 6 mths excl bf....can you give me a link to this? I wonder if you are mistaken about this?

The links you give are really not evidence of undermining the 6 mths guideline.

The EAT study is a very specific on going investigation linked with allergies - it won't even report its findings for quite some time.

The ESPGHAN review confirms no sooner than 4 mths, no later than 6 - it's not evidence that guidance should change, as guidance is more or less that ('allowing' weaning no earlier than 4 mths). There is no evidence of babies benefitting from solids earlier than 6 mths.

I think you are incorrect about other European countries and 4-6 mths, except in the sense that the guidance points out that if parents want to wean earlier than 6 mths they should be careful not to do it before 4 mths.

The OP's HV is incorrect - there is no concern about proteins at all. There is no reason to start at 5 mths for most babies.

This is from the Europrevall review which I linked to above

Table 1. Summary of international infant feeding practices
Exclusive breastfeeding to 6 months (all infants) Australia, Czech Republic, Denmark, Greece, Iceland, Ireland, Italy, Lithuania, South Africa, UK
Use of partially hydrolysed formula (high-risk infants) Australia, Czech Republic, France, Germany, Lithuania, Netherlands, Poland, Russia, USA*
Use of extensively hydrolysed formula for (high-risk infants) Australia, Denmark, Germany, Ireland, Italy, Poland, Russia, Spain, USA*
Introduction of solids after 6 months (all infants) Australia, Czech Republic, Denmark, Iceland, Ireland, Lithuania, Netherlands, South Africa, UK
Introduction of solids 4?6 months (all infants) Austria, France, Germany, Greece, Italy, Poland, Russia (3 months), Spain, USA
Delayed introduction of allergenic foods (high-risk infants?) Australia?, Czech Republic, France, Germany?, Greece, Lithuania, Poland, Russia, UK (peanut only)
Detailed guidance regarding order of food introduction (all infants) Australia, Austria, Czech Republic, Denmark, France, Greece, Iceland, Poland, Russia, South Africa
*These countries do not specify which type of hydrolysed formula.
?For some countries recommendation is for all infants (see Appendix 4 for details).
?Recently revised and now delayed introduction of allergenic foods no longer recommended for high-risk infants by peak body.

Also from the Europrevall paper

"However, AAP has now revised its guidelines based on the lack of evidence of their effectiveness in preventing food allergy and no longer recommend delaying the introduction of allergenic foods beyond 4?6 months (11)."

The AAp website no longer gives a date it just says sitting up and reaching for food.

The whole point is that there have been scaremongers on this board basically saying if you wean before 6 months that you will be doing all sorts of harm, there is no evidence that weaning after 4 months does any harm at all.
Yes the EAT study is early days but the reason behind it is the rise in allergies since the later weaning guidelines. The EAT study is actually introducing certain foods at 3 months to see if that improve matters

You're confusing the guidance about allergies with the routine guidance for weaning, bruffin.

The 6 month guidance has never been about allergies - despite what might have been said on the mumsnet boards

The 6 mth recommendation for exclusive bf is based on our best knowledge of infant nutritional needs. There is no evidence that infants need anything but breastmilk before the age of 6 mths, no evidence of benefits if solids are given before this age, and some evidence of increased risk of gastro conditions.

Babies show signs of being ready for solids with various behaviours. These happen in most babies at around 6 mths, but a few babies show them earlier. If parents want a date for the 'right' time on the calendar, they can confidently wait until 6 mths, knowing that for the vast majority of babies, this date means the baby is ready to enjoy and digest and handle a variety of foods alongside breastmilk.

The HV who spoke to the OP is plain wrong - there is no need to worry about protein intake in a healthy, normal baby of 6 mths and therefore no need to start the baby on rice and veg at 5 mths.

The AAP statement on age for intro'ing other foods is still six months (as far as I know) and has not been changed. There will be very few infants 'sitting up and reaching for food' at 4 mths.

AAP website guidelines 4-6 months

The AAP have been setting up a new website and sometimes the link is to their older guidelines which does not give a date.

mosschops I can't believe your baby's 5 months old already

It's very odd. Looks like what the AAP say to mothers is a bit different from their policy statement...aappolicy.aappublications.org

Whatever.

UK guidance is still the same with no plans to change it. OP's HV was wrong. Starting solids before 6 mths has no nutritional benefit but evidence that it is connected with allergies is not strong.

It's not just one HV Tiktok, there are lots of reports on here of HV going on some sort training courses and coming back with this advice, there is obviously some sort of change of official advice going on whether you approve of it or not.

I thought the 6 mth recommendation for exclusive bf is so that it doesn't contradict the WHO guidelines .

It is without doubt that bm is definitely preferable to what some mothers feel appropriate to feed their children. I saw a GMTV interview with a mum of 5 month old twins who was feeding them her takeaway curry, fish and chips etc because it offered a 'variety of tastes and textures'. If exclusive bf to 6 months helps to limit this ignorance and interpretation of guidelines, then fine.

What I don't get Tiktok, though, is not all babies are exclusively bf. If a child is ff, then is it okay to wean from 4-6 months..?

What can I tell ya? There is no change imminent or current in official advice in the UK - the DoH breastfeeding leads have posted on this officially in the past few weeks. I have no idea what is going on in some HV training, but if it's saying policy has changed or is about to change, it's just wrong.

It takes ages for policy and guidance to change - years and years, normally. It is never done on a whim. It took several years for the UK to adopt the WHO/Cochrane review guidance - things have to go through a number of professional and expert committees, documents go out for consultation, and it takes a while for all this to happen.

The current guidance has been in place since 2003. It applies to formula fed babies, too, frazzles, though the evidence base for formula and mixed fed babies is not as strong, because the research has been done on breastfed babies.

But just because policy takes ages to change, it doesn't mean that the current advice is accurate?

I really do appreciate that you are an expert in breastfeeding and far better read up on this than I. But that doesn't change the fact that the two specialists that I saw were both conducting research and hoping that the advice for weaning would change as they do believe that there IS a nutritional benefit to weaning before 6 months.

But then that is 'science' - two camps that refute each other. GUidelines will always change.

Frazzles, you are right that advice and guidance changes, as further evidence gets thrown into the pot and looked at...and that's a good thing.

The experts you saw still need to publish their research, with all the peer review and discussion and careful examination that comes with it...and it will be looked at in the context of other research and previous knowledge. That's good for babies - nothing should be set in stone and one drawback of guidelines is that there is a tendency for 'one size fits all', when individual needs may well differ.

I have not read anything that suggests babies risk going short of protein before six months and need extra in their diet by that time - are you sure this is what the docs you saw said to you?

(quick aside tiktok, thanks for putting that about nutritional requirements as opposed to allergy issues; I was struggling so much last time to articulate but I knew there were other considerations besides just avoidance of allergies )