The battle of the breast

Medical experts and breastfeeding advocates are debating the best age to start solids.
Medical experts and breastfeeding advocates are debating the best age to start solids. 

A push to encourage parents to give their babies solid food from four months has angered breastfeeding advocates, who say it goes against national guidelines that say “breast is best” for the first six months.

Allergy experts believe that there’s growing evidence that shows the early introduction of solids can prevent children from developing food allergies and coeliac disease. They want the National Health and Medical Research Council to change its infant feeding guidelines – currently under review – to recommend solid food from as early as four months.

In a paper published in this month's Australian Family Physician journal, Adelaide doctor Brian Symon argues that current guidelines, which recommend exclusive breastfeeding until six months, are no longer appropriate.

“The human gut has this window of opportunity, which is there from at least four months of age, and if we're to utilise that window of opportunity the baby may have a significantly lower risk of developing allergies,” Dr Symon, a clinical senior lecturer at the University of Adelaide, said.

The Australasian Society of Clinical Immunology and Allergy reviewed its advice last year, and now recommends introducing solids between four and six months.

It doesn't seem to help to delay the introduction of solids and, for certain foods, there might be a protective effect in introducing them early

It followed a study from the University of Melbourne and Murdoch Children’s Research Institute in 2010, which found that babies who were given cooked egg between four and six months were five times less likely to develop an egg allergy than babies introduced to it after 12 months.

But breastfeeding specialists say the research is inconclusive, and that babies could miss vital nutrients if weaned off breastmilk too early.

“Once you start putting other things in there like solids … [babies] take less breastmilk. That's one of the reasons the World Health Organization recommends exclusive breastfeeding until six months. It's what babies need,” said Jennifer James, a midwifery expert from the Australian Lactation Consultants Association.

“There are so few babies in Australia in particular who are exclusively breastfed to six months, so how these researchers can say it has a direct correlation with the incidence of allergies is quite startling. It's a huge leap.”

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Food allergies are rising in Western countries with the frequency of allergic disease in Australia doubling over the past 25 years.

Sydney's Westmead Children's Hospital is conducting a study into the early introduction of egg. Professor Dianne Campbell, who is leading the study, agreed that none of the research into the link between delaying solid food and allergies was conclusive.

“All you can say is it doesn't seem to help to delay the introduction of solids and, for certain foods such as egg and wheat, there might be a protective effect in introducing them early in those first four to six months,” she said.

A spokeswoman for The National Health and Medical Research Council said new infant feeding guidelines will be finalised this year, but they will stick with the six-month recommendation.

What do you think of the recommendations? Have your say in the Essential Baby forum.