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Article re bfing and intro of solids


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#26 lucky 2

Posted 16 April 2012 - 11:01 AM

QUOTE (g_uzica @ 16/04/2012, 10:52 AM) <{POST_SNAPBACK}>
Unfortunately I ate a lot of dairy and egg while pregnant and breastfeeding with DD and she became intollerant to both Cows Milk Protein and egg from about 2-3 months of age. She would rash up when coming into contact with these products and vomit if ingested (formula).

If you read the line under the sentence you quoted you will read that I wasn't saying you should or should not do this, I wouldn't know what is best, I was responding to a pp.
FTR I was completely milk product free (for my problems with them) prior to and during pregnancy and when bfing and dd still gags on milk products, she cant stand them.
As for eggs, they are a pretty common part of our diet in Australia, I can't imagine avoiding them unless you personally have a problem with them


#27 No-pants Agnodice

Posted 16 April 2012 - 11:23 AM

QUOTE (lucky 2 @ 15/04/2012, 02:07 PM) <{POST_SNAPBACK}>
I don't think that has been established (could be wrong of course), and as the article points out, how can we even study it in our Australian population when only a very small percentage of babies are actually being exclusively bfed near or at 6 months (14%? I think).


Some people may see this issue as being insignificant, ie that we are talking about such small amounts of food its a "storm in a teacup", but there are many parents who will take any guideline as gospel so this is where our health authorities need to be very clear (ie the Infant Feeding Guidelines that are based on current research, knowledge and understandings).
There are parents who when told the so-called "new" recommendations are for 4-6 months will start solids with gusto at around 4 months (or earlier) and do put their infants at risk by displacing milk out  of the diet too fast.


1. That comment about 'how did they do the research' from the lactation expert unfortunately just made her sound a bit dumb (to a researcher). It's not a Populaion level study. The make up of the Australian population is irrelevant. You recruit people into the study, and do your analysis based on the two arms of the research group. The Murdoch is a reputable organisation and it it a methodologically sound study. And a relative risk of 5 (so holding off egg protein until after 12 months is associated with a five times higher risk of later egg protein allergy as compared to introducing it at 4 months) is actually pretty impressive. The study did not look at 'all allergens' like the article made out, it was jut egg protein. The study also did not look at the difference between introducing egg protein at six months vs four months, it only compared 4-6 months vs 12+ months.

2. This is a genuine question and not meant to be inflammatory. Is there a proven dose-response effect for breast milk? If you live in a society where there isncertainly and abundant food, is there really a consequence to a decreased amount of breast milk (marginally because no 4-6 monther really fills up on solids)? I get in Africa weaning a 4 month old onto solids is dangerous if you have an unreliable food supply and no access to immunisation - but will a couple tbsp of egg or rice cereal in Austalia really displace breast milk so much that babies don't get benefit from it? I mean, sure we all assume some is good and more is better, but is there actually any proof thats true? I guess my ultimate question is - why is this breastfeeding vs allergists? Why is there a conflict of interest? And I don't feel like the conflict is coming from the allergists - they're not saying 'stop breastfeeding and give nothing but allergenic foods at four months'. But the lactation expert was saying 'no solids full stop'. Why an't we take both recommendations and implement them harmoniously? Or do we think the general population is too dumb to understand (which is just patriarchal).


#28 lucky 2

Posted 16 April 2012 - 11:40 AM

Hi MsN, I cant and wont argue with you as you will no doubt run rings around me, research is not my forte and I'm not able to engage at your level. I'm not bothered by this, it's just the way it is.
I will respond the best I can so be gentle on me biggrin.gif.
QUOTE
I guess my ultimate question is - why is this breastfeeding vs allergists? Why is there a conflict of interest? And I don't feel like the conflict is coming from the allergists - they're not saying 'stop breastfeeding and give nothing but allergenic foods at four months'. But the lactation expert was saying 'no solids full stop'. Why an't we take both recommendations and implement them harmoniously? Or do we think the general population is too dumb to understand (which is just patriarchal).

I'm interested in the opinions and recommendations of the NHMRC in regards to the official Infant Feeding Guidelines. I presume they will be looking at the evidence as it stands today (or during the review period 2010-2012).
They will look to see if there is a conflict of interest or a conflict of opinion. They will then update the guidelines accordingly.
I don't see a conflict of interest, I see a situation where there are competing influences and expansion of knowledge in this area.
I presume the new guidelines will reflect all current evidence (again I cant argue the specifics, it would be a waste of everybodies time, mine included) about what optimises the health and wellbeing of infants, that includes what type of milk diet, how long and recommendations on bringing other foods and what type of other foods.
I will be leaving it to the experts to argue it out, it seems the 6 months will stay and that tells me something as I have stated above. If they changed to 4-6 months I would also accept that, I know I don't have access to all the relevant information, I presume they do.
As for Dr James, I can't argue for her either, she's not a silly woman, I suspect as in all media representations they take "grabs" of what she has said and it would be understandable if comments were at times taken out of context.

Edited by lucky 2, 16 April 2012 - 11:46 AM.


#29 Froger

Posted 16 April 2012 - 11:42 AM

QUOTE (pookems85 @ 15/04/2012, 07:12 PM) <{POST_SNAPBACK}>
Right. So I saw something about this on the telly. Is it recommended to hold off til 6 months purely to preserve breast feeding? That's what it sounds like but I could be missing something, I'm tired. If so, what about formula fed babies? Or have I already failed him nutritionally so further failures don't matter so much? Argh, I'm in a cranky mood, aren't I?


Don't be upset with yourself pookems85. That's not going to help. I'm sure you are doing the best you can with your own personal circumstances.

My own personal thoughts on the subject as to perhaps why some people recommend that formula fed babies start solids early is not because any further "failures" don't matter so much, but because formula is a mono food and doesn't change like breastmilk, so babies may perhaps be needing different nutrients, like Omega 3's from meat or fish etc introduced earlier. As I say I really don't know, as I have no nutritional training, but I also have wondered about the difference in some recommendations between formula fed babies and breastfed babies.

Anyway, I'm not sure why celiacs and allergies were lumped in toegether, as how I understand it celiacs is not an allergy as such, but rather a genetic inability to digest gluten. No amount of holding off wheat, or alternatively introducing it early, would change this genetic inability to digest gluten I would have thought? shrug.gif

#30 Tesseract

Posted 16 April 2012 - 11:45 AM

QUOTE (MsN @ 16/04/2012, 11:23 AM) <{POST_SNAPBACK}>
2. This is a genuine question and not meant to be inflammatory. Is there a proven dose-response effect for breast milk? If you live in a society where there isncertainly and abundant food, is there really a consequence to a decreased amount of breast milk (marginally because no 4-6 monther really fills up on solids)? I get in Africa weaning a 4 month old onto solids is dangerous if you have an unreliable food supply and no access to immunisation - but will a couple tbsp of egg or rice cereal in Austalia really displace breast milk so much that babies don't get benefit from it? I mean, sure we all assume some is good and more is better, but is there actually any proof thats true? I guess my ultimate question is - why is this breastfeeding vs allergists? Why is there a conflict of interest? And I don't feel like the conflict is coming from the allergists - they're not saying 'stop breastfeeding and give nothing but allergenic foods at four months'. But the lactation expert was saying 'no solids full stop'. Why an't we take both recommendations and implement them harmoniously? Or do we think the general population is too dumb to understand (which is just patriarchal).


Great post MsN!

I want to talk about the points I've bolded:

I don't have time to hunt down references right now, but for immunological benefit there is a proven dose-response effect for breast milk. In population studies we see that exclusive breastfeeding is better than comp feeding (breastfeeding and formula), but this is better than exclusive formula feeding. So, yes, dose responsive. How this would apply to solids intake of course is not strictly shown.

4-6 monthers do fill up on solids. Or rather their carers fill them up on solids. Rice cereal in a bottle anyone? I see it all. the. time. All of the mums I have known who have introduced solids at 4 months move very quickly onto 3 meals a day ie by 5 months. Anecdotal of course. I think what happens is that once you start with the solids there is this assumption that the solids are better/more filling than breastmilk (or formula for that matter). So when your breasts are feeling a little soft in the evenings it just seems natural to give some cereal etc to "help the baby sleep". Which of course interrupts the supply/demand of milk production and it can be a slippery slope from there.

To my mind it is all about weighing up risks. Introduction of solids before 6 months is thought to be problematic for gut health and the breastfeeding relationship. But introduction of egg between 4-6 months, as opposed to 12 months, is beneficial for allergy avoidance. What I would really like to see is a study that compares introduction of egg at 4 months with introduction of egg at 6 months - is the result the same? Then we could have a proper discussion about this.

In regards to your last point, it is something I have often wondered myself. The blanket health messages relating to pregnancy and baby care are painfully simplistic, and this simplicity is causing problems. But all the research on health promotion says the messages must be simple enough for a 12 year old to understand. So I see the tension that health promoters must face. And the whole thing is patriarchal I agree.

#31 Bel Rowley

Posted 16 April 2012 - 11:55 AM

Wonderful post above Tesseract. I am not a breastfeeding counsellor (one day when I have time to do the training I hope to be) but if I had a dollar for every time I've heard my breasts aren't full/baby is still feeding overnight/baby is crying or frustrated etc etc as reasons why supposedly the baby is supposedly not filling up on breastmilk and needs solids, I'd be a rich woman. I fear if guidelines for starting solids move earlier, parents will keep pushing it earlier still. Most recently a friend of mine started her little girl on solids at 3 1/2 months because she was 'so hungry'. In my opinion cases like this have nothing to do with allergy avoidance and everything to do with unrealistic expectations about breastfeeding.

#32 lucky 2

Posted 16 April 2012 - 11:59 AM

QUOTE
will a couple tbsp of egg or rice cereal in Austalia really displace breast milk so much that babies don't get benefit from it?

After reading Tesseracts great response-
No, having a couple of tbspns of whatever will not be displacing much milk, no one could logically say it could.
But, the point I'm trying to convey is that giving other food to a baby who is under 6 months and bfing well (ie thriving) just isn't necessary from a nutritional point of view. Recommending food from 4 months conveys the message that breast milk may not be enough, ie some babies may "need" more than breast milk, but the point is that breast milk does contain everything that a baby needs up until this time.
It's not that a little bit of food will necessarily risk malnutrition (although it has happened), its that it isn't needed and potentially undermines maternal/societal confidence in the safety of exclusive bfing till around 6 months. And this is not a positive health promotion message.
But, if the allergy experts do find conclusively that it is better to bring in food (or certain foods earlier) from an allergy perspective then this would be appropriate.
There is nothing wrong with changing the guidelines  if there is a clear need to do so, but it doesn't seem that there is enough of a case to change the guidelines, otherwise the NHMRC will change them.

#33 lucky 2

Posted 16 April 2012 - 12:10 PM

QUOTE (MadameCatty @ 16/04/2012, 11:39 AM) <{POST_SNAPBACK}>
Not that I'm cynic or anything but have a look at The Australasian Society of Clinical Immunology and Allergy's sponsor page - http://www.allergy.org.au/about-ascia/sponsors

Thank you for pointing this out. There is a fight to take the dollars of parents, anything that encourages parents to feed their babies anything other than mothers milk is putting the dollars right where those companies what it, in their coffers.
I'm reading an interesting book at the moment by Gabrielle Palmer called "Complementary feeding: Nutrition, Culture and Politics", she also wrote "The Politics of Breast Feeding" many years ago, that's also a good read.
Also James Akre "The Problem with Breast Feeding".

#34 Guest_bottle~rocket_*

Posted 16 April 2012 - 10:09 PM

I can see there are two recommnedations i.e. the WHO recommendation to exclusively breastfeed for six months which logically leads to the recommendation to start solids at 6 months.  

The reality is that most babies in Australia are not exclusively breastfed for 6 months - i.e. the majority are partially or fully formula fed by six months.  This is before taking the introduction of solids into account.  

So if recommendation re: exclusive breastfeeding is not being followed for most babies in Australia then how valid is the recommendation to wait 6 months before giving solids to these babies?  

It seems that there are a lot of conflictling opinions between different stakeholders, no wonder parents are confused.  

QUOTE
There is a fight to take the dollars of parents, anything that encourages parents to feed their babies anything other than mothers milk is putting the dollars right where those companies what it, in their coffers.


Sorry to bang on again about baby-led weaning, but I think that this is why BLW has not been been researched very much or considered as an option, given the influence of the baby food industry.


#35 Froger

Posted 16 April 2012 - 10:11 PM

I read the politics of breastfeeding quite awhile ago now. It was quite eye opening. I think I'll have a read of those other two books.Thanks for posting lucky 2.

#36 skylark

Posted 16 April 2012 - 10:25 PM

I honestly think it's such a spectrum, with an incredibly wide range of "right" for a wide range of babies. The blanket recommendation needs to be just that - a recommendation, and not some immutable law.

From my own anecdata: I had a baby who was rolling round the house by 10 weeks, crawling at 4.5 months, and insane with hunger as a result. He was fully breastfed (and I fed him until 22 months so solids had no correlation with weaning), and I had so much milk that my let down was still spraying wildly like a hose, but it didn't matter - that kid needed solids and that was all there was to it.

I started him on solids at 5 months, because I had bruises all over my chest* from his constant desperate attempts to get at my breasts, but I wish I'd been told I could start him at 4 months. He fed every 45mins to 2 hours round the clock in that interim period (from say 4 to 5 months) and it set up the most dreadful sleep patterns that took months to alter and really took it out of the entire household. So I don't really care what the recommendations are, I want people to have a way of getting the care, knowledge and information to allow them to make the right choice for them, based on their individual child. 5.5 years ago the recommendation was 6 months, and it was totally wrong for my son, and I had to run the gauntlet of disapproving and discouraging ECHNs in order to start him at 5 months as a result.

PS. He is now (and always has been) a happy healthy kid with no allergies or gut trouble who eats absolutely anything you put in front of him. Which proves nothing, except that there are no absolutes, and anyone scare-mongering about solids before 6 months needs to look at in on a case by case basis.

*I have photos to prove it, he was absolutely destroying me out of his need for constant feeding.

Edited by skylark, 16 April 2012 - 10:34 PM.


#37 Flutter Bug

Posted 16 April 2012 - 10:59 PM

I haven't the time to read the whole thread but I am confused?!

During the time between having my first and second children (22 months apart) the advice on introducing solids has changed.

I was informed at our 4 months old (breastfed) baby health check the other week that solids can be introduced from 4 months (when I had DD two years ago it was 6 months). Also told that the timing of the introduction of 'allergen' foods (e.g. eggs) has no bearing on whether or not the child will experience an allergic reaction or not (hope this makes sense - i'm tired and not at all eloquent tonight!).

What I gathered from this info was that if my baby was showing an interest in food/eating when we are eating or if she is having low weight gains (which she is) then I can introduce solids now. Then to introduce the various food types progressively and not have to worry about what age she is before introducing things like eggs etc. With DD1 I remember having a list of the different foods and at what age it was OK to introduce them but now this seems to be irrelevant?

So I was planning to introduce solids to my 4 month old this week and continue to breastfeed - don't tell me I'm going to be doing my child some sort of disservice by feeding her solids early?



#38 lucky 2

Posted 16 April 2012 - 11:02 PM

QUOTE
So if recommendation re: exclusive breastfeeding is not being followed for most babies in Australia then how valid is the recommendation to wait 6 months before giving solids to these babies?

If you are referring to combination or formula fed babies, I don't know the answer to your question, that's why (IMO) complementary feeding recommendations need to take into consideration the diet of the baby (ie only breast milk or other).

#39 lucky 2

Posted 16 April 2012 - 11:14 PM

QUOTE
So I was planning to introduce solids to my 4 month old this week and continue to breastfeed - don't tell me I'm going to be doing my child some sort of disservice by feeding her solids early?

I don't know the answer. I only know what I read and there is dispute out there. That's why I'm keen on the NMHRC Infant Feeding Guidelines being released.
You can only be guided by those caring for you.
If you are unsure about solids could you ring your CHN for another chat, she knows your situation.
All the best.


#40 Guest_bottle~rocket_*

Posted 16 April 2012 - 11:22 PM

QUOTE (lucky 2 @ 16/04/2012, 11:02 PM) <{POST_SNAPBACK}>
If you are referring to combination or formula fed babies, I don't know the answer to your question, that's why (IMO) complementary feeding recommendations need to take into consideration the diet of the baby (ie only breast milk or other).


That's OK lucky2 I didn't expect that anyone would know the answer, I doubt there is one!

#41 lucky 2

Posted 16 April 2012 - 11:40 PM

Ha, I didn't expect you to expect me to answer that question... But I thought I'd give it a try biggrin.gif !



#42 organic~sab

Posted 17 April 2012 - 01:24 PM

How about breastfeeding your baby and following your baby's cues to start solid foods? We started at 6 months by offering food that he could grab and munch on. He's 14 months now and not very interested in solids. He's just started to become interested. He is breastfed on demand, he's healthy, strong and happy.




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