Deciding when to wean your baby is currently a nightmare. While official advice is very clear (“wean at six months“), the issue is clouded by the recent change in the advised weaning age, from four months to six. This has produced three confusing results: 1. Hardly anyone follows the official advice. The 2005 Infant Feeding Survey reported that the proportion of UK women exclusively breastfeeding until six months was ‘negligible’. However, the change in guidelines has successfully reduced the proportion of babies weaned prior to four months (which everyone seems to agree is too early). This makes it seem as though the new advice is there to encourage parents to wean later than four months, with no expectation that anyone will really wait until six months. 2. Food labels haven’t changed at all, while books have been updated badly. Baby food labels still recommend some foods as being suitable from four months. Books are reluctant to contradict the official advice, but apparently also reluctant to do a complete rewrite. This means you get the utterly confusing advice to start with some foods, at six months, then move on to other foods, at six months. The assumption is clearly that you won’t really start at six months, and it’s not at all clear what you’re meant to do if you wait. Do you just skip the first foods, hoping they didn’t serve a purpose, or do you start with them anyway and hope your baby doesn’t need the nutrients in the second stage foods? Which brings us to 3. The debate over the evidence. Unusually for pregnancy and parenting advice, the evidence base is publicised and debated. The government guidelines are based on the World Health Organisation’s recommendation, which is based on several studies. The overall message is that weaning too early is bad due to the baby’s under-developed digestive system, and can lead to problems such as gastroenteritis. The catch is that some of these studies were carried out in the developing world, where poorer access to nutritious food and good sanitation make late weaning a really good idea. In addition, a recent review highlighted some good reasons to consider weaning earlier. Babies’ iron levels are getting low by six months, putting them at risk of anaemia. There’s also some evidence that allergies are more likely if foods are introduced too late, as well as too early. There seems to be a window of opportunity that shouldn’t be missed. Combining all this evidence leads to the conclusion that weaning should occur at six months exactly. But of course this is silly. Babies develop at their own pace; there’s huge variation in when babies reach their developmental milestones like sitting, crawling, teething, and talking. Why would readiness for food be any different? And so, to try to incorporate this into guidelines, there are a set of signs to look for – e.g., interest in food, ability to sit unaided, and chewing motions. These, of course, are less useful than they sound. My six month baby has always wanted to grab food from me, is more interested in rolling than sitting, and how would I know about chewing without putting food in his mouth? An additional concern is that the time when you choose to introduce solid foods is not necessarily the time when your baby decides to eat them. This is particularly worrying if you choose baby-led weaning, as it may take your baby some time to get the hang of feeding himself. I was worried that if I didn’t start giving my baby solid food until 6 months he might be 7 months old before he took in appreciable amounts of nutritious food.
This is an odd rant because I don’t really feel like anyone’s to blame. It’s a difficult issue, there’s a lot of available evidence to weigh up, and at the end of the day when to wean is a subjective decision that parents have to make for their own baby. I exclusively breastfed until 24 weeks, then introduced fruit and vegetables when my baby stopped gaining weight and started waking up every hour or two all night. Then I introduced other foods quite quickly once he got to 26 weeks. Who knows if this was the right decision. My baby is healthy and eating well, but it seems like one of those issues where future generations might regard us with horror when we tell them what we did.
One of the most useful things I read was this position statement from the British Dietetic Association, which summarises the evidence and provides good, evidence-based advice.
Evidence-based rants 