Wondrous Weaning

My kids may be well past their weaning ages, but if there's one thing I remember vividly it's that weaning was a daunting mountain for me as a first time mum and that the information out there wasn't really in line with what I was looking for. I was concerned with low weight gain, and when presented with having to prepare purees, there was a whole range of vegetables that I'd never cooked in my life. As an almost vegetarian household I also had to make decisions about if, how and when to introduce meat to my child's diet. I remember the patchy information provided by the health visitor team, which effectively presented us with leaflets and 3 purees of varying consistency, and gave an opportunity to buy a masher and puree tool at discount prices.

I'm much more relaxed this time around, but weaning was still a worry. By now I'd heard of baby led weaning and when Snowflake refused the spoon, I didn't worry and just let her eat whatever I was having. She didn't eat much and still doesn't, but she delights in food now and gets utterly excited about the announcement of "dinner time".

In a way I felt a bit let down both times around with the support available at this critical time in a baby's life.
Put it into context, we are experiencing an explosion of childhood obesity, with 30% of primary aged children in Scotland being overweight or obese. It's not just about kids being a bit heavier than they should, obesity leads to shorter lives, and these short lives are not as fun filled (with a family history of obesity and obesity related illnesses, I know this all too well).

So it strikes me that a bit of support and information that makes sense at this crucial stage might be a good idea. I did a bit of research on what's been proven to be the good and the bad in weaning for later life health and found out some interesting facts that even after 5 1/2 years of being a mum were new to me.

The risk of obesity and overweight is increased significantly if a baby is breastfed for less than 4 weeks AND solids are introduced before 16 weeks. This increases the risk of obesity a staggering 6 times. There is also an increased risk of obesity if a baby is formula fed AND solids are introduced after 6 months, though not as pronounced. So for the formula fed infant it's important that solids are introduced no earlier than 17 weeks and no later than 26 weeks. For breastfed babies, there is no significant increase of obesity risk depending on when solids are introduced.

Now we all know the guidelines to introduce solids no earlier than 17 weeks but ideally no earlier than 6 months. However, a whopping 51% of infants in the UK are introduced to solids before they are 16 weeks (this statistic is quite recent, Bolling et al.: 2007). This means that half of our children are put at a six fold risk of obesity from when they are not even 4 months old.

Then there's the interesting subject of protein. I won't go into the details because you'll just get all bored on me, but the bottom line is that a weaning diet rich in protein significantly increases the risk of obesity and overweight. Protein would be dairy and meat. So a diet rich in Carbohydrates is much better, and it's important to keep protein intake below carbs intake (= too much cow's milk can be bad): "Children who were overweight at 5yrs consumed significantly higher protein as a percentage of energy than non overweight children." (Scaglioni et al.: 2000)

Third up is earliest weight gain - which may be linked to protein intake. Infants who cross growth centiles upwards are hat significantly higher risk of obesity and overweight. This is particularly prominent in the first weeks of life, but the effect carries on through the first year: "Emerging evidence therefore strongly supports the first few post-natal weeks as a critical window for programming long-term health in both humans and animals" (Singhal/Lanigan: 2007). Researches aren't clear what causes this upward movement, and as it's observed mainly in formula fed infants, it may be something to do with formula being too rich in protein (although there are another few suggested causes, such as breast milk ingredients keeping insulin receptors happy and formula fed babies not being able to fully self regulate food intake). Anyeay, I wish I'd known this one earlier, it would have spared me all the worry of both my girls moving downwards on their percentiles... All I was concerned about was to get them up as high as I could, and I'm sure this is an instinct most parents share.

I also looked into the approach to weaning and how this may make a difference. There is one small study that indicates that spoon fed babies tend to be at higher risk of obesity than infants who feed themselves (baby led weaning). However the study is so small and the difference between the groups not big enough to allow for any conclusions. At the same time, the results, even if limited, indicate that baby led infants choose carbohydrate rich foods above protein rich foods which may indicate that they make food choices which are healthier for them.

So the bottom line is that it's most important to ensure solids are not introduced before 17 weeks and that most of the energy of the weaning diet comes from carbohydrates and not from protein. For formula fed babies, it's better to introduce solids before 6 months (but no earlier than 17 weeks), while for breastfed babies it doesn't matter.

References:
1.Rebecca Kendall. Weaning: Risk Factors for the Development of Overweight and Obesity in Childhood - A Systematic Review (2011)
2. A. Singhal and J. Lanigan. Breastfeeding, early growth and later obesity (2007)
3. Susanna Huh. "Timing of Solid Food Introduction and Risk of Obesity in Preschool-Aged Children" (2011)
4. E. Townsend and NJ Pitchford. "Baby knows best? The impact of weaning style on food preferences and body mass index in early childhood in a case-controlled sample (2012)

Hard Lesson

Snowflake is hitting the 7 month mark. This past month should be all about our weaning journey and yes, maybe it is, just that somehow, she's still as good as a milk baby. Short of force feeding her, she won't take solids. It's all a bit disconcerting because when I introduced solids last time, Cubling went to 3 meals a day in the space of a week, loved most foods and it was all good (which of course is overly simplified - she does not touch most fruit, and still demands being spoon fed on occasions).

This time, it appears that all attempts of introducing solids fail, in spite of being relaxed about it and having a wider variety of approaches available.
So I've tried baby rice and baby porridge. Only to be faced by a tightly shut mouth and desperate attempts by Snowflake to wrestle the spoon out of my hands. Oh, and the bowl. So she gets a spoon and I try again. She wants the spoon that I hold, sticks it far into her mouth until she gags. Gets the bowl (how does she do it, she gets it every single time!), pours contents over high chair, herself and everything in general.
It is impossible.

Thankfully I can just turn to baby led weaning and pretend I'm one of the cool gang. In theory, because if I'm perfectly honest, I hate the mess of baby led weaning with a passion. Some say it's the lazy way to weaning. Hm, I thought so initially, but then realised pureeing wins over washing the floor and high chair after every single meal. I'd rather do a neat spoon job.

What makes me inclined towards baby led weaning is that I can either force the food down my little girl, or let her have the say about food intake, especially as she seems to be keen to be in control herself. If respect is at the core of our interaction, forcing her to take the spoon is more than sending the wrong message. But then I see her gag rather a lot, and for the past few day, I have also seen her bring up all her solid food with the gagging, and I'm not so sure anymore.
Mention baby-led weaning in Germany and nobody has heard of it. So I can't get  much in the line of advice from my friends. It takes a lot of confidence in an approach to go with the flow to the extent that at 7 month hardly any solid food makes it into baby's system (which of course I can tell by what comes out the other end), ginger nut biscuits being the exception to this rule.

My mantra so far is that if a baby needs food, they will take it and that eventually we all end up eating solids. Maybe she acutally doesn't need it yet. There seems to be a physical lack of readiness - she's more than keen to pick up (she even has the pinching figured out) and put in her mouth, but she cannot sit up yet or chew the bits sufficiently for them not to cause gagging. I know that some babies refused solids up to 8 months, so we still have another while to go.

Once again, letting go of having control is what being a mum is teaching me. And it still is a hard lesson.

4 months and weaning onto solids

Yesterday was Snowflakes four months' birthday.

Today there's a whole debate going about when is the best time to introduce solids to a breastfed baby.

I look at her and introducing solids is the furthest from my mind, such a small baby, and I don't want to see her grow up any quicker than needs be.

Of course the research fails to mention that early cutting of the chord depletes iron stores by 33%, so if chords weren't cut so quickly, the whole debate would be nil and void, and we could simply sit back and let baby take the lead. It seems odd then that the headlines don't ask for delaying chord clamping rather than introducing solids between 4 and 6 months.

It's not that I'm an advocate of waiting at least 6 months. It's just that those headlines are confusing.

I've seen babies who were clearly ready for weaning in their 5th months, and I've seen others who only started on solids at 8 months because they were clearly not interested. Cubling was 24 weeks, and basically she watched me eat and grabbed the food off my plate. That's readiness, not shoving a spoon into a choking mouth.

Physiologically, babies are less likely to choke at 6 months. They are less at risk of SIDS. They are less at risk of an immature gut. They are thus also less at risk to develop food intolerances. On the other hand, if it's all about iron, I do wonder how you would feed red meat to a 4 month old. The link to gluten intolerance incidentally is based on a combination of late weaning and formula feeding, so it seems to me beside the point to create a link to breastfeeding and weaning after 6 months.

Above all, there is no evidence that the report is based on research that is conclusive. No new evidence, just a question mark, so what's the point of these headlines?

I've got a feeling that there is none.

I'll be back watching my girl and not worrying so much about when to introduce her to solids. We'll get there, and for now I'm enjoying the still puree free time.

*************

Snowflake:
- is slowly getting into a routine of naps, but still has lots of sleep vs very little sleep days. We had two evenings in a row where she slept for 2 hours, and I was rejoicing, started a sewing project and all that. Tonight we're back to square one and half awake cluster feeds all evening.
- still mostly hates car journeys, though sometimes will tolerate them (no rhyme or reason)
- quite likes her pram, though not today
- wants to be worn facing outwards when awake
- kicks her legs wildly when hungry or tired
- loves grabbing my hair, my necklace, my top
- loves chewing/sucking on fabric and eating her fists (until she makes herself sick...)
- will sometimes have a long nap in the pram now, or on the bed.
- loves to be played with and we can now even delay feeds with interesting play
- definitely laughs now, though it's a very special laugh: mostly without any sound, just a wide open mouth, occasionally accompanied by a quick dirty laughing sound. Very sweet.
- loves the bath, tummy time if not too long, and her big sister still gets the biggest smiles
- is still exclusively breastfed much to my surprise. I was determined to take things easy this time around and not fret about the odd formula feed. And look at it, the instant formula cartons and new bottles are untouched. I have no idea how often she feeds, don't watch the clock, I think feeding to sleep is the best thing since sliced bread and I'm only ever so slightly hoping that maybe the evening clusterfeeds (which are really due to overstimulated and tired baby that can't quite drop off to a good sleep) could become a thing of the past. I can see it coming though and am not too worried.
- is totally fascinated by lights