Solids at four months?

How, when and why to introduce foods other than breastmilk

Postby flaneur » Sat Jan 22, 2011 2:22 pm

BIN - thank you - that makes me feel a bit better about making an informed decision. I've had a tough BFing journey so far, (as EmilyKate knows!) so I feel that to introduce formula would be a personal fail for me. I understand people introduce formula for all sorts of reasons, but i've really been hoping to avoid it.

EmilyKate - hi again! Looks like just as we overcome one hurdle, another appears, hey?!

Off to do some reading on this sunny afternoon for me then.
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Postby EmilyKate » Sat Jan 22, 2011 2:36 pm

So true flaneur! Enjoy the sunshine!
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hmm

Postby studentmum » Sun May 08, 2011 4:43 pm

So, I understand the recommendations and for my first 3 kids it wasn't an issue, none of them showed any interest in food before 10 months.

What I am facing ATM is a baby who is hungry. He was born on Jan 2 so with Feb in the count he is possibly close to the 4 month mark. I would never consider formula top ups so that is not an option.

I demand bf and he feeds a lot which is fine by me but in the wee hours of the morning he often feeds every hour which leads to him having terrible tummy pains and stinky gas.

Other info I can think of...

He was born 11lb 3oz/5075g and is currently about 8kg and in sz 0-1, he is not fat (although he does have big chubby thighs) he is just very long.

He says "hungee" which gets him a bf. He drools at foods others are eating and has displayed chewing (not tongue pushing) he also makes "ah ah" (happy) sounds when food is around - he is usually on my knee when I eat so this happens a lot.

I am iron deficient (significantly) and this cannot be corrected by upping my intake of iron, it is a blood disorder.

I am also feeding my 2 yr old but he always finishes the breast bub has had his fill of last. If bub has recently only fed for a short time I save the hind milk for him and big DS has the other breast.

So I am unsure about this food issue although I am exhausted I still kinda feel that everything is good for bub...

Any advice???

Ta :D
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Postby breastfeedingisnormal » Sun May 08, 2011 6:05 pm

Hi there
this one might be worth a call to the helpline. 1800 686 268. It's free. They're there all weekend. They're there 24 hours. (But please saver after 10 or before 6 for emergencies.) I am not sure I understand what the issue is. Are you saying that you have a 4 month old baby who is talking? That would be incredibly unusual. Many babies of this age become very interested in solid foods but all the research tells us that their guts and immune systems are not ready to handle them until they are six months old. Just because they are interested in doing what you are doing (normal developmental stage) doesn't mean they are ready to begin weaning (which is what happens as soon as you start solids.)
It sounds like pretty normal 4 month old behaviour. Use the search function to search 'four month monsters' and you'll find plenty of discussions about perfectly lovely babies who become feral monsters at this age.
Iron deficiency anaemia can influence milk production. What is happening with DS's nappies? Any change? Lots of wet and copious unformed yellow poo tells you that he's getting enough milk. If not, is a transfusion (or infusion) an option?
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Postby Ezekielsmummy » Sun May 08, 2011 9:15 pm

we din't start solids till my DS was 1 wek off 9 months because we were tracelling in countries where food was dubious - my Dr said that was fine as long as i kept up lots of breastfeeds - my DS is now 2 and a half and super healthy not ever been sick even with a cold and loves his food no allergies or anything...
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Postby studentmum » Tue May 10, 2011 1:37 am

Thanks n,
Main issue would be my energy levels and mild concern that he is hungry (and therefore irritable and a poor sleeper) due to lack of quality &/or quantity of milk.

He rarely poos but neither did my first two, once a week maybe, which I was told was normal (or rather 'fine' for bf babies with my first)

He doesn't say hungry as such, it is an intonation with a whinge that starts on a 'h-n' sound and ends with a 'g' sound, very distinct just before crying for a bf begins, if I hear him whinging h-n-g he gets fed before he cries. My first did it also, second for a very short time too.

I think I am more tired than concerned, I am sticking with that at the moment and he looks healthy. I am due a weigh and immunisation with the chn, she is just a bit of a judgemental, uninterested thing to be honest, she frowns upon my home water birth saying with a bub his size he must've had shoulder dystocia and I was lucky he didn't have issues from lack of oxygen, told me I shouldn't still be babying my 2yr old by bfing him and was annoyed when I refused the live rotavirus vax... Rural healthcare, I love it.

I think I will just comfort myself with more support in here (try the thread suggested) and not worry about bub.
Ta
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Postby breastfeedingisnormal » Tue May 10, 2011 7:14 am

Hi Sarah
I reckon your fatigue is almost entirely due to iron deficiency anaemia. Can you see you GP or specialist about that? I have a number of friends who have this problem and they feel entirely revived after an infusion or transfusion.
As for your MCH nurse, is there some reason you keep putting yourself through that? Surely there's a scale at a pharmacy in your town that you could use to check your bub's weight each month? And a GP who might do the shots. I know life in a small town can be tricky but have you thought about writing to the Director of Service to tell her/him about your experience? The service will not improve if no-on knows there's a problem.
Have a look at www.thewonderweeks.com I would say that the wonder week almost entirely explains your LO's behaviour. Assuming your LO is growing into/out of his clothes, is having 5 heavy wet disposable nappies a day, his poos are copious (up the back, down the legs) and unformed (liquid or paste) then you can be sure he's getting enough to eat.
That said, you need to address your own health issues. Iron deficiency can be insidious and can affect your breastfed baby.
cheers
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Postby studentmum » Tue May 10, 2011 2:48 pm

I have had specialists in the past who have found no way to increase my iron, the amount going in is not the problem but rather how my body stores and uses (or rather doesn't use) the iron. The condition is not classified as an anaemia.
No scales in town but I have scales that he would register on anyway, there is a clinic at the hospital that does vax along with a whole host of other things at inconvenient times and with no booking i.e. Take the baby and 2 yr old, get triaged and wait...so seeing her for vax is easier, I have only been once so perhaps it was a 'bad day' - I'll see what she's like this time and if she annoys me I'll let her know and see what her response is.
Back to bub, he certainly doesn't have big poos, I just recall the same concern with DD 1 & she was little & a slow gainer so i was continually harrassed about bf, told to top up and feed from 4mths.
Old concerns die hard???
I think we'll be okay :D
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Postby EthansMumma » Fri Jul 01, 2011 5:40 pm

[quote="flaneur"]I've read through this thread, and am more confused than ever. There is obviously a lot of hostility around this topic, which I find quite sad, as I thought the ABA was supposed to be a supportive organisation.

Dear Flaneur, I too have been reading through this thread and found the hostility in the topic really disappointing and disrespectful. All we want to do is do what is best for our child which is why we are breastfeeding in the first place. My son is almost 5 months old and I will be returning to work when he is 6 months so have been trying to express everyday to enable my husband to feed him whilst I am at work and this is very difficult and time consuming, taking me away from giving lots of love and cuddles to my child who is still feeding every 2.5 hours around the clock! I am lucky that when I return to work my beautiful son will be able to come in for lunch each day for a feed, however I would still like to have started him on a little bit of solids before I return to work to ease the transition for my hubby. Anyway thank you for speaking out in a forum that seems more alienating than supportive.
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Postby Squip » Fri Jul 01, 2011 6:12 pm

Hi, I just wanted to add my two cents to this discussion. I did post graduate studies in child health nursing (as they are known as CHNs in WA). So I could be working as a child health nurse now, if I was able (full time work unsuitable at the mo). Anyway, nowhere in my studies did I learn about breastfeeding, apart from that we need to be following NHMRC and WHO guidelines. We were directed to ABA as the expert on breastfeeding, HPs are also able to call the helpline and get up to date with a professional subscription.

What I'm trying to say is that subjects such as breastfeeding are specialised fields of knowledge and there are big differences in how much health professionals know about it. Some people are up to date, a lot are not.

And personal experience... I expressed at work until my DD was 15 months, she refused (and I mean refused) to eat anything at all until about eight months and was very slow with eating. It was hard, I had a very busy job at the time and I had mastitis 8 times in total. But I'm glad I did, I stopped BF at 23 months and she has been unwell on and off ever since. Coincidence maybe but it provides me with motivation to do it again for next one.
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Postby lilysmum21 » Fri Jul 01, 2011 9:01 pm

nice 2 cents worth! well done on your bfing:-) I find this a really interesting topic so I'll add mine too:
I read the whole thread and found alot of the comments very interesting...Maybe I am not a professional, maybe I have not done a great deal of research on the topic (just a bit), maybe I have only one child and maybe I have no idea what I'm talking about but I do know this: I know MY child, I know absolutely everything there is to know about her and I know her better than anyone else in the world. Yes I will always take into account recommendations and advice-whilst rememberring that some HPs are not up to date, some family members have their own ideals and older recommendations that they go by and that independant bodies like the aba are more specialised in their field and do not have anything to gain (financially etc) from the advice they give and so may be more accurate. However, IMO if someone is telling me something that does not make sense to me and that I know will not suit my daughter, then I will go with my gut.
I started farex at 5 months-it was awful-constipating and smelled bad. BLS was great (recommended by the wonderful forum ladies) and worked well. DD ate some of it and didn't eat other parts of it, but that didn't matter because I knew it was more about development and play than actually eating. If, considering the research, some people would suggest that my decision to start dd on BLS at 5 months was poor, then this is one of those instances where I say :smt019 to the research.
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Postby mum to jess » Fri Jul 01, 2011 10:19 pm

marchbean wrote:I wrote to the NHMRC to enquire about any changes to the guidelines (as many HPs are claiming) Copy of the reply -


The Dietary Guidelines for Children and Adolescents including the Infant Feeding Guidelines for Health Workers (2003) represents NHMRC's current nutrition advice, i.e. exclusive breastfeeding of infants up to 6 months of age.

Your local health care clinic nurse may be referring to the fact that NHMRC is currently revising this publication. The revision will take several years (the revised publication is expected to be released in mid 2011) because NHMRC is undertaking an extensive systematic literature review (SLR) to review and update all the relevant evidence that underpins the guideline recommendations.

It is possible that some of the recommendations will change for the revised publication, however it is not possible to know this at present because the SLR is still underway. A draft version of the revised publication is expected to be publicly released for comment in December 2010. The 2003 publication will remain current until the final version of the revised publication is released in 2011. Information on the review can be found at http://www.nhmrc.gov.au/your_health/hea ... review.htm.

I hope this information is of assistance.




Does anyone know if the draft version or the final version is available yet?
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Postby fiizz » Wed Jul 06, 2011 9:12 pm

little n had his 4 month check up today and the gp said to me " some people feel like they can start solids at four months, but looking at ds id say hes getting just what he needs from breast milk at the moment so keep at it" was plesantly surprised! also said that its better that they show signs of being "ready" was lovely
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Postby flaneur » Fri Jul 15, 2011 9:49 pm

Ethansmumma- thank you :) Good luck with your return to work. It sounds like you have a really supportive DH and workplace which is really lovely. I hope your little DS is going well whether you've decided to continue to exclusively BF or introduce some solids.

I just wanted to write a little update to my story. i ended up introducing rice cereal at just over 4 months, then a little cooked pureed pear after that. DD has taken so well to her food. She is now 9months and eating wonderfully, as well as BFing on demand (4-5 times a day and any time she wakes at night).

I did have to give her formula for one feed on any of the three days i'm at work when DH can't get her settled on food alone. This has only been since she was about 7 months and no more than twice a week. i just found my lunch break at work too short to both express and eat!

Anyway, despite the mummy guilt my daughter is doing well and is superbly healthy.

Good luck to all those considering when to introduce solids!
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Postby julpul » Tue Jul 19, 2011 7:49 pm

Hi, I just wanted to say this has been an enthralling read, and I didn't find it hostile. BIN is right in terms of who to believe: the WHO guidelines trump everything else every time. I am a paediatrician and am horrified at some of the things I hear my colleagues recommending. We don't have the time to do extensive literature searches on every topic so we just repeat what we last heard, usually at a drug company lunch or a conference. We don't remember all the details either, but numbers do get remembered well. Last year I went to a dinner and talk sponsored by a formula company, on timing of introducing solids. It was given by a well known researcher, and I learned a lot. Basically she said everything that BIN has already said, and specifically said breastfeeding should be continued while solids are introduced. She spent a lot of time talking about the incredible probiotics present in breastmilk (which are now being added to ABM) so I was proud to tell her I was still breastfeeding my 3 year old while also pregnant. The formula company reps were lovely and didn't try to push their products. So basically, this was a great opportunity to be up-to-date on this topic, yet there were only a handful of paediatricians and dieticians there. This is why you must take people's advice with a grain of salt. Most doctors will be up to date in an area they are particularly interested in but there are so many different areas it's not possible to be completely up to date with everything. I usually tell patients if I know I'm not current on something. For me with my son, I had heard something from the ABA about 'delaying' solids until 6 months. I don't even remember why. I did it though and am glad. For my 5 month old daughter I'll be doing BLW as I'm convinced this is right. So the age is irrelevant and doesn't bear thinking about; she won't developmentally be swallowing food before 7-8 months anyway. Bit by bit I'm discarding well-held societal beliefs about everything to do with rearing children - and loving it! :D :D :D
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