I always accepted on good faith the WHO/NHS advice that exclusive breastfeeding for 6 months is the ideal. I am well aware of the risks associated with introducing formula milk and breastfeeding cessation, but what is the actual evidence against introducing solids before 6 months while continuing to breastfeed?
An interesting analysis in the BMJ recently (Fewtrell M et al 2011) raises the issue. Evidence for the advice is apparently quite weak, especially as 6-months-exclusively-breastfed infants represent less than 1% of infants. Also, there are risks to waiting too long to introduce solid food, the most well-known being iron-deficiency. It may even be that there is a 'critical window' during which to introduce foods in such a way as to minimise risk of development of allergies, ie not too early, but not too late either. A couple of studies point to increased incidence of coeliac disease when gluten was introduced before 3 months or after 6 months. They make the interesting point that prolonged exclusive breastfeeding may affect the window of opportunity to introduce bitter foods and later dislike of vegetables.
Since I was somewhat anaemic in the latter stages of pregnancy, although cord clamping was delayed, I am a little more concerned about Aruna's own iron stores. I am not now so keen to follow guidelines to the letter if they aren't backed up with sound reason. I liked this:
"Signalling of hunger by the infant is probably an evolved mechanism that individualises timing of weaning for a mother-infant pair" (from Reilly & Wells 2005)
So I'll give it a little more time but perhaps we will venture into a few first tastes sooner than planned. Oh, and I intend to breastfeed for as long as possible.
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(1) BMJ 342: 209-212
(2) Reilly JJ, Wells JC (1995) Duration of exclusive breastfeeding: introduction of complementary feeding may be necessary before 6 months of age. Br J Nutr 94:869-72
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