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When should you start baby on solids?

Posted by Karen Faulkner on
When should you start baby on solids?
Are you confused out there about the solids debate and when you should start it?

It's reached a whole new pitch and not for the better I fear.

There was an article out in the Sunday papers (Sun Herald), last weekend, debating the whole issue of when to start. I read it and shook my head many many times.

http://www.smh.com.au/national/health/back-to-the-future-on-breastfeeding-20120414-1x0gh.html - unfortunately the article has since been removed (09/04/16)

Please read it. It'll make this, more sense to read!

The solids thing is difficult as there is little hard factual research (randomised controlled trials) in this area. We work on New South Wales National Health and Medical Research council guidelines in NSW. However these guidelines are a little at odds to the Journal of clinical immunology and allergy. They say that introducing solids earlier i.e. 4-6 months is better for reduction of allergies and early introduction of egg in a very careful way (see my blog on introduction of solids) can reduce egg allergy by five fold. Now that is huge.

However as a parent you need to be careful if you or your partner have any history of atopic disease such as asthma, eczema or hayfever. And especially if both of you have one or more of those diseases or a food intolerance or allergy (anaphylaxis). Then things are very different. In my work as a practice nurse for a GP practice in Alexandria I had a 5 month old baby present last week with what sounded like an egg reaction. There was a family history of dad having eczema. The amount of egg given was rather large. I recommend an amount of 1/8th of a teaspoon, i.e. a really small bit. Give the yolk first hard boiled for 2-3 days, once a day, then introduce the white next for 2-3 days. Again just a very small amount each day that you're trying it. Because if your child reacts it will be a smaller reaction. 

If you're worried or not sure then consult your GP or dietician and in the inner West of Sydney we have the amazing professionals at the Allergy Clinic at RPA on Layton Street. I have been there myself as a patient and I cannot speak more highly of them. My life has improved immeasurably since I worked out what my body didn't like so much.

In the Eastern suburbs of Sydney there is an allergy clinic at the Children's Hospital at Randwick. You need a referral from your GP to attend an allergy clinic.

So why are the NHMRC saying 6 months? My feeling is, that it's all to do with the breast feeding statistics. We collect stats on how many mothers exclusively breast feed their baby till 6 months of age. Exclusive breast feeding is defined as just that, breast milk. Not infant formula and not solid food.

So if we say you can give baby food at 4 months we are reducing our stats for exclusive breast feeding. Child and family health services and hospitals are judged/bench marked on their breast feeding rates. In Australia initial breast feeding rates are high (compared to what I was used to in England). We have breast feeding rates of around 80% at birth but these drop to 48% at 4 months and 14% at 6 months.

https://www.breastfeeding.asn.au/bf-info/general-breastfeeding-information/breastfeeding-rates-australia 

We know that breast feeding is beneficial to both baby and mum, that is not in dispute. However, we need to look at other factors that affect these rates. A huge one I can see, is lack of support for mums with older babies, the 4 month old ones. We concentrate on the young bubs and mothers attend groups, run by Child & Family Health Services till they're 2-3 months old. After that age the support dries up. There aren't enough Child and Family Health Nurses and the drop in clinics have fallen out of favour in place of universal home visiting. This means offering and giving a home visit to all new mothers. Again these are stats that the Child & Family Health Services are measured on. Drop in clinics are not valued by the managers. They have only so many nurses, hours to fill and benchmarks to meet....

Interestingly in England we did home visiting, as Health Visitors, on a needs basis. I had a well baby clinic at my GP's every week. Parents could ring me direct (there was no central intake). We had a Baby Friendly Initiative accreditation and I ran a community breast feeding group in Salford for over a year. My caseload was large. I had 350 families to provide support and advice for as well as developmental screening and immunisation services! I was busy but I was satisfied. The needs of my caseload were met on an equal footing. Long term support is crucial.

My breast feeding rates were good. My mothers were supported. It makes a big difference. Long term support, not just in the early days and weeks.

That's why I have chosen to work for myself, blog and work as a practice nurse. I see those babies that otherwise would have fallen through the cracks and I certainly promote breast feeding but I also look at the holistic needs of that baby and the family. It's the Health Visitor in me....

 

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