Yet another "ready for solids?"

Hi -

Since a computer crash late last year, I no longer have specific cites.
But basically, what you're doing is playing roulette. It may be that
you can start peanut butter at 4 months and have no problems. Or it may
be that you delay solids completely until 10 months and have huge
problems. But the odds are in your favor if you wait until your baby's
gut has sufficiently matured, around 6-7 months, to avoid allergies.

It's your first parenting test: do you do what your child wants, or do
you do what's healthiest for their physical well-being?

I'd certainly wait at least until the 6-month mark, regardless.

--Beth Kevles

http://web.mit.edu/kevles/www/nomilk.html -- a page for the milk-allergic
Disclaimer: Nothing in this message should be construed as medical
advice. Please consult with your own medical practicioner.

NOTE: No email is read at my MIT address. Use the AOL one if you would
like me to reply.

Akuvikate wrote:

If
you have cites or links to the research or recommendations I'd love to
see them.

These are the cites on kellymom - if you look them up and
they say anything interesting, I'd be interested.

Halken S, Host A, Hansen LG, Osterballe O. Effect of an
allergy prevention programme on incidence of atopic symptoms
in infancy. A prospective study of 159 "high-risk" infants.
Allergy 1992 Oct;47(5):545-53.

Marini A, Agosti M, Motta G, Mosca F. Effects of a dietary
and environmental prevention programme on the incidence of
allergic symptoms in high atopic risk infants: three years'
followup. Acta Pædiatr 1996;Suppl 414 vol 85:1-19.

Saarinen UM, Kajosaari M. Breastfeeding as prophylaxis
against atopic disease: prospective follow-up study until 17
years old. Lancet 1995;346:1065-69.

Savilahti E, et al. Prolonged exclusive breast feeding and
heredity as determinants in infantile atopy. Arch Dis Child.
1987 Mar;62(3):269-73.

Phoebe
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Beth Kevles wrote:

It's your first parenting test: do you do what your child wants, or do
you do what's healthiest for their physical well-being?

I know where you're coming from, but "I have no cites but
you're gambling with your child's health" really hits me
wrong, and the quote above with no cites is a just a guilt
trip. The only way for Kate (or I) to assess whether
starting solids is appropriate is to review the literature,
particularly in light of the fact that the AAP, WHO, the
working links on your page *all* say 6 months, and most
pediatricians (at least in my area) say 4 months is fine.

Phoebe
--
yahoo address is unread - substitute mailbolt

"Phoebe & Allyson" wrote in message
...
The only way for Kate (or I) to assess whether
starting solids is appropriate is to review the literature,
particularly in light of the fact that the AAP, WHO, the
working links on your page *all* say 6 months, and most
pediatricians (at least in my area) say 4 months is fine.

Phoebe
--
yahoo address is unread - substitute mailbolt


Pheobe,
No offence intended but it seems to me like you had your mind made up before
you posted your original question. If that's the case then I understand you
standing your ground so strongly but why the post in the first place then?
We started Nicolas on a couple solids at about 5 months, but we also have no
history of allergies on either side of our families and frankly Nicolas made
more of a mess than ate anything. Yep, it was totally cute the first few
times but the cuteness wore off pretty quickly because of the cleanup. If I
were you I would maybe do one or two things for pictures and then let it go
for awhile. It's an awfully weird kid that doesn't eventually eat, he'll
have a lifetime of being able to try new things. Since you have allergies on
both sides of your family why not wait and not take an unneccessary chance
on restricting his diet when he is an adult.

Jen

badgirl wrote:

it seems to me like you had your mind made up before
you posted your original question.

It wasn't my question, it was Kate's question. I had my
mind made up, so wasn't asking, but I would be willing to
have my mind changed by evidence. Not by "don't you want to
be a good parent?"

If I
were you I would maybe do one or two things for pictures and then let it go
for awhile.

I'm unaware of any (health-related) advantage to starting
solids at this age then stopping them again. As far as I've
been able to determine, it would be locking the barn door
once the horse was out.

It's an awfully weird kid that doesn't eventually eat, he'll
have a lifetime of being able to try new things.

But at some point you need to start offering, and the only
issue is when that point is (and to a lesser extent, which
things to offer when).

I can't wait until Caterpillar is succeeding at (rather than
trying) snatching things off our plates, because she's
likely to snatch peanut butter (potential allergen) from her
Grandpa or dairy (known allergen) from her Grandma or wheat
(known allergen) from her Mama or Ah-mah. I can't ban
peanuts and tree nuts and dairy and wheat (and fish and
shellfish and soy and egg and all the other things that
little allergic babies shouldn't eat) from 2 households. I
can say, "If you're going to eat in front of her, mash a
little banana for her to play in."

Since you have allergies on
both sides of your family why not wait and not take an unneccessary chance
on restricting his diet when he is an adult.

Honestly, I'm not sure it's going to help. She's obviously
been exposed to both wheat and dairy proteins through my
breastmilk. I've given up both of those in hopes that one
day she'll outgrow her allergies to them, but there's a
chance she won't.

Short of switching one of us to an elemental formula, she's
going to continue to be exposed to whatever other proteins
are getting through while I try to determine what I can eat
without making her sick. And afterwards, she's going to be
exposed to the proteins in whatever it turns out I can eat
without making her sick.

Increasing the odds that she'll develop a banana allergy
from trying it at 6 months instead of waiting for 7 or 8 or
10 or 12 months is a much more minor worry for me.

Phoebe
--
yahoo address is unread - substitute mailbolt

"Phoebe & Allyson" wrote in message
...
badgirl wrote:

it seems to me like you had your mind made up before
you posted your original question.

It wasn't my question, it was Kate's question.

Oops Sorry about that

I had my
mind made up, so wasn't asking, but I would be willing to
have my mind changed by evidence. Not by "don't you want to
be a good parent?"

Since I don't have any allergies on either side, DH's or mine, I really
don't have a reason to find the evidence. If I had some I would gladly post
it for you though.


If I
were you I would maybe do one or two things for pictures and then let it
go
for awhile.

I'm unaware of any (health-related) advantage to starting
solids at this age then stopping them again. As far as I've
been able to determine, it would be locking the barn door
once the horse was out.

Hmm, that makes sense. I would think that the more the exposure the higher
the chance of the allergy exposing it's ugly head though. Again, no
allergies, no education ;(


It's an awfully weird kid that doesn't eventually eat, he'll
have a lifetime of being able to try new things.

But at some point you need to start offering, and the only
issue is when that point is (and to a lesser extent, which
things to offer when).


I agree with that. I just think personally that if there's even the
slightest chance of the allergy being lessened by waiting then that's the
road I would take.

I can't wait until Caterpillar is succeeding at (rather than
trying) snatching things off our plates, because she's
likely to snatch peanut butter (potential allergen) from her
Grandpa or dairy (known allergen) from her Grandma or wheat
(known allergen) from her Mama or Ah-mah. I can't ban
peanuts and tree nuts and dairy and wheat (and fish and
shellfish and soy and egg and all the other things that
little allergic babies shouldn't eat) from 2 households. I
can say, "If you're going to eat in front of her, mash a
little banana for her to play in."

Yeah, that has got to be pretty rough. But hopefully they can understand the
risk they would be taking by not offering something safe for her to want to
snatch.


Since you have allergies on
both sides of your family why not wait and not take an unneccessary
chance
on restricting his diet when he is an adult.

Honestly, I'm not sure it's going to help. She's obviously
been exposed to both wheat and dairy proteins through my
breastmilk. I've given up both of those in hopes that one
day she'll outgrow her allergies to them, but there's a
chance she won't.

Isn't it different being exposed to it through breastmilk as opposed to
solids though? I mean, if there were a problem with something in your milk
wouldn't she have already had a reaction?


Short of switching one of us to an elemental formula, she's
going to continue to be exposed to whatever other proteins
are getting through while I try to determine what I can eat
without making her sick. And afterwards, she's going to be
exposed to the proteins in whatever it turns out I can eat
without making her sick.

Increasing the odds that she'll develop a banana allergy
from trying it at 6 months instead of waiting for 7 or 8 or
10 or 12 months is a much more minor worry for me.

At least if it's only one food though it won't be such a bad restriction. I
couldn't imagine not being able to eat whatever I want to because they could
be potentially life threatening (sea food is typical for that isn't it?)
I am that much more thankful that I don't have allergies in my family
because frankly I LIKE to eat

Jen

Phoebe
--
yahoo address is unread - substitute mailbolt

In article h4Atb.163818$ao4.532013@attbi_s51, badgirl wrote:

"Phoebe & Allyson" wrote in message
...
But at some point you need to start offering, and the only
issue is when that point is (and to a lesser extent, which
things to offer when).

I agree with that. I just think personally that if there's even the
slightest chance of the allergy being lessened by waiting then that's the
road I would take.

Then you have to *never* feed your children potentially allergenic
foods, and darn near everything is potentially allergenic. If you
never feed it - you'll never see an allergy.

Elaine

badgirl wrote:

if there were a problem with something in your milk
wouldn't she have already had a reaction?

She has had a reaction - she gets eczema if I have anything
with milk in it, and GI symptoms to wheat and possibly
shellfish (which I've been scrupulously avoiding since
discovering it's a possible trigger for her, but who knows
what damage has already been done).

My (completely unscientific) opinion is that if 50% of women
"leak" peanut protein into their milk (which some study has
shown), that it's possible that a similar percentage of
women have other proteins from food they eat in their milk.
Some babies will react, some won't. Mine reacts to some,
but a lack of reaction doesn't mean she isn't being exposed
to others.


At least if it's only one food though it won't be such a bad restriction. I
couldn't imagine not being able to eat whatever I want to because they could
be potentially life threatening (sea food is typical for that isn't it?)

Potentially life-threatening would be really scary for me,
too. But not being able to eat things isn't that miserable
once you get used to it - after giving up dairy, wheat's
been pretty easy (lots of wheat things have dairy, so were
out already). And I know what I'm missing.

Phoebe
--
yahoo address is unread - substitute mailbolt

Elaine wrote:

Then you have to *never* feed your children potentially allergenic
foods, and darn near everything is potentially allergenic. If you
never feed it - you'll never see an allergy.

Yes! That's exactly my problem. I could have a darn good
shot at guaranteeing hypothetical Baby#2 a food allergy-free
existence by starting it on elemental formula from birth,
and never ever introducing solids. Not to say that PB&J and
chocolate milk are good first foods for 2-week olds, but
there must be some happy medium. Unfortunately, it's hard
to know what will turn out to have been the right decision.

Phoebe
--
yahoo address is unread - substitute mailbolt

Phoebe & Allyson wrote:

Akuvikate wrote:
I've seen the 7 months figure cited here but haven't found it anywhere
else [snip] If
you have cites or links to the research or recommendations I'd love to
see them.

These are the cites on kellymom - if you look them up and
they say anything interesting, I'd be interested.

Full Medline abstracts are appended. Not one uses 7 months as an
exclusive breastfeeding endpoint.

Halken S, Host A, Hansen LG, Osterballe O. Effect of an
allergy prevention programme on incidence of atopic symptoms
in infancy. A prospective study of 159 "high-risk" infants.
Allergy 1992 Oct;47(5):545-53.

Six months

Marini A, Agosti M, Motta G, Mosca F. Effects of a dietary
and environmental prevention programme on the incidence of
allergic symptoms in high atopic risk infants: three years'
followup. Acta Pædiatr 1996;Suppl 414 vol 85:1-19.

4-6 months

Saarinen UM, Kajosaari M. Breastfeeding as prophylaxis
against atopic disease: prospective follow-up study until 17
years old. Lancet 1995;346:1065-69.

6 months


Savilahti E, et al. Prolonged exclusive breast feeding and
heredity as determinants in infantile atopy. Arch Dis Child.
1987 Mar;62(3):269-73.

Conclusion does not actually support prolonged exclusive breastfeeding
for allergy prevention in atopic families at all (I would need the full
study to assess the validity of their conclusion).

Lara
===
Effect of an allergy prevention programme on incidence of atopic
symptoms in infancy. A prospective study of 159 "high-risk" infants.
Halken S, Høst A, Hansen LG, Osterballe O
Allergy 1992 Oct 47:545-53

A total of 105 "high-risk" infants born in 1988 were studied
prospectively from birth to 18 months of age. The infants were
recommended breastfeeding and/or hypoallergenic formula (Nutramigen or
Profylac) combined with avoidance of solid foods during the first 6
months of life. All mothers had unrestricted diet. Avoidance of daily
exposure to tobacco smoke, furred pets and dust-collecting materials in
the bedroom were advised. This prevention group was compared with a
control group consisting of 54 identically defined "high-risk" infants
born in 1985 in the same area. All infants had either severe single
atopic predisposition combined with cord blood IgE or = 0.5 KU/l or
biparental atopic predisposition. The control group had unrestricted
diet and was not advised about environmental factors. Apart from the
prevention programme and year of birth the prevention group and the
control group were comparable. The parents were highly motivated and
compliance was good. The rate of participation was 97%, and 85% followed
the dietary measures strictly. The cumulative prevalence of atopic
symptoms was significantly lower at 18 months in the prevention group
(32%), as compared with the control group (74%) (p 0.01), due to
reduced prevalence of recurrent wheezing (13% versus 37%; p 0.01),
atopic dermatitis (14% versus 31%; p 0.01), vomiting/diarrhoea (5%
versus 20%; p 0.01) and infantile colic (9% versus 24%; p 0.01). The
cumulative prevalence of food allergy was significantly lower in the
prevention group (6% versus 17%; p 0.05).(ABSTRACT TRUNCATED AT 250
WORDS)

===
Effects of a dietary and environmental prevention programme on the
incidence of allergic symptoms in high atopic risk infants: three years'
follow-up.
Marini A, Agosti M, Motta G, Mosca F
Acta Paediatr Suppl 1996 May 414:1-21

A prospective case-control study is presented to assess an allergy
prevention programme in children up to 36 months of age. Infants born at
three maternity hospitals were followed from birth: 279 infants with
high atopic risk (intervention group) were compared with 80 infants with
similar atopic risk but no intervention (non-intervention group). The
intervention programme included dietary measures (exclusive and
prolonged milk feeding diet followed by a hypoantigenic weaning diet)
and environmental measures (avoidance of parental smoking in the
presence of the babies, day care 2 years of life). Mothers in this
group who had insufficient breast milk were randomly assigned to one of
two coded formulas: either a hydrolysed milk formula (Nidina HA, Nestlé)
or a conventional adapted formula (Nan, Nestlé). Other environmental
measures remained the same as for the breastfeeding mothers. The
non-intervention group were either breastfed or received the usual
Italian milk feeding and weaning diet, without environmental advice. The
main outcome measures were anthropometric measurements and allergic
disease manifestations. Normal anthropometric data were observed both in
the intervention group and in the non-intervention group. The incidence
of allergic manifestations was much lower in the intervention group than
in the non-intervention group at 1 year (11.5 versus 54.4%,
respectively) and at 2 years (14.9 versus 65.6%) and 3 years (20.6
versus 74.1%). Atopic dermatitis and recurrent wheezing were found in
both the intervention group and the non-intervention group from birth up
to the second year of life, while urticaria and gastrointestinal
disorders were only present in the non-intervention group in the first
year of life. Conjunctivitis and rhinitis were present after the second
year in both the intervention group and the non-intervention group.
Relapse of the same allergic symptom was less in the intervention group
(13.0%) than in the non-intervention group (36.9%). In comparison to the
non-intervention group, there were fewer intervention group cases with
two or more different allergic symptoms (8.7 versus 32.6%), and they
were more likely to avoid steroid treatment (0 versus 10.8%) and
hospital admission (0 versus 6.5%). Babies in the non-intervention group
fed with adapted formula were more likely to develop allergies than
breastfed babies in the same group. In the intervention group the
breastfed infants had the lowest incidence of allergic symptoms,
followed by the infants fed the hydrolysed formula (ns). Infants in the
intervention group fed the adapted formula had significantly more
allergies than the breastfed and hydrolysed milk fed infants, although
less than their counterparts in the non-intervention group. Of the
affected subjects in the intervention group, 80.4% were RAST and/or
Prick positive to food or inhalant allergens. Total serum IgE values
detected at birth in the intervention group were not predictive, but at
1 and 2 years of age, IgE values more than 2 SD above the mean in
asymptomatic babies were found to predictive for later allergy. In
breastfed babies the total IgE level at 1 and 2 years of age was lower
than in the other two feeding groups. Of the various factors tested in
the non-intervention group, the following were the most important in the
pathogenesis of allergic symptoms: (i) formula implementation begun in
the first week of life; (ii) early weaning ( 4 months); (iii) feeding
beef ( 6 months); (iv) early introduction of cow's milk ( 6 months);
and (v) parental smoking in the presence of the babies and early day
care admission ( 2 years of life). All the preventive measures used in
this study (exclusive breastfeeding and/or hydrolysed milk feeding,
delayed and selective introduction of solid foods, and environmental
advice) were effective at the third year of follow-up, greatly reducing
allergic manifestations in high atopic risk babies in comparison with
those not receiving these intervention
===
Breastfeeding as prophylaxis against atopic disease: prospective
follow-up study until 17 years old.
Saarinen UM, Kajosaari M
Lancet 1995 Oct 346:1065-9

Abstract
Atopic diseases constitute a common health problem. For infants at
hereditary risk, prophylaxis of atopy has been sought in elimination
diets and other preventive measures. We followed up healthy infants
during their first year, and then at ages 1, 3, 5, 10, and 17 years to
determine the effect on atopic disease of breastfeeding. Of the initial
236 infants, 150 completed the follow-up, which included history taking,
physical examination, and laboratory tests for allergy. The subjects
were divided into three groups: prolonged ( 6 months), intermediate
(1-6 months), and short or no ( 1 month) breastfeeding. The prevalence
of manifest atopy throughout follow-up was highest in the group who had
little or no breastfeeding (p 0.05, analysis of variance and
covariance with repeated measures [ANOVA]). Prevalence of eczema at ages
1 and 3 years was lowest (p = 0.03, ANOVA) in the prolonged
breastfeeding group, prevalence of food allergy was highest in the
little or no groups (p = 0.02, ANOVA) at 1-3 years, and respiratory
allergy was also most prevalent in the latter group (p = 0.01, ANOVA)
having risen to 65% at 17 years of age. Prevalences in the prolonged,
intermediate, and little or no groups at age 17 were 42 (95% CI 31-52)%,
36 (28-44)%, and 65 (56-74)% (p = 0.02, trend test) for atopy,
respectively, and 8 (6-10)%, 23 (21-25)%, and 54 (52-56)% (p = 0.0001,
trend test) for substantial atopy. We conclude that breastfeeding is
prophylactic against atopic disease--including atopic eczema, food
allergy, and respiratory allergy--throughout childhood and adolescence.
===

Prolonged exclusive breast feeding and heredity as determinants in
infantile atopy.
Savilahti E, Tainio VM, Salmenperä L, Siimes MA, Perheentupa J
Arch Dis Child 1987 Mar 62:269-73

We followed 183 infants for two years, 31 of whom were breast fed less
than three and a half months (median 70 days; short breast feeding
group) and a further 31 of whom were exclusively breast fed for more
than nine months (long breast feeding group). We assessed heredity for
atopy, number of infections, and duration of breast feeding as
determinants of atopy. During the first year of life 14 infants has
signs of atopy. During the second year parents reported signs of atopy
in a further 31. Heredity was the only significant predictor of atopy.
Atopy was seen in 33% of infants with a positive heredity and in 16%
without family history for atopy. The duration of breast feeding
affected the incidence of atopy only among the infants without family
history for atopy: fewer in the short breast feeding group (1/18) had
atopy than in the long breast feeding group (5/13). Duration of breast
feeding did not associate with incidence of respiratory infections.
Diarrhoea was more common in the short breast feeding group than in the
long breast feeding group during the first year of life. We conclude
that prolonging exclusive breast feeding from the median of 70 days to
nine months did not contribute to the prevention of infantile atopy and
respiratory tract infections