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#11
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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. |
#12
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Yet another "ready for solids?"
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 -- yahoo address is unread - substitute mailbolt |
#13
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Yet another "ready for solids?"
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 |
#14
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Yet another "ready for solids?"
"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 |
#15
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Yet another "ready for solids?"
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 |
#16
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Yet another "ready for solids?"
"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 |
#17
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Yet another "ready for solids?"
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 |
#18
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Yet another "ready for solids?"
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 |
#19
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Yet another "ready for solids?"
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 |
#20
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Yet another "ready for solids?"
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 |
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