Weaning from four months or six? Latest research questions current guidelines

The report does recommend, however, that in developing countries waiting until six months can be beneficial, due to concerns over food hygiene and nutrition.

The researchers agree that breastfeeding is the healthiest option for feeding your baby, and recommend exclusive breastfeeding until at least four months.

Dr Fewtrell suggests that after four months mums should start to wean once, and only once, their babies start showing the signs that they’re ready for solid food. As all babies are different, the report suggests that mums shouldn’t feel they have to wait until the day their baby turns six months.

What does the report say?

The scientists raise two main concerns:

Increased risk of allergies - The report suggests that waiting until six months can increase the likelihood of a child developing certain allergies. Whereas the DoH currently advises that waiting until six months decreases the risk of developing allergies.

Low iron levels – Holding off until six months can increase the risk of your baby having low levels of iron, leading to anaemia.

We know that babies are born with six months’ supply of iron, but that after this time they need to absorb iron from their diet and breastmilk alone can not supply enough iron content.

By starting weaning at six months, the risk is that it may take some mums a while to reach the stage where they’re giving their baby iron-rich foods (most mums will start with baby rice and simple fruits and vegetables). This could mean a baby isn't getting enough iron, during important developmental growth.

What evidence does the report look at?

In 2001, the World Health Organisation advised that babies should be exclusively breastfed for the first six months and not weaned until this point. This advice was based on a review of a large number of studies conducted worldwide.

In 2003, this policy was adopted by the Department of Health.

The new report states that other studies suggest this is not the best advice for babies in Western countries. For example:

• A review of 33 studies found "no compelling evidence" not to introduce solids at four to six months, the experts said.
• An American study in 2007 found there was an increased risk of anaemia compared with babies introduced to solids at four to six months.
• Research from Sweden also found that cases of early onset coeliac disease increased after mums were told to delay giving their baby gluten until age six months. When the advice reverted back to four months, the number of cases decreased, suggesting that it’s better to introduce gluten between four and six months.

Dr Alan Lucas, director of the Institute of Health involved in the research, explained, "The WHO recommendation is very sensible for developing countries. "But in the UK, it's important we take a balanced look at the evidence."

What do others say?

The Royal College of Midwives (RCM) has criticised the report, along with the National Childbirth Trust (NCT) and the Royal College of Paediatrics and Child Health.

Janet Fyle, professional policy adviser at the RCM, stated, "I really must challenge the suggestion that the UK should reconsider its current advice on exclusive breastfeeding for six months.

"I believe that this is a retrograde step and plays into the hands of the baby-food industry which has failed to support the six-month exclusive breastfeeding policy in the UK.

The Department of Health is currently sticking to its advice to wait until six months.

"Breast milk provides all the nutrients a baby needs up to six months of age and we recommend exclusive breastfeeding for this time,” explained a DoH spokesperson.

"Mothers who wish to introduce solids before six months should always talk to health professionals first."

However, the DoH also announced that it has asked a panel of scientists to consider all the evidence, including these new findings, and a report will be produced later this year.

What do other countries do?

Only 35% of European countries, including the UK, currently advise waiting until six months. The US and majority of European countries recommend starting from four months.

So, what should mums do?

For a start, trust your instincts and use your commonsense.

Once your baby is four months old, look out for the signs that he's ready (or not ready) to start solids. But wait until the signs are there - don’t be influenced by whether your friends’ babies are starting to wean or not.

And talk to your GP or health visitor, who’ll be able to reassure you as to whether it’s the right time to start and give you advice.

If your baby is ready to start earlier than six months, then you can afford to take the whole weaning process more slowly. The main thing is to make sure that at around six months your baby is getting a good source of iron from solid food.

If you have a family history of allergies, it’s a bit trickier as the experts seem to be split at the moment.

On one hand, some scientists advise that waiting until six months will reduce the risk of allergies.

This new research suggests the opposite – that it could increase the risk. Again, talk to your GP or health visitor, and watch how your baby reacts to different foods. Introduce new foods slowly and one by one, so you can identify if any foods may be causing a reaction.

On either side of the debate, no one is saying stop breastfeeding. In fact, the advice is to continue breastfeeding after you start weaning. As you slowly increase the volume of solid food, your baby will naturally cut down the amount of milk he drinks. However, you can supplement the milk he’s taking from breastfeeds by adding expressed milk into some of the meals.