Thursday, 14 April 2011

Early infant feeding practices

Feeding babies, or more precisely, what to feed babies and young infants has been quite a long-running debate.
I don't think anyone would really argue with the fact that breast milk is nature's way of providing everything a young infant needs to grow in those tentative early days, weeks and months, packaged up at just the right temperature with no late-night sterilisation of bottles or teats required. Perfect also for the groggy husband who grumbles to himself as he patters downstairs at 3am to do his paternal preparation duties.
Whether or not new mums want to, or can use this 'natural' option is another matter entirely.
I approach this subject with caution being, as I am, the wrong gender to make such a choice. I do however follow quite closely the various guidelines and debates on 'breast vs. bottle' and 'when to start weaning' as a matter of professional interest. Not least because of the link between very early weaning and increased risk of coeliac disease. Not least also because of the possible link between early feeding issues and autism as described in my posts here and here.
In recent times the question of 'when to start weaning' has been the source of some debate. One of the main issues is the age at which infants should start eating solid food and the conflicting advice being offered in this area. Here in the UK the official guidance is very clear: recommending exclusively breast / bottle feeding (or combined) for the first 6 months of life and weaning on to solid foods thereafter. This advice is backed up by the World Health Organisation (WHO) no less.
That would be all well and good if a report from the European Union hadn't mixed things up a little by suggesting that for some children, earlier weaning (from about 4 months onwards) might be OK and possibly advantageous. Added to that an article appearing in BMJ questioning our 6-month rule and again suggesting that there may be a case for revising guidance (backed up by the British Dietetic Association, BDA).
A case perhaps of the head saying do one thing, and the arms and fingers perhaps wanting to do something else.
I have thought about this issue quite a bit. Working backwards from the notion that all babies are different; have different constitutions, raised under different environments, raised by different parents one could argue that the n=1 principle might apply. Thinking also to what happens when research and guidelines get too generalised to a population there may be perhaps some scope for taking on board some of the suggested revisions at least for some infants (although please do not base your decision on my analysis, speak to your physician and healthcare provider about this).
The idea also that there is a window of opportunity for developing tolerance to foods is also an interesting concept. Readers may know of my interest in all things diet and gut-related, and in particular, the concept of the hyperpermeable gut (leaky gut) in connection to lots of things. One of the most interesting parts of how gut hyperpermeability might tie into weaning patterns is trying to ascertain when the gut is 'unpermeable' enough to tolerate food without permeability potentially leading to allergy or intolerance. The infant gut is quite permeable on purpose because: (a) it is still maturing, and (b) it has to allow the passage and absorption of all those goodies in breast milk (and formula) into the CNS, some of which are quite large molecules. Gut hyperpermeability may also have a role to play in producing that lovely soporific effect that babies love following their milk from all those warming opioid peptides and how this may relate to neural growth.
I will be interested to see where this debate goes eventually and how it may (may not) influence guidance and practice.