Baby-Led Weaning

What is Baby-Led Weaning;

Baby Led Weaning (BLW) is an alternative way of getting into solid foods when the baby is about 6 months old or developmentally ready. It is a relatively new infant feeding method, which made its first appearance in England, Canada, and New Zealand, although it’s becoming more and more popular worldwide. What makes it superior to the classic feeding method? What do health organizations recommend and what are the most common parenting concerns? These are some of the topics that will be discussed below.

How is it different from the traditional way of baby feeding?

The image of a mom spoon-feeding her baby is well known to all of us. Offering pureed foods or commercially prepared baby foods is the usual or traditional way of feeding infants. With the BLW approach, feeding is completely different. The baby sits and the mom offers on the tray or dish, not pureed food, but pieces, so that the baby can feed himself. These pieces are in a form that makes it easier for the infant to hold them with his palm (finger size food) and with a specific texture (soft to melt in the mouth) to avoid the risk of choking.

Benefits of the BLW method

Moms who have practiced this method are usually those who breastfeed their baby, as breastfeeding serves the basic requirement of the BLW: the baby is in charge of his diet, meaning he decides by himself how much and/or if he will eat. And if this is something that frightens most parents of low baby weight gain, studies show that not only there isn’t any cause of concern, but there are indications showing it may help prevent obesity, which is a much bigger problem in western societies.

Another advantage of the BLW method is that it does not require extra time to prepare the baby dish, since we provide food from the family meal, always making sure that it is properly set up and that no salt is added. Then, of course, there is another benefit to consider: we expose the baby to whole foods. For example, we offer broccoli and the baby knows exactly what it looks and what it tastes like, rather than offering a mix of various vegetables. Therefore, it may be a technique to enhance the intake of a wider variety of foods later in toddler age, a ‘difficult’ age for the introduction of new foods.

Other potential benefits of this method are the reduced stress expressed by mothers on their baby’s eating and the ability for the infant to practice hand-eye coordination.

Common parents’ concerns

The most common factor preventing parents from using the BLW method is choking. The excuse that “the baby has no teeth at the onset of solids, so it is impossible to feed him in chunks because he will choke” is a myth, as the baby has very strong gums that are able to chew soft foods with great success. In the BLISS study, the results clearly show that when parents are well trained in the BLW method, there is no greater risk of choking than the traditional way of feeding. Nevertheless, it is helpful for parents to attend first aid classes, because they will be equipped with confidence, as well as they will learn to distinguish choking from gagging, as the latter is normal. In addition, the BLW method does not lead to underweight babies or iron deficiency, since parents are trained to provide appropriate foods.

Requirements for application

Some basic requirements must be met in order to minimize the risk of choking but also to avoid other undesirable conditions, such as lack of iron and growth faltering or excessive consumption of salt and sugar.

Firstly, the infant should be developmentally ready to receive solid foods, which is around 6 months of age (a subject that we will analyze in-depth in an upcoming article). In addition to that, we just need to afford any baby dining chair that provides a straight back and a footrest so that it can properly support the spine and head in an upright position.

Also, a useful “tool” for parents is nutritional education, as it will help them design healthy and balanced meals rich in nutrients and fats, to provide iron and energy, but at the same time low in sodium and sugar.

Which are the official recommendations

The official recommendations of health authorities for the introduction of solid foods cite as appropriate the traditional method, with the exception of the UK National Health Service (NHS) which cites both methods. However, both the American Pediatric Association (AAP) and the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) report that finger food may also be given, although further studies are needed to include this method in official recommendations. This is not something that should prevent parents from trying the BLW approach, as the guidelines may change very soon, and let’s not forget that feeding a baby is not a medical condition that requires specific treatment, but a normal procedure that may vary depending on the infant we have to feed.

Regardless of how solid foods are introduced, parents should remember that the differences between the two methods are only a concern for the first 2-3 months of complementary feeding. After that, there is absolutely no difference in how we started, as all pediatric organizations officially agree that around 9 to 10 months of age the infant should be encouraged to feed him/herself with small pieces of food rather than be spoon-fed purées.

Conclusions

Introducing solid foods by the BLW method is an alternative way of feeding the infant instead of the traditional way. The literature so far has been positive on BLW use, as there are indications that it offers several advantages, but further research is needed to support them or to consider this method more appropriate than the traditional one. After all, so far, the main factor in choosing the BLW method is not its proven superiority, but the willingness of the parent to try it, followed by the infant who does not wish to be spoon-fed. So, if you want to adopt this form of feeding for your baby too, you just have to be well-informed and ‘equipped’ with the necessary nutritional information and after that, you have nothing to fear.

Read more: “Baby-Led Weaning, our experience“

References

• Fewtrell M. et al., (2017) Complementary Feeding: A Position Paper be the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition, JPGN, 64:1(119-132)
• Erickson L.W. et al., (2018), Impact of a Modified Version of Baby-Led Weaning on Infant Food and Nutrient Intakes: The BLISS Randomized Controlled Trial, Nutrients, 10:740
• Brown A., Jones W.S. & Rowan H., (2017), Baby-Led Weaning: The Evidence to Date, Curr Nutr Rep, 6(148-156)
• D’Auría E. et al., (2018), Baby-Led Weaning: what a systematic review of the literature adds on, Italian J of Paediatrics, 44:49
• Starting Solid Foods (2018), American Academy of Paediatrics (https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Starting-Solid-Foods.aspx)
• What to feed your baby, Start4Life, National Health Service
  https://www.nhs.uk/start4life/weaning/what-to-feed-your-baby/around-6-months/
• Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals (2009), World Health Organization, Session 3: Complementary feeding (p. 19-28)

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