MLB Weekly Digest September 3rd Edition - NGSC Sports

Baby-Led Weaning: What Does The Research Say?

Baby-led weaning is an approach for introducing babies to solid food that involves serving whole pieces of food that the baby picks up and feeds to themselves. Baby-led weaning puts the baby in control of what, when, and how much they eat. Babies are encouraged to explore different textures and tastes with very little pressure to actually ingest the food. The term is a little confusing—"weaning" in this case refers to the gradual process of replacing calories from breastmilk and formula with calories from solid food (it does not mean that the baby completely weans from breastmilk or formula, which are the baby's main sources of nutrition in the first year of life).

Proponents of baby-led weaning make claims including that it will make your child less picky, a more intuitive eater, and may even reduce their risk for future obesity. But are these claims backed by research?

Baby-led weaning should not be started until a child can sit independently (without support), has excellent head control, and can grab and bring food to their mouth without assistance. Parents should always consult with their doctor before starting any solid foods. Research finds that providing parents specific instructions on baby-led weaning—a method called Baby-Led Introduction to SolidS (BLISS) minimizes choking risks and ensures that babies get adequate nutrient intake.

Does baby-led weaning make children less "picky"?

The research (which is usually correlational) is mixed as to whether it does. Fortunately, however, there is a randomized controlled trial of the BLISS method. This study found that the BLISS approach did result in less pickiness and greater enjoyment of food at 12 months.

Other lines of research shows that children's early exposure to food does influence later food preferences. An experimental study found that 12-month-old infants were more likely to eat chopped carrots if they had been exposed to chopped foods (versus only purees) in the past. Research also suggests that parents should expose infants to more complex textures to increase acceptance of these foods. One study found that children who were introduced to "lumpy" foods after the age of nine months were pickier and ate fewer food types and had more feeding problems at age seven.

No matter the approach, it is important for parents to provide a low-pressure attitude towards food and allow your infant to determine when they start and stop eating. Research finds that pressure from adults to eat more or eat certain foods during mealtime is associated with more picky eating in children.

Does baby-led weaning help children develop a healthier relationship with food?

Supporters argue that learning how to regulate eating may be linked to a healthier relationship with food and a lower risk for obesity. A randomized controlled trial of the BLISS method found that baby-led weaning infants weighed less at 12 months and were less likely to be overweight. Another randomized controlled trial involving the BLISS method found no difference in BMI at 12 and 24 months. However, this study found that baby-led weaning infants at 24 months were less satiety responsive.

Research also finds that parents who use baby-led weaning report less controlling behavior around food and less anxiety than parents who spoon feed and that using baby-led weaning predicts how controlling parents are of their toddlers' eating.

Does baby-led weaning improve family meal time?

Advocates for baby-led weaning believe that it allows infants to participate in family meals, a practice that has been linked with healthier eating habits. These advocates also argue that baby-led weaning may improve the family's overall nutrition since they may eat more of the healthy foods that they are feeding to their baby.

Research finds that families practicing baby-led weaning are more likely to eat lunch and dinner together and their infants are more likely to eat the same food as the rest of their family.

A randomized controlled trial of the BLISS method also found that baby-led weaning families were two to four times more likely to eat together and eat the same food. This could be beneficial in that it allows the parent to model healthy eating habits and decreases the likelihood of the baby identifying "kid-food" vs. "parent-food." However if the family does not follow healthy eating practices, they would pass these unhealthy practices on to the infant.

Unfortunately, research does not find any evidence that baby-led weaning improves the rest of the family's eating style or diet when evaluating total energy and key nutrient intakes.

Does baby-led weaning increase the risk of choking?

A common concern among parents is that this method may increase choking rates in infants. Research consistently finds no difference in choking between baby-led weaning and traditional weaning groups.

A randomized controlled trial found that infants randomly assigned to the BLISS method did not show any differences in choking. The baby-led weaning infants did gag more frequently at six months (remember that gagging is harmless but can be scary as a parent) but then gagged less frequently at eight months. The BLISS approach does seem to reduce choking risk when compared to unmodified baby-led weaning.

Does baby-led weaning provide enough calories and nutrients?

Research finds that the overall calorie intake is similar between baby-led and traditionally-weaned infants.

Some observational studies have found that babies who follow a baby-led weaning approach may not be getting the recommended amount of iron. However, a randomized controlled trial found that infants randomly assigned to a baby-led weaning approach that promotes eating iron-rich foods (the BLISS method) did show adequate iron intake and did not show any differences in iron intake when compared to traditionally-weaned infants.

In terms of other types of nutrients, a randomized controlled trial showed that infants who follow the BLISS approach consumed more fat and sodium but no difference in other important nutrients.

What Is Baby Led Weaning?

Baby led weaning (also known as BLW) is a baby feeding method where you let your baby discover solid food by herself, by giving her suitable family foods that she can suck, chew and initially play with.

Your baby is encouraged to join in eating with you at family mealtimes. The idea is to offer your baby food rather than give it to her. At first your baby eats with her hands, moving on to cutlery later.

This is very different to the more traditional way of feeding your baby - called puree or spoon fed weaning, This is where you make special pureed mixes of fruit and vegetables, and meat and fish.

"The core principle of baby-led weaning is to introduce babies to solid food at their own pace," explains baby led weaning workshop leader Adele Stevenson.

"Instead of being spoon-fed, they're encouraged to explore food with their own hands, discovering taste and texture and eating as much or as little as they want. It's also a social experience, as babies join in with family mealtimes and eat the same foods as everyone else."

"You don't need to encourage them, just put it in front of them," says MissusG in our forum. "Their natural reaction is to investigate things with their mouths. My daughter will pick the food up, put it in her mouth and most likely spit most of it back out. With time, she'll chew/gnaw bits off and learn to swallow."

"It took Kayla a while to get into it," says MM_OMG. "After about a week she decided to start chewing on things and eventually swallowing. We didn't give her too many things and instead just replaced one that she had already chewed or dropped with a fresh piece when needed."

More like this

What are the advantages of baby led weaning?

BLW helps build your baby's confidence and independence with food

You don't have to make special purees as babies eat the same as the rest of the family, as long as it's cooked suitably

Babies join in with family mealtimes from the start

It can encourage chewing and hand-eye coordination skills

Not enough long-term research has been done around BLW yet, but some evidence suggests that BLW may reduce fussy eating and childhood obesity

"When Jeannie was six months I gave her a roasted carrot stick to play with while we ate," says Moira, mum to Jeannie, now 10 months. "The next day it was evident that she'd eaten some of it because it was in her nappy."

"By around 9 months she was eating whatever we were having and enjoying three meals a day. We all sit together for meals, and I've never had to worry about packing bowls and spoons when we go out because I can just grab a sandwich."

What are the disadvantages of baby led weaning?

Parents may worry about their babies gagging on solid food

It's very messy!

As babies may play with rather than eat much of the food at the beginning, parents may worry their babies aren't eating enough. Remember, they're getting their main nutrients through milk at this early stage

"I think baby led weaning is actually harder work as you have to deal with food thrown around and mashed up," says smiling_fairie. "I have to admit I tend to feed Oliver with a spoon when I can, just because it's easier."

But won't my baby choke?

The one issue that many of us worry about with BLW is gagging or choking on solid food. "Gagging is very common with baby led weaning, as babies get used to chewing and swallowing," accepts Adele Stevenson. "But this is a reflex that actually helps your baby learn how to master these eating skills. Babies may cough and even vomit, but this helps them move food to the front of their mouth to prevent choking."

Adele is keen to point out that this is not the same as choking. "True choking, where the airway is blocked, is rare."

How to reduce the risk of choking

By taking care, BLW shouldn't increase the risk of choking, but you do have to watch your baby closely and follow some helpful guidelines:

Make sure your baby is able to sit steadily, and sits upright when she's eating. Ensure she can use her hands and arms freely

Cut fruit into little pieces, even small fruit such as grapes. Grapes are often a favourite food of babies, but are known to be a choking risk if not chopped up

Never give your baby whole nuts

Remove any stones or cores from fruit and veg

Explain how baby-led weaning works to anyone caring for your baby

Don't let anyone except your baby put food into her mouth

Don't try to persuade her to eat more than she wants

NEVER leave your baby alone with food

What if my baby doesn't seem to be eating much through BLW?

Some parents worry that BLW may initially lead to a limited diet. Health visitor Maggie Fisher thinks it depends on your baby. "If your baby can cope, it should be fine. Be guided by your baby. If you start with finger foods and progress on to soft lumps and your baby is okay, then carry on."

To counter any worries about baby led weaning offering a more limited diet, make sure your baby's meals offer a wide variety of food including:

Steamed vegetables, such as carrot sticks and broccoli florets

Fruit

Pasta

Toast

Chopped meats

Dairy products

How many mums do baby led weaning?

When we asked 500 mums in a MadeForMums survey, just under 1 in 10 said they did BLW exclusively. However, a further third did a combination of finger foods and purees right from the beginning.

9% did baby led weaning exclusively

31% did a mix of finger foods and purees

60% did purees only

Is it OK to mix BLW with purees?

True BLW means that you don't puree any food, so you can't really mix the two. However, there is a third way - the Mix Method - which involves giving purees and then soft solid finger food right from the off. Successful weaning should be a relaxed experience, so go at your baby's pace and do what you feel comfortable with. While some parents like to avoid purees completely, others prefer the freedom of mixing it up.

Does BLW work for all babies?

The short answer is not all babies or all parents suit BLW, but it can work for most. "Baby led weaning can work for almost all babies, as long as they have the physical ability to pick food up and get it in their mouth," explains baby led weaning advisor Adele Stevenson.

"Some will take longer to grasp the concept than others, and it may seem as if they're eating very little initially, but almost all get there in time. If, however, your baby has any medical or physical needs or was born prematurely, speak to your GP or health visitor for advice about how best to wean."

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When Can I Start Baby Led Weaning?

It's pretty easy to find out when your baby is ready for Baby Led Weaning, as there are clear age and skill guidelines to follow.

You can start baby led weaning if your baby is:

6 months old

able to sit upright with good neck control

can pick up an object and bring it to his mouth

Don't start baby led weaning if your baby is:

under 6 months old

can't sit upright

Why does my baby need to sit upright/support his own head before I start BLW?

"When your baby is in a sitting position, it means he can bring food forward in his mouth and avoid choking," advises Adele Stevenson, baby led weaning expert and workshop leader.

"Your baby also needs to be capable of picking up an object and put it in his mouth – so he can feed himself.

"Most babies will achieve these milestones at around 6 months, which coincides with the Department of Health advice on when to start weaning."

So is it safe to start baby led weaning at 4 months or 5 months?

This is not recommended. Expert Adele Stevenson, explains, "It's very unlikely that a baby will reach these milestones and be ready for baby-led weaning, much before six months.

"If you feel that your baby is ready earlier than six months, it's best to begin with spoon-feeding purees, and move on to introduce finger foods later."

When we started BLW – mums share their stories

Mum Nicola says: "I think you have to be guided by what your baby wants, I wanted to do a mixture of both but so far am just doing purees as my LO will not hold any food herself.

"I have a friend who wanted to do puree, but her daughter will not take anything from the spoon instead she grabs the spoon and sucks it.

"So my friend had to go down the BLW route which she was nervous about but has so far been going well.

"BLW is not advised for babies under 6 months old so if you do want to start weaning early purees will be best."

And Twinkletoes has a nice compromise between spoon-fed and BLW: "You can definitely do a bit of both. What I do is cook up some veggies or whatever for a puree, but then before I blend them I take a couple of bits out (a piece of broccoli or a couple of carrot sticks) and leave them whole.

"Just put them on her highchair tray while you feed her and let her play with them and eat them if she wants.

"It's what I did with my son and he's usually a good eater although he's teething at the moment so doesn't want to eat much :/"

Lilypeach is also BLW, too, but found it wasn't right for her, in the end: "I started off doing BLW in the pure sense, as LO hated a spoon. However, as he became more accepting of it I use the spoon more and more because I wanted him to eat meat, fish etc which he could not really do with his fingers at 6-7 month.

"Though now he will eat mince with his fingers, picking up the little bits! So I'm not a BLWer any more I suppose.

"It works really well for us, and makes me more relaxed knowing he's getting something but also exploring different things for himself.

"Reading a BLW book is really good and I think everyone should read one, however they decided to feed their baby."

If your baby is ready to start baby led weaning, here's what you do next…

Sit your baby down at family mealtimes and let him join in when he's ready

Don't overwhelm your baby with too much food. Give a choice of two or three different foods so he gets to explore different tastes and textures

Don't look at the mess – yes, it's going to get dirty, especially if he has more than four or five things in front of him

Provide soft pieces of food that are easy to hold, such as fruit cut into chip shaped pieces, or steamed broccoli or cauliflower florets, which have a built-in 'handle'

Carry on giving your baby his usual milk until he gets the hang of eating.

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