by Anne Eglash MD, IBCLC, FABM
In the last 10 years, baby-led weaning (BLW) has been a popular strategy in feeding complementary foods to infants, but should we encourage families to follow BLW rather than typical spoon-feeding of solids using pureed or blended foods?
The World Health Organization recommends offering blended foods during introduction of solids at 6 months. By 9-11 months, they suggest that infants are ready to pick up small pieces of food and feed themselves, and by 12 months, infants are usually able to eat family foods, prepared in a modified form as needed. Let’s call this the ‘typical feeding’ method for solids.
BLW is based on the principle that pureeing or blending food is not necessary because most healthy 6 month olds (born near or at term) can self-feed. They typically have the ability to reach, grab, and bring their hands to their mouths. Advocates have hypothesized that BLW allows infants to choose what and how much they want to eat, reduces the risk of childhood obesity, advances motor skills, and enables participation in meal-times at the table.
A recently published article used for this clinical question reviewed all published evidence on the benefits and outcomes of BLW.
What do you think are evidence-based outcomes of BLW, as opposed to typical feeding of solids?
- The BLW method is associated with introducing solids later (closer to 6 months) as opposed to under 6 months for typical feeding of solids.
- Families who practice BLW are more likely to allow their infants to control their own feeding, and are therefore less likely to pressure the infant to eat, or to control portion sizes or choices.
- Infants fed by BLW were less likely to be overweight at 18-24 months as compared to infants fed by the typical method.
- Choking was higher in the BLW group as compared to typical feeding.
See the Answer
The answers are A,B,C (not D)
June 2017, Volume 6, Issue 2, pp 148–156
Baby-Led Weaning: The Evidence to Date
Amy Brown, Sara Wyn Jones, Hannah Rowan
Purpose of Review
Infants are traditionally introduced to solid foods using spoon-feeding of specially prepared infant foods.
Recent Findings
However, over the last 10–15 years, an alternative approach termed ‘baby-led weaning’ has grown in popularity. This approach involves allowing infants to self-feed family foods, encouraging the infant to set the pace and intake of the meal. Proponents of the approach believe it promotes healthy eating behaviour and weight gain trajectories, and evidence is starting to build surrounding the method. This review brings together all empirical evidence to date examining behaviours associated with the approach, its outcomes and confounding factors.
Summary
Overall, although there is limited evidence suggesting that a baby-led approach may encourage positive outcomes, limitations of the data leave these conclusions weak. Further research is needed, particularly to explore pathways to impact and understand the approach in different contexts and populations.
Milk Mob Comment by Anne Eglash MD, IBCLC, FABM
BLW has been taking off in my community in the last decade, but mainly among my breastfeeding families. I find that the most useful clinical data from this study is the information on choking. The authors found that approximately 35% of infants have at least 1 choking episode when eating solids, and the incidence was not higher in the BLW group.
If you get a chance, check out some of the BLW videos on youtube, such as the 6-month old eating avocado, or this little guy gagging his way through the early trials of BLW. Frankly, I felt a bit of unease watching the latter.
When my patients ask me advice on whether BLW is preferred over typical feeding of solids, I discuss the difference between the methods, encourage them to watch some of the youtube videos on BLW, and refer them to www.babyledweaning.com, to learn how to do this safely. My personal approach is to encourage families to use the method that is most comfortable and intuitive for them.