ALISON SPENCE: Hello. I’m Dr. Alison Spence. An approach to feeding babies their first foods that has gained popularity in the last decade is baby-led weaning. This approach is not a health recommendation, but a term coined by a nurse, Gill Rapley, basically suggesting that babies can feed themselves from six months of age. So unlike more traditional approaches, there is no adult spoon feeding. No purees or mesh. And no parents trying to coax children to eat. Mostly, it involves serving appropriately-textured finger foods that the baby holds and feeds themselves. A key premise of baby-led weaning is that the child is mostly in control of their eating.
This approach reflects responsive feeding principles, which suggests that babies who are provided a range of nutritious foods and are allowed to determine themselves what and how much they eat are more likely to have better appetite regulation, than children who are pressured to finish their meals, whether that pressure is intentional or not. Such feeding practises promote children to eat when they’re hungry and stop when they’ve had enough, reducing the likelihood of over-feeding. In addition to promoting responsive feeding, baby-led weaning encourages parents to focus on the experience of introducing and trying complementary foods, rather than the quantity eaten. Some further benefits are that the approach generally encourages serving of home-cooked, fresh, unprocessed family foods.
It promotes the idea that parents should serve their child texture-appropriate versions of what they are eating themselves, rather than complicated or expensive special infant foods. Additionally, by adopting the baby-led weaning approach, parents might be more likely to eat at the same time as their child. Since they’re not trying to spoon feed the baby, which means they have to hand their own meal. And we know there are numerous benefits of parents eating with their children. While there are a number of potential benefits to baby-led weaning, there are also challenges to consider. In particular, there have been concerns that this approach might cause children to choke, not get enough iron, or not take in enough energy, so calories or kilojoules.
There is currently insufficient research on the safety and nutritional adequacy of baby-led weaning when not supported by nutritional advice. However, a recent New Zealand child, known as the baby-led introduction to solids trial or BLISS, for short, tested a guided approach to baby-led weaning to address some of the concerns regarding choking, iron, and energy intakes. Parents received specific advice on offering an iron-rich food such as meats and iron-fortified cereals at every meal. Offering an energy-dense food such as avocado or cheese at every meal. Avoiding foods, textures, or piece-sizes that present choking risks. For example, ensuring foods are of a texture to easily mash between the tongue and roof of the mouth.
And also sitting with the baby, and ensuring they are upright while they self-feed. The trial found that all of these concerns could be managed using the BLISS approach, with participating children showing no differences in iron intakes, energy intakes, growth, or choking. Indeed, they found that many infants were offered foods posing a choking risk, whatever the feeding method followed. This tells us that parents of all infants might benefit from more advice and caution about choking hazards. Naming the trial baby-led introduction to solids deliberately removed the term weaning, which could incorrectly imply that it’s time to wean the baby from breast milk or formula when introducing more solid foods. This is not the intention.
Babies from six months to one, you will continue to rely on breast milk or formula as their main source of nutrients. Another potential challenge of baby-led weaning is that it’s sometimes portrayed as avoiding the spoon. Where, in fact, there is no need to avoid nutritious foods that are best eaten with a spoon such as fortified cereal, meat-based sources, or yoghurt. Responsive feeding principles can still be used if the child remains in control of how much they eat and is encouraged to hold the spoon themselves when able. One further challenge of this approach is that baby-led weaning may seem like just another set of rules for parents to follow. And that it might not work all the time for every baby.
Therefore, I would say, that if a parent runs out of ideas for finger food, or is eating porridge or soup themselves, or has a child who decides that there are some meals they really want to eat with cutlery– like that parents mostly do– then there is no need to dogmatically follow the approach of serving only finger foods. In my opinion, responsive feeding principles can be followed by serving either finger foods or spoon foods. And that a combination probably results in the most practical, varied, and nutritious diet. Overall, baby-led weaning provides parents with a different approach to feeding with key benefits of promoting responsive feeding, serving of family foods, and eating with parents.
But, as with all infant feeding, there are some important general principles about avoiding choking, providing iron-rich foods, and a nutritionally adequate diet that still always need to be considered. In other words, baby-led weaning is a way to feed children. It doesn’t replace the infant feeding guidelines, but can be a useful part of a parent’s toolkit of strategies to achieve those guidelines.