Strengths and Weaknesses of the Baby-Led Weaning

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This entry is adapted from the peer-reviewed paper 10.3390/nu14122372

Baby-led weaning (BLW) is an increasingly popular way of expanding an infant’s diet. It is based on the baby becoming physically ready to eat on his or her own, effectively supplementing his or her diet, which was previously based on breast milk or modified milk. In the traditional approach to complementary feeding, parents usually feed their infants pureed foods (mush) with a spoon, gradually introducing an increasing variety of tastes and textures as they grow, until solid foods are introduced. The process of diet expansion with the BLW method is guided by the child, using its skills and instinct. According to Brown and Lee, BLW is “a procedure in which the infant feeds himself, and feeding by the parent or serving smooth purees may occur occasionally, up to 10% of the total feeding time”. The role of the first solid foods, often referred to as complementary foods, in expanding an infant’s diet is not to replace breast milk or formula milk, but to be in addition to it.

child nutrition expanding the diet of infants BLW complementary feeding

1. Strengths of Baby-Led Weaning (BLW)

For children, the opportunity to eat by themselves has many benefits, not only nutritional. The opportunity for the child to eat on his or her own strengthens his or her development and draws his or her attention to the variety of food on offer rather than the person serving the food. Children who have the opportunity to eat freely not only improve their feeding skills in the nutritional sense but also develop the precision of grasping the products, and motor coordination, become active participants in the meal, and are involved in the full process, in contrast to infants who do not have the opportunity to reach for food independently and become an inactive child during the feeding process ^[1]^[2]^[3]^[4].

Using BLW the family sits down at the table together. The child is not fed while eating dinner with its parents so that the parents’ dinner does not become cold. For the most part, you can offer the child the same as the rest of the family. However, care should be taken that the products are not rich in salt, sugar, or saturated fatty acids ^[3]. In the BLW method, the infant dictates the pace of eating and what it wants to eat and what it does not want to eat. The infant treats eating meals as a kind of play, thanks to which it can imitate the behavior of people present at the table. They learn to share, wait for their turn, they watch carefully how different foods are eaten ^[5]. According to a study by D’Auria et al. ^[4], positive relationships within the family are deepened from the start, although they do not necessarily improve the family’s eating style. For many mothers, the fear of using the BLW method is the difficulty in serving a meal to a child outside the home, including the inability to warm up the food. However, with BLW this fear is unfounded. Restaurants have extensive menus, so there will be something the baby can eat. This is because children who eat using the BLW method are more curious about new tastes. Additionally, they are more willing to try eating something new. They pay attention to the difference between homemade food and food from a restaurant, for example. Therefore, such food will smell, look and taste differently, and additionally it will be brought to them only after some time. This is a new experience for children ^[5].

Children who were fed according to the principles of the BLW method at the time of introduction of complementary foods, according to the study ate healthy meals with their families and had less predisposition to bad eating habits in the future. An important factor is the dietary practices used by parents. If the parents eat properly and feed the child with such food, this way the infants, as adults, lead a healthier lifestyle and are more open to different culinary experiences from the beginning ^[6]. Healthy eating practices from early childhood can also protect against other diseases the background of faulty nutrition, not only obesity but also diabetes or metabolic syndrome ^[7]^[8]^[9].

2. Weaknesses of BLW

One of the most frequently mentioned fears of parents in the use of BLW is the possibility of choking the child, which is connected with giving bigger pieces of food. Scientific studies show that infants from the age of 6–7 months have the developmental capacity to eat a variety of solids. The avoidance of solid food may in the future result in food refusal or selective eating. It has been proved that frequent administration of meals requiring biting and chewing pays off in the acceptance of particular foods and dishes and supports the development of the speech apparatus ^[7]^[10]^[11]^[12]. The American Academy of Pediatrics (AAP) recommends avoiding round and small products with a smooth and hard surface and a cross-section similar to the shape of the child’s airway ^[13]. Foods that are most likely to cause choking include: sausages hard candies, seeds and nuts (whole), raw apples and carrots, chewing gums, and roasted corn. Non-food items that are most likely to choke a child are usually: plastic bags and balloons, and small and round toys ^[14]. Avoidance of the above foods reduces the risk of choking. The AAP includes eating while moving and during other activities, when the child is not focusing attention on chewing, among the circumstances conducive to choking in a group of healthy children ^[13]. Choking is a vomiting reflex that allows the removal of food fragments from the airway when they prove too large to swallow. In adults, this reflex starts from the back of the tongue. In children, on the other hand, this reflex is activated in a different part of the tongue—i.e., closer to the anterior part of the tongue. Therefore, in children, this fact makes it easier to trigger. The reflex itself is part of the body’s defensive reaction, but it is rarely associated with a choking hazard. It occurs sporadically and is certainly not a danger for the child because a piece of food is spat out before it reaches the throat ^[5]. The majority of infants develop the ability to eat solid food between 17 and 26 weeks of age. They develop the ability to sit with support and acquire neuromuscular maturity that allows them to control head and neck movements to eat from a spoon. At this time, the reflex to remove foreign bodies from the mouth, which made feeding with food other than liquid difficult, ceases ^[15].

Children who use the BLW method are sometimes exposed to a variety of food products and foods eaten by the family, including ready-to-eat foods, which can lead to the appearance of allergic reactions to food. In the future, children who consume heavily processed food may be at greater risk of developing several diseases resulting from poor nutrition, including type 2 diabetes, as well as obesity and metabolic syndrome, which are increasingly common among younger people. Children fed using the BLW method are exposed to many risks, therefore further research is needed on feeding children using the BLW method ^[5]. Morison et al. ^[16] analyzed the diet of infants aged 6–8 months who were fed using the BLW method (n = 25) or traditionally, with a spoon (n = 26). Despite similar energy intakes, BLW infants consumed less protein, carbohydrate, and fiber and more fat (including saturated fat). Lower intakes of iron, zinc, calcium, vitamin B12 and vitamin C were also observed, although there was no apparent difference in sodium intake. It has not yet been established whether these differences persist at older ages, which would be relevant to the method of infant dietary expansion used.

References

Rapley, G. Spoon-Feeding or Self-Feeding? The Infant’s First Experience of Solid Food. Ph.D. Thesis, Canterbury Christ Church University, Canterbury, UK, 2015.
Brown, A.; Lee, M. Maternal child-feeding style during the weaning period: Association with infant weight and maternal eating style. Eat. Behav. 2011, 12, 108–111.
Rowan, H.; Harris, C. Baby-led weaning and the family diet. A pilot study. Appetite 2012, 58, 1046–1049.
D’Auria, E.; Bergamini, M.; Staiano, A.; Banderali, G.; Pendezza, E.; Penagini, F.; Zuccotti, G.V.; Peroni, D.G.; Italian Society of Pediatrics. Baby-led weaning: What a systematic review of the literature adds on. Ital. J. Pediatr. 2018, 44, 49.
Rapley, G.; Murkett, T. Bobas Lubi Wybór; Mamania: Warszawa, Poland, 2011.
Toporowska-Kowalska, E.; Funkowicz, M. Kształtowanie preferencji smakowych we wczesnym okresie życia. Stand. Med. Pediatr. 2015, 12, 689–697.
Cameron, S.L.; Heath, A.L.; Taylor, R.W. How Feasible Is Baby-Led Weaning as an Approach to Infant Feeding? A Review of the Evidence. Nutrients 2012, 4, 1575–1609.
Schwarzenberg, S.J.; Georgieff, M.K.; Daniels, S.; Corkins, M.; Golden, N.H.; Kim, J.H.; Lindsey, C.W.; Magge, S.N.; Committee on Nutrition. Advocacy for Improving Nutrition in the First 1000 Days to Support Childhood Development and Adult Health. Pediatrics 2018, 141, e20173716.
Baidal, J.A.W.; Locks, L.M.; Cheng, E.R.; Blake-Lamb, T.L.; Perkins, M.E.; Taveras, E.M. Risk Factors for Childhood Obesity in the First 1000 Days. Am. J. Prev. Med. 2016, 50, 761–779.
Coulthard, H.; Harris, G.; Emmett, P. Delayed introduction of lumpy foods to children during the complementary feeding period affects child’s food acceptance and feeding at 7 years of age. Matern. Child Nutr. 2009, 5, 75–85.
Nicklaus, S. Children’s acceptance of new foods at weaning. Role of practices of weaning and of food sensory properties. Appetite 2011, 57, 812–815.
Schwartz, C.; Scholtens, P.A.; Lalanne, A.; Weenen, H.; Nicklaus, S. Development of healthy eating habits early in life. Review of recent evidence and selected guidelines. Appetite 2011, 57, 796–807.
Committee on Injury, Violence, and Poison Prevention. Prevention of Choking Among Children. Pediatrics 2010, 125, 601–607.
Fangupo, L.J.; Heath, A.L.M.; Williams, S.M.; Erickson Williams, L.W.; Morison, B.J.; Fleming, E.A.; Taylor, B.J.; Wheeler, B.J.; Taylor, R.W. A Baby-Led Approach to Eating Solids and Risk of Choking. Pediatrics 2016, 138, e20160772.
Fewtrell, M.; Bronsky, J.; Campoy, C.; Domellöf, M.; Embleton, N.; Mis, N.F.; Hojsak, I.; Hulst, J.M.; Indrio, F.; Lapillonne, A.; et al. Complementary Feeding: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition. J. Pediatr. Gastroenterol. Nutr. 2017, 64, 119–132.
Morison, B.J.; Taylor, R.W.; Haszard, J.J.; Schramm, C.J.; Williams Erickson, L.; Fangupo, L.J.; Fleming, E.A.; Luciano, A. Heath AL How different are baby-led weaning and conventional complementary feeding? A cross-sectional study of infants aged 6–8 months. BMJ Open 2016, 6, e010665.

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1. Strengths of Baby-Led Weaning (BLW)

2. Weaknesses of BLW

References