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Baby-Led Weaning


During the holidays I was talking to a mother who was transitioning her infant to eating table food. She taught me about baby-led weaning. While this is not a new theory, it is a current trend that fascinated me. I was a traditional mother. I breast fed my sons, because it was natural, apparently their IQ’s were going to be higher, they would be “healthier” and they would bond to me. (all very true, I may add) They are now, 22, 20, and 17 and of course brilliant! They started baby foods at six months, and ate table food at eight months. Perhaps if baby-led weaning was in vogue in the late 90’s and early 2000’s, I would have tried it. I was so fascinated by this concept of Baby-led weaning. After asking the Sugar Plums mom many questions, I did some additional research. I hope that you find this study as interesting as I did. Keep in mind that part of this study was done in the UK and differs from dietary status of the US.

Common questions for self feeding are:

"Will my baby get enough to eat?"

"Will my baby eat the right foods?",

"Won’t they choke?"

"Are there any babies for whom self-feeding is inappropriate?"

“Baby-led weaning (BLW) is an approach to the introduction of solid foods that, although not new, has gained popularity rapidly since it was given this name. While there is currently little direct evidence to justify the approach, there exists a range of research that provides support for the principles that underpin it, namely the developmental readiness of infants to feed themselves using their hands, and their innate ability to respond appropriately to both appetite and satiety. In its practical application, BLW is in line with current weaning recommendations and there is tentative evidence that suggests it may lead to positive health outcomes. It is therefore something that health visitors should be prepared to discuss with parents.

Baby-led weaning is not new. Many parents were implementing it long before it had a name. Baby-led weaning respects an infant’s natural abilities and instincts in relation to self-feeding and appetite regulation. The practical aspects of baby-led weaning are in line with the current UK recommendations for introducing solid foods.

There is some evidence that baby-led weaning may lead to positive health outcomes.

Introduction

Most parents will find themselves discussing their baby’s introduction to solid foods with their health practioner at some point, whether at their own instigation or the health visitor’s.

Nowadays, it is likely that baby-led weaning (BLW) will feature in that discussion, since many parents have heard of it and are either following it or contemplating doing so. Anecdotally, though, it seems that not all health professionals feel equipped to talk about BLW, while a few trusts are advising their staff to avoid the topic completely, on the grounds that it is not ‘evidence based’. This article explains whatBLW is, what the evidence is that supports it, and why it should form part of routine discussions about weaning.

What is baby-led weaning?

First and foremost, baby-led weaning is an overarching approach to the introduction of solid foods, not merely a method of feeding. It incorporates several practical elements but is built on an underpinning ethos of respect for the baby and a belief that his instincts are reliable. On a purely practical level BLW differs very little from the current guidance. In this sense, in the 12 years since BLW first began to be talked about, it has become mainstream. What sets it apart from the simple practice of using self-feeding and finger foods as a method for introducing solid foods is the underlying trust that is accorded to the baby. Baby-led weaning is firmly rooted in the overall normal development of infants (Rapley, 2013). Thus, the introduction of solid foods from six months is appropriate not only because exclusive breastfeeding until then has been shown to lead to optimal health outcomes (Kramer and Kakuma, 2012), and because of the normal developmental readiness at this age of the gut, oral motor functions and immune system to extend the diet beyond breast milk (Naylor and Morrow, 2001), but also because it is at about six months that infants naturally begin to want, and become able, to investigate their environment using their hands and their mouths. Sharing meals is an essential aspect of BLW, freeing parents upto act as role models for food choices and mealtime behavior. In addition, shared mealtimes help babies to learn which foods are safe, allow them to begin using cutlery and cups through imitation as and when they are ready, and promote the development of speech and language.

Baby-led weaning recognizes the fact that healthy, term babies are capable of feeding

themselves from the moment they are born and that feeding is something they do, rather

than something that is done to them. At the point of birth, when they are at their most

vulnerable, babies know how to feed, when to feed, how fast to feed and how much

breastmilk to take, and they will demonstrate this if they are given the opportunity. There is no logicalreason why these innate abilities, to obtain nourishment and regulate intake,

should desert the infant at the point where he or she begins to need other foods. Thus, in the same way that, given the right circumstances, newborn infants are capable of locating the breast, attaching and feeding themselves (Widström et al, 2011), so infants of around six months, given the opportunity to reach out and grab food, will naturally begin to pick it up and take it to their mouths (Rapley, 2003)

When a decision to allow the infant access to solid foods is made by the infant’s caretakers whether at four months, six months or some other age, the ‘baby-ledness’ of that transition is immediately compromised to some extent, in that the infant’s first contact with solid food happens at a point in time chosen by someone else. When, in addition, spoon feeding is used, the opportunity for the exercise of autonomy by the infant is significantly reduced. However responsive the carer, spoon feeding can never be entirely baby-led because the baby is not in charge of what goes on the spoon. He is able to decide whether or not to accept it– a yes/no decision – but is prevented from choosing between options. This is even more true if the food is offered as a mashed or puréed all-in-one meal, when the ratios of the various elements – and nutrients – are pre-determined. Spoon feeding, then, is something done to a baby: he can either accept or refuse it, and he may be able to influence its pace, but he cannot otherwise direct it. In addition, the need to spoon feed the infant makes it difficult for the parent to eat at their own pace alongside their child, thereby reducing the potential for role-modeling of normal eating behavior.”

Below I have highlighted some of the questions most asked about baby led weaning:

  1. Will my baby get enough to eat? Our biggest public health challenge is obesity, especially childhood obesity. If a breastfed baby can determine when they have had enough to eat, evidence suggests that we should be more concerned about the risk of overeating infants who are not allowed to exercise natural appetite control. Spoon fed babies are often given too much food that the child does not want to eat.

  2. Will they eat the right foods? Since a well-balanced range of healthy foods is offered, there is good reason to believe that self feeding infants will choose a balanced diet (Strauss, 2006) and that they will develop healthy eating habits.

  3. Won’t they choke? Infants develop the ability to move chewed food to the back of their moth for swallowing. Prior to this, chewed food normally falls forward, out of the mouth. If your child is sitting upright, his airway is not at any more risk than adults would be. Babies learn to how to keep food at the front of their mouth until they are ready to swallow it.

  4. Are there any babies for whom self-feeding is inappropriate? Baby led weaning relies on the individual infant. If a baby has developmental delays or disabilities they may feed themselves later. This does not mean that self-feeding is out of the question for infants with special needs. Ask your doctor if you have any concerns.

http://www.researchgate.net/publication

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