Baby-led weaning

Baby-led weaning, or BLW, is a method of introducing infants to solid foods as part of a general transition away from obtaining nutrition exclusively from breastfeeding or formula. Child development and infant feeding expert Gill Rapley and author-journalist Tracey Murkett are credited with popularizing the concept with their 2009 book, Baby-Led Weaning.

The central feature of baby-led weaning is that it skips the usual step of spoon-feeding pureed food to babies. Instead, infants move directly from exclusively consuming breast milk or formula to self-feeding as they experiment with complementary finger foods. Proponents of baby-led weaning believe that it promotes sensory development, hand-eye coordination, and fine motor skills while potentially reducing the risk of childhood obesity. Some parents and health professionals oppose the practice on the grounds that it poses choking hazards. Data from a limited number of observational studies also suggests that it could carry an increased risk of iron and caloric deficiencies.

Background

According to the World Health Organization (WHO), a United Nations (UN) agency, babies should consume only breast milk or formula for the first six months of life; the WHO also has guidelines for recommended formulas. They should then transition to complementary breastfeeding or formula feeding until at least the second year of life. When breast milk or formula becomes complementary, children consume increasing amounts of solid food as they get older. This process of transitioning an infant to solid food is known as weaning. Its objective is to establish dietary patterns similar to those seen in older children and adults by about the end of the second year of the infant’s life.

As the WHO notes, infants begin to require more nutrients and calories than just breast milk or formula can provide around the age of six months. The agency recommends introducing safe, easily digestible foods and endorses the use of an approach known as “responsive feeding.” This involves engaging infants with speech and eye contact while spoon-feeding them pureed foods with thin consistencies, and allows infants to wean off of breastfeeding.

Researchers characterize weaning as a highly impactful developmental stage. Experts note that in healthy infants, it is a time of rapid and profound change. There is also scientific evidence suggesting that weaning has a strong, lifelong impact on food preferences, eating habits, and body weight. Traditional approaches to weaning involve direct parental participation, with one or both parents initiating and leading complementary spoon-feeding. Over time, breast milk and formula are gradually phased out as infants obtain increasing proportions of their nutrition and calories from solid foods. The WHO also endorses a structured approach to weaning, recommending that infants aged six to eight months eat solid foods two to three times per day. This guidance increases to three or four meals of solid food per day between the ages of nine and twenty-three months, with one to two additional solid snacks as needed.

Baby-led weaning is an alternative to traditional weaning strategies. Instead of being parent-led, it places infants at the center of eating activities. Instead of spoon-feeding, baby-led weaning allows infants to self-feed on solid foods offered to them by their parents.

Overview

The best practices for baby-led weaning involve parents including the infant in family mealtimes, serving the baby a select variety of foods. In some cases, parents elect to offer infants the same foods they are having themselves. Regardless, most approaches to baby-led weaning involve separating the offered foods into distinct groups. This allows babies to readily experiment with single foods, moving between the various foods being offered to them as desired. This helps infants and their parents readily identify the foods the baby responds to best. During baby-led weaning, infants feed themselves, moving at their own pace and continuing to eat until they seem satiated.

Several important principles shape the baby-led weaning process, particularly during its initial stages. The foods offered to infants should have soft, pliable textures or dissolve readily when placed in the mouth, since babies normally have few if any teeth at the age of six months. When beginning, proponents recommend cutting foods into pieces large enough for babies to hold in their hand while biting downwards from the food’s exposed top end. The process also eschews rigid feeding schedules or intake requirements; babies are simply offered solid foods at mealtimes, eating as little or as much as they like. In the meantime, parents continue to breastfeed or bottle-feed their infants as usual, with the same frequency and schedule they used before introducing solid foods. Around the age of nine to ten months, most babies develop the ability to grasp objects between their forefinger and thumb (the “pincer grasp”). At this stage, baby-led weaning can evolve to incorporate foods cut up into bite-size pieces. Parents can also introduce foods with a wider range of textures and characteristics as the infant’s teeth grow in.

Research into the effectiveness and health impacts of baby-led weaning is just beginning to emerge, given the technique’s relative novelty. Its advocates claim that it has several distinct benefits: baby-led weaning is said to promote the development of manual dexterity, fine motor skills, and hand-eye coordination while introducing broader ranges of food textures and flavors than infants normally experience using traditional weaning methods. Proponents also believe that it promotes greater levels of autonomy and independence while noting that it puts infants in control of the amount of food they eat. Some initial research suggests that this may reduce the likelihood of babies becoming obese in later childhood, adolescence, or adulthood. One theory suggests that baby-led weaning makes children more attuned to their body’s natural satiation signals, which parents cannot override by continuing to spoon-feed the infant more food than they want or need.

Baby-led weaning is considered suitable for infants that does not have special needs or developmental disabilities that render them unable to grasp foods or feed themselves without assistance. However, the practice has some detractors, who cite early studies and anecdotal evidence in identifying several drawbacks. Baby-led weaning has been linked to iron deficiencies and inadequate calorie intake, prompting the health professionals that support it to revise their guidelines to explicitly encourage parents to include iron-rich foods. Others believe that it unnecessarily exposes children to additional food allergy risks while posing choking hazards that could endanger infants if their parents do not have the knowledge or training to respond to an emergency. As of 2021, the WHO and the American Academy of Pediatrics (AAP) both officially endorse traditional parent-led spoon-feeding over baby-led weaning.

Bibliography

Cameron, Sonya L., Anne-Louise M. Heath, and Rachael W. Taylor. “How Feasible Is Baby-Led Weaning as an Approach to Infant Feeding? A Review of the Evidence.” Nutrients, Vol. 4, No. 11 (Nov. 2012): pp. 1575–1609.

Carrus, Emily and Jenna Helwig. “What Is Baby-Led Weaning? How to Help Your Infant Feed Themselves.” Parents, 15 June 2021, www.parents.com/baby/feeding/solid-foods/dos-and-donts-of-baby-led-weaning/. Accessed 14 Oct. 2021.

D’Auria, Enza, et. al. “Baby-Led Weaning: What a Systematic Review of the Literature Adds On.” Italian Journal of Pediatrics, Vol. 44 (May 2018).

“Infant and Young Child Feeding.” World Health Organization, 9 June 2021, www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding. Accessed 14 Oct. 2021.

Poniedzialek, Barbara, Natalia Paszkowiak, and Piotr Rzymski. “Baby-Led Weaning (BLW) from Maternal Perspective.” Journal of Medical Science, Vol. 87, No. 2 (2018).

Rapley, Gill and Tracey Murkett. Baby-Led Weaning: Helping Your Baby to Love Good Food. Random House UK, 2009.

Taylor, Marygrace. “Baby-Led Weaning.” Everyday Health, 25 Jan. 2021, www.whattoexpect.com/first-year/feeding-baby/baby-led-weaning/#definition. Accessed 14 Oct. 2021.

“What to Feed Your Baby.” Public Health England, 2021, www.nhs.uk/start4life/weaning/what-to-feed-your-baby/around-6-months/. Accessed 14 Oct. 2021.