Current World Health Organisation guidance recommends that infants are initiated with complementary foods using a smooth blended collected of solids. Progression of textures should occur over a 12 month period progressing to solid family meals by about 1 year of age. Finger foods are recommended from about 7-8 moths generally and are given alongside puree foods.
Over the last 10 plus years however the baby led weaning approach (BLW) has become more popular following the release of Gill Rapley’s global selling ‘Baby Led Weaning Book’ in 2008. With this approach, instead of blending food to a smooth puree, infants are allowed to self-feed with family foods taking these foods in their full form. The idea is that infants will be allowed to choose what they wish to eat and to self-feed to the point of satiety. It also encourages infants to play a part in family meal times and feel involved.
Advocates of the BLW approach have suggested that this method offers many benefits including better appetite control, a wider diet and even advanced motor skill development. However these claims are often based on anecdotal experience in practice and there has been little in line of large scale studies to support this. Recently published systematic reviews on the topic highlight that there are still many unresolved questions around the BLW weaning approach and further larger scale studies are required before any claims can be made by healthcare professionals/advocate of the diet alike. The European Society for Paediatric Gastroenterology (ESPGHAN 2017) stated in a recent position paper that there is not enough evidence to draw conclusion around the BLW approach at this stage.
It is therefore likely to remain a parental choice at present and one which should be supported should it meet the specific needs of the infant and family. From a practical point of view should you wish to adapt this approach to weaning the following points may assist:
- Aim to wait until your baby is developmentally ready to self-feed/wean. Technically this should be around the 6 month mark however strong chewing skills may not develop until closer to 9 months. Speak to your dietitian / health care professional around specific signs of readiness to begin and general tips around weaning
- The foods offered should be ones which are easy to pick up and are easily held. Batons of 5—6 cm of well-cooked soft foods tend to work quite well
- Always avoid addition of any added salt and sugar to foods
- Avoid honey, mould ripened cheese, pate, predatory fish, unhealthy heavily processed foods and any caffeine
- Aim to try to include some iron rich foods for example some small pieces of red meat and also always consider the nutritional adequacy of the foods offered. Energy dense foods are important
- Aim to include a wide variety of foods in the infant diet but don’t overwhelm baby with too many selections at the one sitting
- Respond to the hunger cues and satiety cues promptly – don’t prolong mealtimes
- Get ready for the mess and encourage this!
- Always ensure you don’t leave your baby on their own with foods due to safety concerns and choking risks
- Monitor growth parameters especially during the first few months of weaning
If you are interested in or are considering the baby Led weaning approach and would like to discuss if this is a suitable approach for your baby, we can provide you with bespoke feeding plan taking in to account any risks and possible advantages.
Marie Power – Senior Paediatric Dietitian