Traditionally the introduction of the complementary feeding is based in the exposure to food in different textures in a gradual way, eating grounds and puree (since 4-6 months age) before solids (from 8-9 months age). The World Health Organization (WHO) advised in 2002 the extension of breastfeeding time exclusively till 6 months, the beginning of complementary feeding is delayed till this age, advisable also for babies that have formula milk.
The baby-led weaning (BLW) is based in offering solid food since the introduction of complementary feeding at 6 months age. There is no use of grounded, puree or spoon (or at least 10% of the total daily intake), but whole food that babies can catch with their hands and like this they can feed themselves. Moreover, it is about complementary feeding by request, when the baby choose what to eat (among food offered), the amount and the rhythm, without forcing or helping him.
A child’s nutritional state depend on the diet that the mother had during pregnancy and later on the food that he has on his first years of life, that’s why parents have the responsibility to offer diverse and healthy food. Daily diet has to be completed with breastfeeding when they ask for it, or formula milk, because they don’t have the skills to eat by their own with proper amounts of food.
This method is also differentiated from the traditional when introducing food, because it offers a wide range of products since the beginning. We advise to leave 3-5 days between new food, being more important than the order in which they are introduced. It is recommended to not introduce new food for dinner just in case there is an allergic reaction.
Among its benefits are these:
- It allows the baby to discover tastes, textures, colours and smells, which seems to be related to a healthier and more varied diet in his future. However, to have a healthy diet depend on the family type of diet.
- It promotes the independence and self-confidence, as well as psychomotor development promotion favouring different skills development as hand pressure, the clamp, eye-manual coordination, chewing or swallowing.
- It encourages breastfeeding maintenance, because they continue having it when they want to, respecting hunger, thirsty and satiety signs.
- It generates less stress in families, without forcing their sons to eat, enjoying the moment of eating together.
- It improves the solid diet transition. It is considered that there is a critical period to introduce non standardized food (around 7-9 months age) and that if solid food is added after this period, it favours onset of texture advance and chew skills difficulties.
- He could have less overweight risk in the future. Because it is the baby that regulates the amount of food that he has, he develops satiety senses and can prevent obesity development.
Start tips:
- One of the objectives of the BLW is to achieve feeding to happen when the child needs it, so it is essential he knows how to show hunger and satiety with his gestures (when we give food to the baby and he opens the mouth and shakes his head onward, while if the baby is satiated, he closes his mouth and turns his head).
- Begin the method when the baby is not tired or starving, because he can concentrate in playing and learn. It is recommended to offer new food after breastfeeding during first months. At the age of one year old it is recommended to offer it before, because solids are the main source of energy at this age.
- Sit the baby upright, in front of the table, no matter if it’s on your lap or a high-chair. Check his position is stable and he can use his hands and arm freely.
- Begin with food that are easy to catch, as an adult’s finger. Introduce new shapes and textures gradually. Put food in front of the baby or let him grab it, so he is the one who decides the food he choose.
- Include the baby in family meal events whenever you can.
- Offer water with meals so he can drink if he needs it.
- Don’t distract the baby while he’s manipulating food.
- Don’t force him to eat and never put a piece of food directly in his mouth. Mostly at the beginning he won’t eat all food you offer him. He will touch and suck it or bite first, and that day or later on he will swallow it. Maybe you have to offer till 10 times the same food (different days) so he can adapt.
- Don’t be hurry to finish. Give him time and respect his hunger and satiety signs
- Don’t stress about cleaning, it is better to put him a big bib and let him experience.
- You can start by offering food as:
- Vegetables (steamed, cooked, roasted or fried): courgette, pumpkin, potato, green beans, onion, leek, carrot, tomato…
- Fruits: pear, banana, mango, plum. Always prepared peeled.
- Meat (stewed, cooked, grilled, like hamburger): chicken, cow, turkey, lamb, pig.
- Cheese cut in long blocks.
- Carbohydrates as bread, rice, pasta, etc.
- It is recommended to delay some months white fish and egg because of allergies.
- Food to avoid: Among products with high risk of choking are: raw vegetables (carrot, celery, peas), some fruits (apple, pineapple, cherries and grapes), popcorn, whole or dried nuts (raisins, blueberries), corn, olives, chips, rice or corn biscuits, sweets and candy. Also it is important to avoid salty or added sugar food (separate babies food before season it and add ingredients that he can’t still eat), as fast food and ready meals. It is no recommended to give him any kind of sausage or processed meat. It is not recommended food rich in nitrates as spinach, Swiss chard, lettuce, cabbage, beet, celery, thistles and borage till 12 months age, neither mercury high content fishes (swordfish, shark, pike and fresh tuna) till he is 3 years old.
Possible disadvantages
Many professionals considered if it exists a higher risk of choking and nutritional deficit with the method.
It is recommended to begin complementary feeding with iron-rich food, as fortified cereals or meat, but this method normally starts with cooked vegetables or fruit, that are iron low. Iron deficit can generate anaemia and be associated to irreversible cognitive delay, so that is why BLW should be applied in a planned way and have a varied diet.
Drowsiness risk seems higher with this method, so we have to keep in mind all safety advises described before. According to a study of the American Academy of Pediatrics (AAP) if BLW is followed having good advise by health professionals it turn to be a safe practice as the traditional one. It is important to differentiate choking arcades, because arcades are knee-jerk reaction, temporary and the baby usually solve it quickly. By contrast, when choking food blocks the airway, the baby begins to cough to unblock it, solving the problem in most of the cases.
On the other hand, preterm infants can’t reach needed skills to begin the method at 6 months age, so complementary feeding should adapt to its abilities. In case children with retarded development, brain damage or neuromuscular diseases, the process of swelling can be affected and shouldn’t follow BLW.
Recommendations for a safe method:
- the hands to catch pieces of food and take them to the mouth. Moreover the baby should make oral movements for food mashing and intake. These skills are acquired by 68% of nursing babies at 4-6 months age, 96% at 7-8 months age and 98% at 9-11 months age.
- Cut big and long pieces so he can grab them easily. From 9 months on he could grab smaller pieces if he can make the clamp with the thumb and index finger.
- Remove bones if there are some of them.
- Explain the method and food to avoid to people that take care of the baby.
- The baby should be under adult supervision all time when he eats.
- Observe that the extrusion reflex disappeared (it happen when something solid is introduced in the mouth and he immediately stick out his tongue). It normally disappears around 6 months age.
- If you have family history with food allergies, intolerance or digestive disorders you should inform your pediatrician before starting the method.
