Baby-Led Introduction to Solids
By Jennifer Yoon, RDN/LDN, Pediatric Alliance — St. Clair.
Weaning is the process of adding complimentary foods to an infant’s primary diet of breast milk or formula. As the intake of food increases, baby drinks less breast milk or formula, until she is eating a full diet of solids. Baby-Led Introduction to Solids (BLISS), also known as Baby-Led Weaning, is a relatively new method of introducing solids, foregoing the pureed spoon feeding phase and allowing babies to self-feed and self-select foods.
Unlike traditional spoon-feeding of pureed foods which parents often begin at 4-6 months, Baby-Led Weaning encourages exclusive milk feeding for 6 months followed by the introduction of baby-selected solid foods when the baby is able to sit up and reach for foods independently. With traditional spoon-feeding, babies learn to swallow, then chew. In Baby-Led Weaning, babies learn to chew, then swallow. Gagging is accepted as a normal part of this learning process.
Proponents hypothesize this method may decrease obesity risk as babies self-select and self-regulate. However, a study by Rachael W. Taylor, PhD, et al published in JAMA Pediatrics last month, does not support this, showing no difference in BMI at 12 and 24 months among the 206 participants in New Zealand:
A baby-led approach to complementary feeding did not result in more appropriate BMI than traditional spoon-feeding.
The study did demonstrate other benefits of Baby-Led Weaning compared to the spoon-fed control group, including successful weaning, a greater enjoyment of feeding, a reduction in picky eating, and an increase in self-feeding at 12 months.
The study also supported the safety of Baby-Led Weaning. Babies in the BLISS group gagged more frequently than the control group at 6 months, but less frequently at 8 months. There were no serious choking events. In an editorial accompanying the published study, Rajalakshmi Laksham, PhD and colleagues suggest that the results of this study should alleviate physicians’concerns regarding the safety of this method.
Parents choosing this method should be advised on feeding safety:
— Take a parent CPR and First Aid course.
— Feed the baby in a high chair with supervision.
— Food offered should be about the size of a chip or cracker. Foods may be smaller once the pincer grasp develops at 9 months.
— Food offered should be soft. It should be easily pinched apart. Examples include soft cooked vegetables, cubed pieces of soft bread or zwieback toast, boiled or broiled chicken off the bone, soft cheese. Meats that are difficult to chew such as pork chops or steak should be delayed until teeth emerge.
— Choking hazards such as hot dogs, nuts and seeds, whole grapes, popcorn, hard or sticky candy, chunks of hard fruit or vegetables should be avoided.