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13 Baby Led Weaning Myths

"Baby-led weaning (often also referred to as BLW) is a method of adding complementary foods to a baby's diet of formula or breastmilk. 

Baby-led weaning allows babies to control their solid food consumption by "self-feeding" from the very beginning of their experiences with food. The term weaning should not be taken to imply giving up formula or breastmilk, but simply the introduction of foods other than formula or breastmilk." (wikipedia)

I love BLW for lots of reasons;   it allows baby to regulate their own intake, offers oodles of sensory opportunities and the chewing and processing promotes good oral development.

Seven years ago when I used it to introduce solids to my baby, my health visitors had never heard of it (although one did come round to learn more) and as he was born at 34 weeks gestation a few people thought I was rather mad, he would surely choke or starve! Yet it worked brilliantly.

As more people recognise the benefits of letting babies feed themselves, I've noticed when working with parents (in person and online) the same myths and questions arise.  So I thought I would share my thoughts here to save repeating :-)

1. Baby must be able to sit unaided to start solids.

A mum the other day online asked whether that meant when baby was placed in the seated position, or when they could actually get themselves there from laying down?

Some babies are 8/9 months before they can sit unsupported, why can they not eat before then even if showing other signs of readiness?  Once babies can sit unsupported you wouldn't feed them without support until truly stable, as they will still randomly tip over after a bit which is hardly safe when consuming food.

So what's the relevance?

The key is that baby is upright and has a clear passage from mouth to stomach....

This baby is reclined, eating solids in this position is not recommended.
Both these babies are supported, yet have good head control, are not slumped to one side and food can move easily from mouth, to throat to stomach.  They may or may not be able to sit unsupported but as we can see that's really irrelevant, they are maintaining a safe eating position.
In fact lets compare it to a baby in a high chair:


Again we have no idea whether this baby can sit unsupported or not, because she's supported by the seat behind and the tray in front.  It really doesn't matter as she has a clear passage from mouth to gut.  She would be sat in this chair exactly the same way whether she could sit by herself or not.

Gill Rapley says:
"Sit the baby up to the table with everyone else. He can be either in a high chair or on an adult's lap – supported, if necessary, so that he can use his hands and arms freely. Make sure he is sitting upright to handle food, not lying back or slumped."
I confess it's a long time since I read Gill's book, but I don't recall anything about baby sitting unaided there either.  Anyway as I say, personally I don't see a rationale for it.

2. Vegetables & fruit are the best first solids.

I think it takes a lot for people to make the mental shift from the old fashioned weaning schedule, when solids were introduced before gut closure.  Babies of three and four months (particularly before 17 weeks) are at increased risk of allergies from exposure to solids - therefore vegetables were considered "safer", particularly those considered easier to tolerate, and with low allergenic potential such as carrots, pears and butternut squash!

Pre six months nutritional needs are met by breastmilk, and so babies don't need vitamins and minerals from foods.  From around the middle of the first year, requirements for additional protein, iron, zinc, B Vitamins and vitamin D increase  - but the best sources of these aren't fruit and vegetables!  We know some infants are more at risk of low mineral stores than others, for example those born early, at low birthweight or to mums of poorly controlled diabetes.

We also know babies have small tummies, so they need nutrient dense foods - ie foods which provide good amounts of vitamins, minerals and calories even when consumed in small amounts.  Breastmilk has around 70 Kcal per 100g, in comparison carrots for example have 27 Kcal, less if there if they're not drained well.  

Judy Hopkinson, Ph.D., Associate Professor of Pediatrics at Baylor College of Medicine says:
"It is important to remember, that when solid foods are introduced, the amount of breast milk a baby consumes decreases."
If a baby has an underlying feeding problem or isn't taking enough milk, baby may then I believe take food in addition to solids (which is why Dr Newman recommends earlier solids rather than formula if extra nutrition is required from around 17+ weeks), for typical babies though a reduction in milk feeds occurs.

This means that although vegetables are healthy, the vast majority don't offer anything that breastmilk doesn't ie milk is also abundant in these same nutrients too - but they do have less calories and less easy to assimilate iron and zinc.  Vegetables gradually become more significant the more baby transitions to solids, and important when baby is no longer drinking breastmilk or formula.

Therefore whilst parents think they're giving gentle, harmless foods by not offering their 8 month old anything more than plums and pears, to ensure optimum growth and protect against deficiencies, food should contain nutrients babies begins to need first.  

In Canada meat and eggs are now recommended as ideal first foods, the La Leche League have suggested this for years - in fact there are not many cultures who wean on to refined grains, vegetables and fruit.  This makes sense as baby has all the enzymes to easily digest meat  at 6 months, and it's also high in protein, iron, B vitamins and zinc - the foods we know infants need first.  Egg yolks are extremely easy to digest and if organic are also an excellent source of vitamin D.  Obviously vegans and vegetarians can meet requirements via their normal sources of these nutrients, although as less bioavailable clever food pairing is also required (which I'm assuming those choosing either diet are already familiar with).

3. Closely followed by grains: bread, pasta, cereal.

Let's start with bread as a product.

Made at home contains: Wheat Flour, Yeast, Water, and Salt (with a very small amount of sugar if any).

Wharburtons meduim sliced contains: Wheat Flour,Water ,Yeast, Salt,Vegetable Oil, Soya Flour, Emulsifiers E481, E472e, Preservative Calcium Propionate, Flour Treatment Agents Ascorbic Acid (Vitamin C), E920 (Vegetarian)

The sodium amount in one slice of bread is 0.4g yet according to the NHS:
"The maximum recommended amount of salt for babies and children is:up to 12 months – less than 1g salt a day (less than 0.4g sodium)"
Which means one slice equals more than baby's total daily maximum allowance - yet breastmilk and infant formula also contain sodium..

Wheat gets even more complicated as: 
"Today's wheat is a far cry from what it was 50 years ago.  Back in the 1950s, scientists began cross-breeding wheat to make it hardier, shorter, and better-growing.
Today's hybridized wheat contains novel proteins that aren't typically found in either the parent or the plant — some of which are difficult for us to properly digest. Consequently, some scientists now suspect that the gluten and other compounds found in today's modern wheat is what's responsible for the rising prevalence of celiac disease, "gluten sensitivity," and other problems."
Read more here, here, here and here.

Lastly grains also contain phytic acid, a substance present in grains in relatively large amounts. Phytic acid is often referred to as an “anti-nutrient,” as it blocks absorption of minerals, like iron, magnesium, zinc, and calcium, in the body; the very things baby needs to absorb.  Other cultures who eat grains early, typically either prechew, sprout or ferment.  You can read more here and here.

As part of a balanced diet for an adult, quality grains may not be a huge issue for some; but when we're looking at nutritionally significant foods for babies who don't consume much, it seems to me there are far more valuable solids to explore, particularly in the first year or two.

The bigger picture is also that we are eating more wheat than ever before, hidden in products you wouldn't necessarily expect to find it. Hit the supermarket and check out how many ice creams, salad dressings and processed meats contain wheat.  Then consider some get cereal for breakfast, bread for lunch and pasta for dinner!

4. And only one type.


Just carrots, peaches or whatever else parents have selected. To me baby led weaning isn't just in the sense they feed themselves, but also that they lead what they choose to eat from a balanced meal.

Gill discusses in her book how some theorise the baby will choose foods with the nutrients he might need, guided by taste (2, 3) - but how if you only have a single food offered?

For those with severe food allergies in the family or where reactions may be serious, it of course makes sense to present things as individual foods before mixing in say a curry or casserole where it may be more difficult for baby to avoid potential allergens.

Similarly higher risk foods such as egg, dairy, peanuts etc should be given at different times so it's easy to identify if there is a problem, which item caused it.

For the most part however there is no evidence supporting the concept of introducing one food every few days and watching for a reaction, particularly once the gut is closed; people can develop a food intolerance at a later date too.

5.  Babies need bland.

Baby rice being the king of!  Breastfed babies are exposed to tastes and flavours via breastmilk and so often parents report their baby is far more interested in tasty meals.  Herbs, spices, garlic and pepper are all suitable.

Cultural norms vary widely so if we look at Indian cuisine and first foods, one example is a "cereal" made from rice (not processed, stripped of any goodness and then refined with synthetic vitamins baby kind!), toor dal (split peas), cumin seeds (bitter, spicy), ajwain seed (strong, spicy thyme like flavor), asafetida (tastes a bit like strong onions with a touch of earthy truffles) and dried ginger - bit of a far cry from a rusk!  Google the nutritional qualities of each ingredient and you will also see it's a good source in magnesium, zinc and iron with a low GI and is considered easy to digest.

6. Baby has to be exactly 182.6 days old (6 months).

Why? Does the magic gut fairy wave a wand on the eve of night 181 thus rendering the baby ready for solids? No.

It's a guideline not a rule.  I hear people say I'm going to start BLW at 6 or 7 months and wonder, if it's baby led, how do you know when you will start unless actually you're picking the date and it's not baby led at all?

I don't want to cover again the ins and outs as I covered everything here  but from a biological perspective it makes no sense babies would be able to pick up food, get it to their mouth, chew and swallow before they're ready to eat, because how would cave woman have known about the 6 month rule?  How would our ancestors have known to withhold food even after the baby was helping themselves?

Furthermore if you're going to buy into the concept of self feeding and that being able to do this indicates solid readiness, then surely it also follows that if babies aren't ready, you can present them with all the solid food in the world yet they won't be capable of eating it?

Indeed Gill Rapley conducted some small scale research and found:
“The babies who participated in the research were allowed to begin at four months. But they were not able to feed themselves before six months. Some of the younger babies picked food up and took it to their mouths; some even chewed it, but none swallowed it. Their own development decided for them when the time was right."
Just like I think baby led is more than self feeding and should encompass self selection of foods, I also think that should extend to when they do so.

7.  Tongue tie doesn't impact on starting solids.

This really confuses me.  The tongue is pretty key to eating (ask anyone who has ever suffered Bell's Palsy ), it needs to move the food laterally to the gums/teeth for mashing, it needs to retrieve bits that get stuck in the cheeks or roof of mouth, it needs to undulate to move the food to the back of the mouth for swallowing - how can that always happen if the tongue is anchored to the floor of the mouth in a way that significantly hinders these actions?

I'm not suggesting for a second all babies slow with solids have tongue tie, nor am I saying a restricted frenum always causes eating problems; but it's equally wrong to say that it never can, as this mum's diary clearly highlights.  If baby is still struggling with excessive gagging, pouching food (getting it stuck in cheeks or roof of mouth) or doesn't really seem to have progressed two or three months into the eating journey and parents have concerns, it's worth ruling out.

8.  Babies need water with their meal as soon as they start solids.

The general consensus seems to be formula fed babies should be offered water when solids are introduced; breastmilk however is around 88% water and so if you are feeding on cue there is no rush to introduce extra fluids with meals.  Playing with cups and water outside of mealtimes (some find in the bath allows for spillage!) can give baby time to enjoy that experience in itself.

9.  Puree on spoons is still BLW - if not you're a purist.

Of course some foods are easier to spoon - yoghurt or soup for example; and preloading spoons for odd foods is I think pretty instinctive.  However recently I've heard of people blending or mashing all meals, before loading up spoons and calling it BLW.  Yet I'm not convinced appetite regulation is that easy when things aren't solid.

Take a punnet of strawberries, you're average 6-9 month old might eat anywhere from a bite to a few. Puree the punnet however and you get a surprisingly small amount of mush.  Think how much fruit you need to make a smoothie, it's much easier to consume larger amounts of blended food than you would consume  in their solid state.

Having to pick up and bring food to the mouth and then process, rather than just swallowing, slows down the eating process allowing the baby more time to recognise they are full.  Babies pushing a preloaded spoon a few inches to their mouth eat much faster than those feeding themselves.

It also removes a lot of the sensory experience - visual identification and textures of foods, learning how to pick up a particular item and manipulate using fine motor skills, not squishing too hard or letting it fall.  I think Gill in one of her presentations has said previously, how can a child build a relationship with foods if green mush is sometimes apple, sometimes avocado, sometimes cabbage?

10.  Everything has to be in its whole untouched state, no mashing or it's not BLW.

I know this seems rather a contradiction to the above statement but some things are shades of grey, not black and white.  Whilst there is the extreme of pureeing everything to a soup and calling it self feeding, there is also the other end of the spectrum - some foods  that are nutritionally valuable are much more difficult for babies to process.  Previously premastication would be used in hunter gatherer societies, plus perhaps bashing something with a rock or squishing it between fingers eg nuts or meat (no mincers then!).

Surely instinct also plays a part?  

If baby enjoyed a meal, yet at a later date the same items are presented cooked/chopped differently, say in a casserole with a slippery sauce baby may struggle to pick it up as well as before - how can they be less ready for the food than they were before?

Helping baby by say roughly squishing to make more "graspable", is hardly comparable to spooning down jars at 4 months.

To some degree processing is often done - we don't present baby with a whole chicken and say he's can only eat it if he can carve himself a leg.  Nor offer eggs but declare baby only ready if he can get through the shell.  When offering a piece of chicken the parent is already subconsciously deciding the size and shape of what baby receives; whether that is one piece baby can hold, shredded which baby can practice picking up skills, made into minced balls or a mixture depending upon what the parent feels baby handles best, is to me personal preference rather than "weaning rules".

11.  Food is just for fun until they're one!

Agh this is up there with my pet hate sayings along with "happy mum = happy baby"!

A blogger who makes some great points (although also some I don't agree with!) sums it up well:
"I think the phrase “Food before one is just for fun” needs to go die a merciful death, to be honest. In all likelihood, the phrase itself was invented by some well-meaning person who wanted to encourage a more relaxed approach to solids among anxious mothers who were engaging in weird little mompetitions with other mothers about who could cram the most “jars” inside their child--and in the process, harmfully crowding breastmilk/formula out of the baby's diet.
But it’s looking increasingly as though this phrase has begun to be interpreted as meaning that solid foods play no nutritional role at all before one year of age—and that therefore, it’s completely fine and not an issue if months and months go by while your older baby eats basically no foods at all and does not receive any micronutrient supplementation either. And the evidence suggests strongly that this is just not true."
Nobody is suggesting babies need vast quantities of foods, to be on 3 meals per day ASAP, if baby is enjoying picking from a balanced diet, normal amounts can vary hugely.  Milk should absolutely be babies main form of nutrition, fueling bone and brain growth and only starting to tip in the favour of solids towards the end of the first year.

What's more nobody is suggesting food isn't fun!  Of course it is, it's an amazing learning experience.  But it isn't just for fun.

I think it's this belief that in part leads to some parents choosing less nutrient rich foods believing they're not actually needed at this age.

12.  Babies have the same tastes we do.

How can I sweeten yoghurt or porridge is a question I frequently hear.  Adding pureed fruit seems to be a common suggestion, but I always have to wonder why?  Whilst many adults are used to eating foods packed full of hidden sugars and so to them things taste bland or sour without,  why encourage sweetening for baby?

It's also normal for them to pull a funny face or shudder if something is bitter, tart or sour - but this doesn't necessarily mean they don't like it or it isn't worth offering again.  It can take ten tastes of something for baby to get used to it. Bitter foods are considered important to our health, despite the fact many now eat very little - these taste buds are typically underdeveloped, whilst sweet are over enhanced.

Recommendations are to eat more vegetables than fruit, and where possible choose traditional varieties; some new types of fruit are being bred for their intense sweet taste to suit ever sweetening palates.  For example grapes should be prominently sweet with a hint of sourness and a deep flavour, yet many now are designed to taste like balls of sugar with thin skins and extra water (juiciness sells) to compete with the every growing confectionery industry.

13.  BLW are slow to start solids compared to puree led and may go hungry.

Many say BLW babies consume less foods than those puree fed, but we could also flip that to say puree weaned babies eat more than those BLW.  Some worry BLW infants will go hungry as they can't consume enough.

A small study published last year found:

"BMI scores differed significantly between groups lower BMI were associated with baby-led weaning in the whole sample. The mean BMI percentile rank for the baby-led group was close to the expected average."
"In contrast, the mean percentile rank for the spoon-fed group was above the average level, indicating that more children in this group were likely to be classed as overweight."
"BMI z-scores were also found to differ significantly between the weaning groups. We found there to be an increased incidence of obese children in the spoon-fed group (n=8) as compared to the baby-led group (n=1)" (6)
and
In contrast, more children in the baby-led group were classified as significantly underweight (n=3)
The baby-led group was close to the expected average, furthermore 9 children were obese, 8 spoon fed and 1 baby led.  3 children were underweight, all baby led.    Therefore the risk of overweight when spoon feeding was statistically much greater than the risk of being underweight was if baby led.  They concluded:

"Our results suggest that baby-led weaning promotes healthy food preferences in early childhood that could protect against obesity. This finding is of note given the serious problems with childhood obesity facing many modern societies."

References

1. The Role of Zinc in the Growth and Development of Children Nutrition 2002;18:510–519

2. Davis, Clara M. Results of the self-selection of diets by young children. Can Med Assoc J1939 41: 257-6

3. Strauss, Stephen. Clara M. Davis and the wisdom of letting children choose their own diets.Can Med Assoc J 2006 175: 1199

4. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2001.

5. Hambidge KM, Krebs NF. Zinc deficiency: a special challenge. J Nutr 2007;137:1101-5.

6.  1.I. Blossfeld, A. Collins, M. Kiely, C. Delahunty, Texture preferences of 12-month-old infants and the role of early experiences, Food Quality and Preference, Volume 18, Issue 2, March 2007, Pages 396-404, ISSN 0950-3293, 10.1016/j.foodqual.2006.03.022.

5 comments:

  1. The advice for premature baby weaning is very inconsistent. Our twins were weaned st 6 months corrected but were only 4 months actual..in fact we were encouraged to wean a few weeks short of that - so essentially just after the 3 month corrected mark.

    This meant that there was no way ours had the motor skills to self feed and we felt under lots of pressure to provide iron-rich foods, so we led the weaning rather than them.

    Later on we introduced finger food etc but struggled with lumpy foods well into the second year. I'd be interested to read up on any research regarding the weaning of prems

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  2. Me thinks Ross is a C&G rep, linking to their site indeed - like THAT comment is going to stick around!

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  3. I practised BLW with my daughter and found it, on the whole, enjoyable (apart from the mess!) and very successful in terms of encouraging her to take control of what she wanted to eat and when. I found that Mums seemed to see it as spoon v no spoon whilst I preferred to think of it as let baby decide. Now my daughter is 4, some of it seems to have gone by the wayside, she is constantly bombarded with opportunities for junk food as you mention in your other post, she is way too busy to want to linger at the family dinner table any more and has become a lot more conservative about food, despite eating all sorts of casseroles as a baby, everything is now preferred to be separate, typically without sauce and generally devoid of flavour :o( Still, I am going with it ... I offer a range of healthy things and she selects which she wants. Her weight has gone from being 91st centile at birth, to 75th at age 1 to 25 to 50 centile now she is 4, but she plays out a lot and I tend to feel that slimming down is natural at this age and certainly preferable to being overweight early on. I would definitely allow any future baby to dictate their own eating - but wish I could stop others proffering junk as soon as they turn into a toddler!

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  4. I have done baby-led weaning with both my children. I have never made a puree. When I tell other mums that they look at me like I fell off another planet and landed by accident on this one. They are both adventurous eaters (now aged 18 months and 3.75 years). I can only imagine that people who don't follow this approach are ignorant on the subject and haven't done the research. I would advocate reading Gill Rapley's book from cover to cover and doing a baby first aid course before starting as both these actions will ease worries about choking.

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