Is BLW a safe and nutritious way to start solids? The latest research recommendations.

Are you confused by all the BLW vs traditional spoon-based approach discussions in parenting communities online? You are definitely not alone.

In my previous articles, I discussed the potential benefits of BLW, popular myths surrounding this approach and the most common mistakes I see parents make.

In the last few months, we had a couple of important research studies, including a first randomized control trial (yay!), published their results. Because of this new evidence, I thought it would be a good idea to update you on the most current evidence on the pros and cons of Baby Led Weaning.

First, the big picture. Despite some amazing work done by researchers in the last couple of years, we still do not have enough data to recommend for or against the Baby Led Weaning approach.

Because of this, no health authorities currently include BLW in their recommendations on starting solids with babies. The New Zealand Ministry of Health, in fact, discourages parents from using the BLW approach. I know it may sound like bad news to BLW enthusiasts around the world, but all it means is that we need more solid data. #sciencegeek

Now, let’s look at the pros and cons of BLW vs the traditional approach to solids.

Please note: The randomized control study BLISS (Baby-Led Introduction to SolidS) I am covering in this article looked at a modified BLW approach, where parents were specifically instructed to introduce safe, iron-rich and high energy foods to their babies, to prevent the risk of choking, nutritional deficiencies and growth problems.

This is important because not all parents are getting special training before starting BLW, so the results of an unmodified BLW approach may be different.

Are BLW babies more likely to be of a healthy weight?

Answer: No

According to the results of the randomized control study BLISS, all babies grow in a similar pattern, whether started on solids using BLW or purees.

Earlier and less rigorous research suggested that babies started on solids with purees were more likely to be overweight, while BLW babies were more likely to be underweight.

Are BLW babies less likely to get enough important nutrients?

Answer: No, if the parents are instructed to emphasize iron-rich foods. Also, it looks like whether parents use BLW or the traditional approach, babies are not likely to get enough iron.

Here is what the researchers said:

“We observed no significant differences in iron intake or status between infants following a baby-led approach to complementary feeding that had been modified to address concerns regarding iron intake, and infants following traditional spoon-feeding. However, iron intakes were low in both groups at 7 months (74% of infants at risk of inadequate intakes) and 17% had suboptimal iron status at 12 months.”

An earlier cross-sectional study found that BLW babies may be getting more calories, saturated fat, and less iron, zinc and vitamin B12.

Can BLW prevent picky eating?

Answer: No, although BLW babies tend to have a more positive attitude towards food.

When the researchers conducting the BLISS study interviewed parents at 12 and 24 months, they found that although BLW babies were less picky than spoon-fed babies at 12 months, there was no difference between the two groups by 24 months.

My personal guess is that parents of puree-fed babies may interpret the typical spoon refusal and a drop in appetite at 10-12 months as a picky eating behavior, that’s why they were more likely to report picky eating.

It is really encouraging to see a confirmation that babies enjoy mealtimes more and have a more positive attitude towards meals when they are allowed to be more independent with their food choices. So whether you are using BLW or not, let them decide how much or whether to eat.

Previous observational research suggested that BLW babies were more likely to respond to their hunger and satiety and more likely to stop when they were full.

Are BLW babies more likely to choke on food?

Answer: No, if parents are instructed on how to avoid choking hazards.

As you remember, the parents who took part in the BLISS study received special instructions on safe finger foods and how to position their babies correctly in order to prevent choking. The study did not find any difference in the choking rates between the BLW and traditional solids groups. When it comes to gagging, the researchers found that BLW was more like to gag at 6 months and less like to gag at 8 months, compared to babies fed only purees.

It makes a lot of sense from the developmental perspective. Babies who have an opportunity to gnaw on big pieces of food can potentially desensitize their gag reflex faster and more effectively, than babies who only eat from a spoon.

An earlier study also did not find any difference in choking rates whether babies were started on solids using BLW or the traditional approach.

So, how can we apply these findings to feeding our babies?

If you would like to try the Baby Led Weaning Approach:

Start solids at around 6 months, or when your baby is ready.
Include iron-rich foods in your baby’s diet from early on.
Avoid choking hazards and make sure your baby sits upright in the high chair. No recliners, please.
Be prepared for the picky eating phase, expect age-appropriate feeding behaviors and continue to trust your child’s appetite as she grows into a toddler.

Above all, be flexible and stay attuned to your baby’s needs and abilities and get support when needed. What was your experience with Baby Led Weaning? Let me know in the comments.

If you would like to get the whole framework and all the steps to start your baby on solids safely, using the mixed approach, check my Stress-Free Solids program – it’s completely online and has videos of babies eating both finger foods and purees, in addition to recipes, schedules and the latest scientific advice on introducing allergens. You will also learn how to progress between textures on time, so your baby learns to self-feed and eat table foods fast!

More articles on starting solids:

Can I combine BLW and spoon feeding when starting solids?

10 foods to avoid when feeding a baby

3 reasons food before one is NOT just for fun

How to help your baby to self-feed

Dietitian’s list of best baby feeding products

References:

Daniels L, Heath A, Williams S Cameron S, Fleming E, Taylor B, et al. Baby-Led Introduction to SolidS (BLISS) study: a randomised controlled trial of a baby-led approach to complementary feeding. BMC Pediatr. 2015; 15: 179. Published online 2015 Nov 12. doi: 10.1186/s12887-015-0491-8 PMCID: PMC4643507 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4643507

Brown A, Lee MD. Early influences on child satiety-responsiveness: the role of weaning style. Pediatr Obes. 2015 Feb;10(1):57-66. doi: 10.1111/j.2047-6310.2013.00207.x. Epub 2013 Dec 17. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/24347496

Townsend E, Pitchford NJ. Baby knows best? The impact of weaning style on food preferences and body mass index in early childhood in a case-controlled sample. BMJ Open. 2012 Feb 6;2(1):e000298. doi: 10.1136/bmjopen-2011-000298. Print 2012. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/22315302

Morison BJ, Taylor RW, Haszard JJ, Schramm CJ, Williams Erickson L, Fangupo LJ, et al. How different are baby-led weaning and conventional complementary feeding? A cross-sectional study of infants aged 6-8 months. BMJ Open. 2016 May 6;6(5):e010665. doi: 10.1136/bmjopen-2015-010665. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/27154478

Brown A. No difference in self-reported frequency of choking between infants introduced to solid foods using a baby-led weaning or traditional spoon-feeding approach. J Hum Nutr Diet. 2017 Dec 5. doi: 10.1111/jhn.12528. [Epub ahead of print]. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/29205569