BABY-LED APPROACH TO EATING SOLIDS

by drnieman on April 27, 2017

in Weekly

It is always interesting to read about parenting trends where parents are influenced by popular books or non-traditional ideas. The level of parental passion determines the speed and magnitude with which trends spread—often globally. What is equally interesting is how fast, or more often how slowly, the medical community catch up with whatever is trending. The safety of these trends is often not clear until proper research leads us to definitive answers.

One such an example is the popular trend of Baby-Led Weaning (BLW) where babies are allowed to feed themselves solids —as opposed to being spoon-fed at first by parents. In a popular book, published in 2010, authors Gill Rapley and Tracey Murkett clearly articulated their reasons for promoting BLW.
The authors claim that it is a myth to believe that babies do best when they are spoon fed. They claim that self-feeding from the start is a better way for the baby to develop. By skipping purees and letting a parent follow the baby’s cues, babies are allowed to join the supper table with the family; they discover food for themselves; they learn to love a variety of foods and enjoy mealtimes more.

Baby-led weaning became an overnight parenting phenomenon in the UK and this practice has become a hot topic globally. There are numerous online parent groups who follow this feeding method and many have shared personal experiences via articulate blogs. In Canada, www.babycenter.ca provides online resources for parents who want to explore BLW.

Almost six years after the BLW trend took off, researchers from New Zeeland published the results of what they claim to be the first randomized controlled trial on the safety of BLW (Pediatrics: October 2016) Their research, named BLISS (Baby-Led Introduction of SolidS), involved one of the largest studies done in history, anywhere in the world, but once again it took a relatively long time for science to catch up with a parenting trend.

What makes the study unique is that the researchers invested in detailed parental teaching and supervision prior to allowing BLW. For example, parents were given information on the difference between gagging and choking; education also included both verbal and written instructions.

The study concluded that a BLW approach, which includes advice on minimizing choking risks, do not appear to be more dangerous than the traditional spoon-fed approach. What surprised the authors though, was that in both the traditional and BLW groups a large number of babies were fed foods that pose a choking risk.
Standard anticipatory advice about the introduction of solids and the prevention of choking include: the avoidance of small foods such as nuts, grapes and fruits with seeds; avoiding raw vegetables; avoiding raw apples—whole or sliced; avoiding under-ripe fruits, citrus fruits such as oranges and mandarins unless each segment has been peeled; avoiding popcorn, sausages, carrots or any other similar food cut into rounds or coins; never leave the baby alone with food and ensure that the bay sits upright.
Surprisingly many parents allowed their babies access to foods such as raw apples and raw vegetables—foods which were most commonly associated with choking.

Some speculate that messages of food-related choking are overshadowed by other topics such as breastfeeding and safe sleeping practices or that information is not easily applied. Whatever the cause may be it is clear that nurses and primary care doctors need to be more persistent in educating both traditional and BLW groups about the dangers of choking on food.

After close to 30 years of having the honor to interact with a wide variety of parents in my role as a community-based pediatrician with an interest in healthy eating, and the prevention of food-related morbidities, I am always impressed by the similarities between religion and nutrition. Whatever the opinions may be, whatever the justifications for various methods of feeding may be, there is never a lack of passion or controversy. Beliefs are deeply and firmly held and science follows late or ends up as inconclusive.

In their book “Baby-Led Weaning” the authors claim that BLW leads to happier and more confident eaters later in life. One has to wonder how long behavioral scientists will take to verify the accuracy of this claim. Will BLW truly lead to a lower risk of obesity and happier children later in life? I anticipate reading more about this by the time I retire from pediatrics.

DR. NIEMAN HAS WORKED AS A COMMUNITY-BASED PEDIATRICIAN SINCE 1987. HE CONTIBUTES BI-WEEKLY TO CTV MORNING LIVE, AND BLOGS REGULARLY ON DRNIEMAN.COM ABOUT HEALTHY HABITS FOR FAMILIES AND CHILDREN. DR. NIEMAN RECENTLY COMPLETED HIS 102 nd MARATHON AND HAS RUN DAILY SINCE 2009.

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