Baby-led Weaning: A Preliminary Investigation

Turkish validity and reliability study of the Baby-Led Weaning Scale

AIM

The aim of this study was to test the psychometric properties of the Turkish version of the Baby-Led Weaning Scale for parents with babies/children aged from 6 to 30 months.

METHODS

The sample for this methodological research consisted of parents with babies aged 6 to 30 months between March and June 2024 in a city in eastern Turkey. The data were collected from 354 parents for exploratory factor analysis, from 213 parents for confirmatory factor analysis, and from 70 for the test-retest reliability study. The data were collected using the "Descriptive Information Form", the "Baby-Led Weaning Scale" and the "Transition to Complementary Feeding Behaviors Scale" (TCFBS).

RESULTS

The total content validity index score of the Baby Led Weaning Scale was 0.92 and the content validity rate score was 0.92. The TCBFS was used for the concordance of the scale with similar scales. During the measurements, the intra-observer reliability of the Baby Led Weaning Scale was statistically significant (p < 0.001). The Exploratory Factor Analysis revealed a three-factor structure, explaining 611.5 % of the variance. The fix index values were χ2/df = 3.036, RMSEA = 0.069, GFI = 0.902, CFI = 0.907 and AGFI = 0.857, IFI = 0.928, and TLI = 0.921.The Cronbach alpha values of the scale were in the range of 0.706 and 0.831.

CONCLUSION

As a result, the Turkish adaptation of the Baby Led Weaning Scale is a valid and reliable measurement tool.

PRACTICAL IMPLICATIONS

The Baby-Led Weaning Scale can be used as a simple and objective tool to measure the knowledge level of parents with babies/children aged 6 to 30 months.

Complementary feeding approaches and risk of choking: A systematic review

There are two main complementary feeding (CF) approaches: traditional spoon-feeding (TSF) and baby-led weaning (BLW). Many parents and healthcare professionals have concerns about the risk of choking associated with BLW. Since asphyxia is one of infants' main causes of death, this study aims to understand the influence of the CF approach adopted by caregivers on infants' risk of choking. A systematic review was performed. The search was conducted through PubMed, Scopus, and Web of Science databases. We included randomized controlled trials or observational studies published between January 2010 and November 2023, with a clear definition of the intervention and directly assessing the risk of choking. After the selection procedure, 7 of the 165 studies initially identified were included. No study reported statistically significant differences in the risk of choking between babies following BLW, baby-led introduction to solids (BLISS), and TSF. In five studies, although not statistically significant, infants in the TSF group had more choking episodes than those in the BLW or BLISS groups. The risk of choking does not seem to be associated with the CF approach. Instead, it may be related to the familiarity of the baby with each texture and the parent's understanding of the information about how to minimize the risk of choking. Recall bias may be present in all included studies. Advice on how to modify foods to make them safer needs to be clearer and reinforced to all parents.

Baby Food Pouches, Baby-Led Weaning, and Iron Status in New Zealand Infants: An Observational Study

Iron deficiency in infants can impact development, and there are concerns that the use of baby food pouches and baby-led weaning may impair iron status. First Foods New Zealand (FFNZ) was an observational study of 625 New Zealand infants aged 6.9 to 10.1 months. Feeding methods were defined based on parental reports of infant feeding at "around 6 months of age": "frequent" baby food pouch use (five+ times per week) and "full baby-led weaning" (the infant primarily self-feeds). Iron status was assessed using a venepuncture blood sample. The estimated prevalence of suboptimal iron status was 23%, but neither feeding method significantly predicted body iron concentrations nor the odds of iron sufficiency after controlling for potential confounding factors including infant formula intake. Adjusted ORs for iron sufficiency were 1.50 (95% CI: 0.67-3.39) for frequent pouch users compared to non-pouch users and 0.91 (95% CI: 0.45-1.87) for baby-led weaning compared to traditional spoon-feeding. Contrary to concerns, there was no evidence that baby food pouch use or baby-led weaning, as currently practiced in New Zealand, were associated with poorer iron status in this age group. However, notable levels of suboptimal iron status, regardless of the feeding method, emphasise the ongoing need for paying attention to infant iron nutrition.

Health Professionals' Knowledge, Perceptions, and Attitudes Toward Baby-Led Weaning: Scoping Review

Introduction

Baby-led weaning (BLW) is a growing method for parents to introduce food to their kids. As advisers who affect the decisions of parents, health practitioners have significant obligations in this regard.

Objective

We aim to identify existing literature on the knowledge, perceptions, and attitudes of health professionals toward BLW.

Methods

We carried out a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. After registering with Open Science Framework, published articles were retrieved from EBSCOhost, PubMed, SciELO, ScienceDirect, Open Grey, and the Portuguese Scientific Open Access Repository. Primary studies with full-text availability in English, Spanish, or Portuguese, and no data publication limitations were included.

Results

The final sample included seven publications conducted in five countries published between 2012 and 2022. Only one study employed a hybrid methodology showing incongruent practices in parents/health professionals on BLW, whereas most studies employed a quantitative approach. Regarding BLW, it is recognized that there is a dearth of evidence, consensus, and advice.

Conclusion

Despite benefits, health professionals hesitate to recommend BLW due to insufficient study and safety concerns, warranting more research. Hence, our scoping review demonstrated that BLW is a scientifically under-researched subject, indicating a significant research gap that must be filled in the future.

Baby food pouches and Baby-Led Weaning: Associations with energy intake, eating behaviour and infant weight status

Although concern is frequently expressed regarding the potential impact of baby food pouch use and Baby-Led Weaning (BLW) on infant health, research is scarce. Data on pouch use, BLW, energy intake, eating behaviour and body mass index (BMI) were obtained for 625 infants aged 7-10 months in the First Foods New Zealand study. Frequent pouch use was defined as ≥5 times/week during the past month. Traditional spoon-feeding (TSF), "partial" BLW and "full" BLW referred to the relative proportions of spoon-feeding versus infant self-feeding, assessed at 6 months (retrospectively) and current age. Daily energy intake was determined using two 24-h dietary recalls, and caregivers reported on a variety of eating behaviours. Researchers measured infant length and weight, and BMI z-scores were calculated (World Health Organization Child Growth Standards). In total, 28% of infants consumed food from pouches frequently. Frequent pouch use was not significantly related to BMI z-score (mean difference, 0.09; 95% CI -0.09, 0.27) or energy intake (92 kJ/day; -19, 202), but was associated with greater food responsiveness (standardised mean difference, 0.3; 95% CI 0.1, 0.4), food fussiness (0.3; 0.1, 0.4) and selective/restrictive eating (0.3; 0.2, 0.5). Compared to TSF, full BLW was associated with greater daily energy intake (BLW at 6 months: mean difference 150 kJ/day; 95% CI 4, 297; BLW at current age: 180 kJ/day; 62, 299) and with a range of eating behaviours, including greater satiety responsiveness, but not BMI z-score (6 months: 0.06 (-0.18, 0.30); current age: 0.06 (-0.13, 0.26)). In conclusion, neither feeding approach was associated with weight in infants, despite BLW being associated with greater energy intake compared with TSF. However, infants who consumed pouches frequently displayed higher food fussiness and more selective eating.

Complementary Feeding Methods, Feeding Problems, Food Neophobia, and Picky Eating among Polish Children

Proper nutrition during the first period of life is primarily related to meeting energy needs and providing essential nutrients that ensure the infant's normal physical and psychomotor development. Improper nutrition during this period, inadequate amounts of nutrients, inappropriate timing and manner of introduction of individual foods, can permanently alter metabolism and the course of physiological processes, increasing the risk of diseases such as obesity, allergic diseases, and cardiovascular diseases. This study aimed to verify how the method of complementary feeding influences the occurrence of food neophobia between 2 and 7 years of age, as well as to assess the different nutritional aspects resulting from the process of starting feeding other than breast milk and milk formula. In this study, 490 mothers and their children aged 2-7 years participated. The research tool was a questionnaire consisting of a child's dietary assessment and standardized questionnaires assessing food neophobia among children: Food Neophobia Scale for Children (FNSC) and the Montreal Children's Hospital-Pediatric Feeding (MCH-FS). In the study group of children, 238 (48.57%) had no Baby-Led Weaning Method (no BLW) method used during complementary feeding (CF), and 252 (51.42%) children used Baby-Led Weaning Method (BLW). According to the FNSC questionnaire, a high risk of food neophobia was found in 32.65% of the children studied and a medium risk in 39.80%. The medium risk of feeding problem occured in 11.63% of children, the high risk in 6.73% of children, and the highest risk in 6.94% (MCH-FS). No statistically significant differences were observed between the BLW and NoBLW groups. High risk of food neophobia occured in 1/3 of the children studied, but there was no relationship in the study group between the mode of CF (BLW/NoBLW) and the risk of food neophobia.

Experiences and opinions towards baby-led weaning by healthcare professionals. A qualitative study

BACKGROUND

Baby-led weaning (BLW) is an alternative method to spoon-feeding to introduce solid foods. This study aimed to describe and understand the experiences and opinions of pediatricians and pediatric nurse specialists of the implementation of the BLW approach.

METHODS

An interpretive descriptive qualitative research was carried out. A focus group with 7 participants and 13 face-to-face interviews were conducted between February and May 2022 (17 females and 3 males). All were audio-recorded, transcribed, and analyzed with the supported by Atlas.Ti qualitative data analysis software.

RESULTS

From the data, two themes developed: (1) BLW as an ideal method of introducing solid food, with the subthemes: "a natural method of introducing complementary feeding" and "BLW is a safe method"; (2) Perceived barriers to the uptake of the BLW method, with the subthemes: "a lack of BLW training prevents the best practice" and "the influence of family and social context on parents."

CONCLUSIONS

Healthcare professionals perceive BLW to be a safe and natural weaning approach. The lack of training of healthcare professionals and the influence of family social context on parents may limit the implementation of BLW.

IMPACT

Baby-led weaning is perceived by healthcare professionals as a safe complementary feeding method that promotes chewing, improves growth, and the development of fine motor skills. However, lack of training of healthcare professionals and the family social context of the parents hinders the uptake of baby-led weaning. The views of the family and parents' social context about baby-led weaning may restrict their willingness to use the method. Family education delivered by healthcare professionals may avoid risks and allay parental anxieties about safety.

Relationship of baby led weaning to other parenting and feeding constructs

BACKGROUND

Baby-led weaning (BLW), a popular complementary feeding style, prioritizes exploration of foods, independence of children in eating, and eating with family. Though BLW has received popular attention, empirical evidence is limited. This study measured parents' reports of BLW, parenting style, and feeding practices; analyzed BLW's relation to children's dietary intake; examined how demographic variables such as age, parent sex, education, and marital status related to the prevalence of using BLW.

METHODS

This cross sectional study recruited 313 parents with children ages 6-30 months via Cloud Research, an online survey platform where individuals complete surveys for compensation. Hierarchical regressions examined how feeding style, dietary intake, and parenting style related to independence, exploration, and family subscales of BLW after controlling for relevant demographics.

FINDINGS

The majority (69.3%) of participants identified as female, white (76.6%), middle-class (52.4%), married (69%), and a third had a bachelor's degree (37.4%). Restrictive feeding practices, Ellyn Satter's division of responsibility, and the parents' sex were significant predictors of all subscales of BLW.

DISCUSSION

Parents who use BLW allowed for an autonomous food experience and were less likely to restrict or control the child's eating. BLW appears to be related to, but distinct from, well-researched parent feeding practices such as restriction and division of responsibility.

APPLICATION TO PRACTICE

These findings might be useful in education and interventions for healthcare professionals. Future research on BLW should examine how child behavior and nutrition outcomes compare to other feeding practices.

Consensus on complementary feeding from the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition: COCO 2023

Complementary feeding (CF) is defined as the feeding of infants that complements breastfeeding, or alternatively, feeding with a breast milk substitute, and is a process that is more than simply a guide as to what and how to introduce foods. The information provided by healthcare professionals must be up-to-date and evidence-based. Most of the recommendations that appear in the different international guidelines and position papers are widely applicable, but some must be regionalized or adapted to fit the conditions and reality of each geographic zone. The Nutrition Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) summoned a group of experts from each of the society's member countries, to develop a consensus on CF, incorporating, whenever possible, local information adapted to the reality of the region. The aim of the present document is to show the results of that endeavor. Utilizing the Delphi method, a total of 34 statements on relevant aspects of CF were evaluated, discussed, and voted upon.

"Baby-led weaning" - Progress in infant feeding or risky trend?

Baby-led weaning (BLW), proposed as a new form of complementary feeding, has emerged as a real trend phenomenon in the media. Infants are seated at the family table from the age of 6 months, facing the foods they grab and bring to their mouth: they decide which foods they want to eat and what amount. The consumption of mashed foods and the use of a spoon are totally discouraged. BLW is increasingly used in nurseries and centers of young children. A bibliographic search carried out between 2000 and 2021 found 423 articles, of which 38 were selected. The clinical studies selected are 11 cross-sectional observational studies and two randomized controlled studies. BLW promotes breastfeeding, the early introduction of morsels, the respect of the child's appetite, the use of unprocessed foods, and the choice of "homemade" and friendliness. These benefits can nonetheless be reached with usual complementary feeding (SCF), according to current recommendations. Other benefits are claimed without scientific evidence such as easier achievement of dietary complementary feeding and an optimal growth with prevention of excess weight gain. BLW has some obvious downsides. The infant may not get enough energy, iron, zinc, vitamins, and other nutrients, or too much protein, saturated fat, salt, or sugar. The risk of choking, which must be distinguished from the physiological gagging reflex, has not been ruled out by scientific studies. Currently, the Nutrition Committee of the French Pediatric Society considers that the data published to date in terms of benefits and risks of BLW do not lend themselves to advice for this practice in preference over SCF carried out according to current recommendations.

Baby-led weaning: A thematic analysis of comments made by parents using online parenting forums

BACKGROUND

Baby-led weaning (BLW) centres on making the baby an active partner, rather than a passive recipient of complementary feeding. Key features of BLW include self-feeding foods in their natural form, eating with the rest of the family and consuming family foods. This differs from traditional weaning (TW) where parents initially spoon feed purees, alongside finger foods, before graduating to more textured food. Previous research, however, has suggested parents may not fully adhere to one weaning style. This study aimed to explore how the meaning and interpretation of BLW may contribute to the weaning style used.

METHODS

Messages and responses posted on three UK parenting forums, and relating to complementary feeding, were analysed using an interpretive thematic approach.

RESULTS

The characterisation of BLW by parents was varied but they described BLW having an ethos which included trusting the baby, role modelling, developing confidence with food and sharing the social aspects of mealtimes. BLW also offered an alternative to those actively seeking something different or a default for those whose baby refused purees or spoon feeding. BLW felt like a natural progression, with low parental effort for some, and a source of anxiety, stress, choking risk and mess for others. Many parents struggled to find a process (what to eat and when) within BLW, that they could follow. Finger foods were used synonymously with BLW but many mixed/blurred aspects of both TW and BLW.

CONCLUSIONS

The interpretation of BLW varies considerably between parents and a broader definition of BLW may be required, along with guidance on the process and purpose of BLW. This article is protected by copyright. All rights reserved.

Use of the Baby-Led Weaning (BLW) Method in Complementary Feeding of the Infant-A Cross-Sectional Study of Mothers Using and Not Using the BLW Method

Baby-led weaning (BLW) is an increasingly popular way of expanding a baby’s diet. It is based on the baby becoming physically ready to feed himself, effectively supplementing his diet, which until now has been based on breast milk or modified milk. The aim of the study was to assess mothers’ knowledge about the use of the BLW method to expand the diet of a young child. The essence of the study assumed the analysis of the advantages and disadvantages of using this method indicated by mothers. Materials and Methods: A total of 320 mothers participated in the study. Data for the study were collected anonymously using the CAWI method. The research tool was the original questionnaire relating to the knowledge about the BLW method and the application of the BLW method in practice. Results: The BLW method was used by 240 (75%) women. The reasons for not using the BLW method were: the child did not cooperate n = 30 (37.5%) and was not ready to use the BLW method n = 20 (25%). In total, 182 (75.8%) mothers using BLW and 63 (78.8%) mothers not using BLW started extending the diet before the child was 6 months old. According to 270 (84.4%) mothers, including 205 (85.4%) using BLW, stable sitting in a highchair/on the lap is a decisive factor for starting the dietary expansion with the BLW method. Conclusions: Mothers’ knowledge of the BLW method as a way of expanding a young child’s diet was insufficient. It seems important to implement appropriate educational activities on the methods of expanding children’s diets to broaden parents’ knowledge of the influence of nutrition on infant development.

Knowledge and attitudes towards baby-led-weaning by health professionals and parents: A cross-sectional study

OBJECTIVE

Baby-led-weaning (BLW) is a novel model of complementary feeding. Although there is little scientific evidence to support the suitability or superiority of this complementary feeding model, BLW is followed by many families today. The aim was to evaluate the knowledge and attitudes of a group of parents and health professionals regarding BLW in Spain.

METHODS

This research was designed as a cross-sectional study in a sample of 502 parents and 364 health professionals. Two questionnaires generated and disseminated through Google forms were used. The differences between groups of professionals were analyzed using the Chi-Square test.

RESULTS

92.3% of professionals and 93.4% of parents knew about BLW. They recommend BLW "always" in 39.8% and 69.3% of the cases, and "sometimes" in 49.7% and 24.9%, respectively. Of the health professionals, 80.5% recommended starting complementary feeding as of six months, 36% of them using BLW, 24% followed traditional weaning, 3.3% bottle feeding and the remaining 36% did not indicate. Eighty-three percent recommended chewing as soon as the child showed interest.

CONCLUSION

Both health professionals and parents recommend BLW and consider it helps promote the developmental milestones of the baby. Providing nurses with an adequate number of resources to guide parents on complementary feeding will continue to improve childcare.

Practical Implementation of the BLW Method During the Expansion of the Infant Diet—A Study Among Polish Children

The aim of the study was to verify the knowledge of mothers of children under 3 years of age about the Baby Led Weaning (BLW) feeding model and their practical implementation of this method. The study involved 761 mothers and their children. After analysis of the inclusion and exclusion criterion, the information provided by women 699 aged 21–48 years was included in the final data analysis. In the study group, most children were breastfed for 6 months to 1 year (n = 256, 36.7%), 1 year to 2 years (n = 179, 25.6%) and over 2 years (n = 71, 10.2%). Starting dietary expansion before 17 weeks of age was implemented in 47 (6.7%) children, between and 17–26 weeks of age in 328 (46.9%) children, and after 26 weeks of age in 324 (46.3%) children. Feeding food and dishes from the family table was practiced by 518 (74.1%) mothers. Spoon-feeding was practiced by 529 (75.6%) children, 157 (22.4%) children were fed this way sometimes. Taking into account the above data, feeding with the BLW method was used in 170 children (24.2%). In the examined group of mothers the use of the BLW method in feeding their children, especially during diet expansion, was declared by 408 women (74.8%). The child's independent decision concerning what the child will eat and what is according to the BLW method is accepted by 434 (62.1%) mothers. Among the positive aspects of using the BLW method, the women surveyed indicated the child's independence, while among the disadvantages, the omnipresent mess and chaos when eating meals.

Traditional complementary feeding or BLW (Baby Led Weaning) method? - A cross-sectional study of Polish infants during complementary feeding

Baby-led weaning (BLW) is an increasingly well-known method of complementary feeding for infants. The BLW method is based on the fact that the baby becomes physically ready to eat on its own and can henceforth effectively supplement its diet, which was previously based on breast milk or formula milk. The aim of the study was to compare complementary feeding among mothers using and not using the BLW method. The study took into account, among other things, the frequency of spoon feeding, eating from the family table, and eating meals with a pulpy consistency. The study also determined the frequency of the risk of choking/gagging, food regurgitation or the occurrence of vomiting during a meal in the study groups. Material and method: a cross-sectional survey was conducted among mothers of children from 6 months to 36 months of age residing throughout Poland.

RESULTS

The study group was divided into three subgroups: mothers using BLW (M-BLW), mothers not familiar with the BLW method (M-NoBLW)), mothers not using the BLW method - mothers using the spoon-feeding method) (M-TS). Among the mothers surveyed, 413 women (63.93%) used the BLW method, 222 mothers (34.36%) did not use the BLW method of which 50 (7.73%) of these were unfamiliar with the method, and 172 (26.62%) simply did not use it. Among M-TS mothers, the child was most often entirely or mostly spoon-fed by an adult (73.84%), and the same was true for the M-NoBLW group (70.0%). In the M-BLW group, 58.60% of children were half-fed by an adult with a spoon. half ate independently.

CONCLUSIONS

Infants fed by the BLW method were more likely to have their diets expanded after 6 months of age, they were also more likely to be given products from the family table than children fed traditionally with a spoon. Full BLW was implemented by only 29% of children in the BLW group. The vomiting reflex, spitting food out of the mouth, and gagging, were more common among children fed by the BLW method. In contrast, choking occurred comparably often in both groups - in 5.4% of spoon-fed children and 6.9% of BLW-fed children.

Estimated energy and nutrient intake for infants following baby-led and traditional weaning approaches

Baby-led weaning (BLW), where infants self-feedwithout the use of spoon-feeding by a caregiver, continues to be a popular approach to starting solids. However, concerns remain amongst health professionals that infants using this method may not consume sufficient energy or nutrients from solid foods. Little research has examined how different weaning approaches shape dietary intake. The aim of this study was to use a three-day weighed diet diary to measure estimated energy and nutrient intake in infants aged 6-12 months. Diet diaries were completed by 71 parents and analysed to compareestimated infant intake from milk and solid foods for those either following a BLW or traditional spoon-feeding approach (TW). Intake was analysed for each weaning group in two age groups: 26-39 and 40-52 weeks, to account for different eating patterns at the start and end of the weaning process. For the younger infants, significant differences in estimatedenergy intake were found, with TW infants consuming 285 kcal from solid foods compared with 120 kcal for BLW infants. Conversely, BLW infants consumed more calories and nutrients from breast or formula milk, consistent with a slower transition to solid foods. No differences were found in estimated intake amongst older infants suggesting BLW infants had 'caught up' with their spoon-fed peers. Overall, few infantsregardless of weaning group met recommended intake guidelines for energy (either over or under consuming) with many deficient in iron and zinc intake. The findings are important for those supporting parents through the transition to solid foods. This article is protected by copyright. All rights reserved.

Food texture experiences across age groups in 4- to 36-month-old children in the United States

The question of what to feed becomes a new challenge as an infant reaches the transition to complementary foods. Limited information is available that provides a texture progression map for complementary food introduction. Thus, the objective of this study was to determine the relationship between age and food texture experiences (FTE) in young children aged 4-36 months in the United States. A parent-reported survey was fielded with 328 children categorized into five age groups (AGs): 4-8 months (AG1), 9-12 months (AG2), 13-18 months (AG3), 19-24 months (AG4), and 25-36 months (AG5). The present study analyzed four questions focused on FTE, with statistical analyses including probit and logit models, and analysis of variance. Results showed that all 16 food textures were tried at least once (>50%) by AG3. The question answered by participants, "How well does your child manage a specific texture," showed that significant differences existed among AGs for the management of 10 food textures (including chewy, hard, soft), whereas teething alone had no effect. The most refused textures by the children were AG1-crispy (27%), AG2-leafy (23%), AG3-leafy (40%), AG4-tough meat (52%), and AG5-leafy (51%). With increasing AG, the refusal probability of nine food textures, including chewy, leafy, and rubbery, also increased (p < .05). The refusal probability of cold food temperatures decreased with increasing age (p < .05). This study observed FTE in children across AGs and provides useful information to parents and practitioners as they introduce food textures into children's diets.

Building Robust Assemblages of Bacteria in the Human Gut in Early Life

The neonatal body provides a range of potential habitats, such as the gut, for microbes. These sites eventually harbor microbial communities (microbiotas). A "complete" (adult) gut microbiota is not acquired by the neonate immediately after birth. Rather, the exclusive, milk-based nutrition of the infant encourages the assemblage of a gut microbiota of low diversity, usually dominated by bifidobacterial species. The maternal fecal microbiota is an important source of bacterial species that colonize the gut of infants, at least in the short-term. However, development of the microbiota is influenced by the use of human milk (breast feeding), infant formula, preterm delivery of infants, caesarean delivery, antibiotic administration, family details and other environmental factors. Following the introduction of weaning (complementary) foods, the gut microbiota develops in complexity due to the availability of a diversity of plant glycans in fruits and vegetables. These glycans provide growth substrates for the bacterial families (such as members of the Ruminococcaceae and Lachnospiraceae) that, in due course, will dominate the gut microbiota of the adult. Although current data are often fragmentary and observational, it can be concluded that the nutrition that a child receives in early life is likely to impinge not only on the development of the microbiota at that time but also on the subsequent lifelong, functional relationships between the microbiota and the human host. The purpose of this review, therefore, is to discuss the importance of promoting the assemblage of functionally robust gut microbiotas at appropriate times in early life.

Brazilian health professionals' perception about the Baby-Led Weaning (BLW) method for complementary feeding: an exploratory study

Objective:

To describe Brazilian health professionals’ perception about the Baby-Led Weaning (BLW) method use for complementary feeding.

Methods:

Cross-sectional, descriptive study including 458 health professionals graduated in Nursing, Speech Therapy, Medicine, Nutrition or Dentistry and working in Pediatrics, being directly or indirectly involved with pediatric nutrition. We used a convenience non-probability sampling. The questionnaire applied to participants addressed demographic characteristics, academic degree, workplace, knowledge about clinical practice and perceptions about the possible advantages of the BLW method.

Results:

Participants had a mean age of 34.5±8.5 years, 64.6% of them working in Southeast Brazil and 65.3% being nutritionists. Most participants reported being acquainted with the BLW method (82.0%). Regarding clinical practice, 38.3% mentioned having recommended the BLW some times, 37.5% often and 20.5% always. Most participants fully agreed that the BLW method could have advantages for babies, for example, having them more likely to share family meals, facilitating adaptation to food flavors and consistencies, enhancing chewing and favoring the development of motor skills. On the other hand, important disagreements were also expressed regarding the BLW convenience and the possibility to create less concerns or anxiety in parents.

Conclusions:

The BLW method reported as advantageous, but disagreements were also raised, probably because scientific evidences on the suject are scarse. Further investigation is needed so we can better understand the risks and benefits and health care professionals can feel effectively assisted to offer support and advice to parents and caretakers.

Comparison of food and nutrient intake in infants aged 6-12 months, following baby-led or traditional weaning: A cross-sectional study

BACKGROUND

A baby-led approach to weaning (BLW) encompasses self-feeding and self-selecting graspable foods, offering an alternative to traditional weaning (TW). This cross-sectional study explored adherence to characteristics of BLW and differences in food group exposure and nutrient intake between babies following either TW or BLW.

METHODS

Nutritional data were collected via multiple-pass 24-h recall, following parental completion of an online survey.

RESULTS

Infants were grouped according to age (6-8 months; TW [n = 36] and BLW [n = 24]) and (9-12 months; TW [n = 24] and BLW [n = 12]). BLW babies were more likely to be breast fed (p = 0.002), consumed a higher percentage of foods also consumed by their mother (p = 0.008) and were fed less purees (p < 0.001) at 6-8 months. TW babies were spoon fed more (p ≤ 0.001) at all ages. Amongst babies aged 6-8 months, total intake (from complementary food plus milk) of iron (p = 0.021), zinc (p = 0.048), iodine (p = 0.031), vitamin B12 (p = 0.002) and vitamin D (p = 0.042) and both vitamin B12 (p = 0.027) and vitamin D (p = 0.035) from complementary food alone was higher in babies following TW. Compared to TW, BLW babies aged 6-8 months had a higher percentage energy intake from fat (p = 0.043) and saturated fat (p = 0.026) from their milk. No differences in nutrient intake were observed amongst infants aged 9-12 months. Few differences were observed between groups in their number of exposures to specific food groups.

CONCLUSIONS

TW infants had higher intakes of key micronutrients at 6-8 months, although there were few differences in nutritional intake at 9-12 months or food group exposure between babies following TW or BLW. BLW appears to be socially desirable. Guidance for parents is required, along with larger, longer-term studies, which explore the potential impact of BLW in later childhood.

Infant Feeding and Information Sources in Chilean Families Who Reported Baby-Led Weaning as a Complementary Feeding Method

Baby-Led Weaning (BLW) is a new and emerging method of introducing complementary feeding in solid consistency, without the use of a spoon and entirely guided by the baby. This study aims to analyze the implementation of the BLW approach in relation to compliance with basic components and sources of information in Chilean families. Using a cross-sectional design, we assessed early nutrition, including breastfeeding and foods offered, maternal/child characteristics and sources of information on BLW among a non-probabilistic sample of mothers of children <24 months who reported practicing BLW (n = 261, median age = 28 years) in Chile. We found that 57.5% of mothers reported their child ate the same food as the family, 44.1% shared ≥3 meals with the family, 84.7% offered ≥3 foods at each meal and 75.6% reported only occasionally offering food with a spoon. The majority reported obtaining information on BLW from social media (82%). Moreover, 56% had offered cookies, 32% added salt and 9% sugar in the first 2 years. Exclusive breastfeeding for 6 months related to higher odds of consuming family foods (OR = 2.45, 95% CI 1.24–4.84), while having received information from professional sources and social media related to lower odds (OR = 0.45, 95% CI 0.22–0.88 and OR = 0.31, 95% CI 0.15–0.66, respectively). Those who had appropriate weight gain had lower odds of consuming ≥3 foods in meals (OR = 0.35, 95% CI 0.13–0.96). Among mothers who reported practicing BLW with their children, we observed a wide variety of feeding habits, sources of information and low compliance with the studied components. Eating the same food as the family was the most prevalent component and social media was the main source of information on BLW.

Complementary Feeding Methods-A Review of the Benefits and Risks

Complementary feeding methods have the potential to not only ensure a diet of nutritional adequacy but also promote optimal food-related behaviours and skills. While the complementary feeding practice known as baby-led weaning (BLW) has gained popularity, evidence supporting the potential benefits and/or risks for infant growth, development, and health warrants consideration. A review of 29 studies was conducted with findings indicating that parents who implement BLW typically have higher levels of education, breastfeed for longer, and differ in other personality traits. Fear of choking was an important factor in parents’ decision not to implement BLW; however, this fear was not supported by the literature. Benefits of BLW included lower food fussiness, higher food enjoyment, lower food responsiveness, and higher satiety responsiveness. While this profile of eating behaviours confers a reduced obesity risk, few studies have examined the relationship between BLW and infant growth robustly. BLW does not seem to increase the risk of inadequate zinc or iron intake; however, emphasis needs to be given to ensuring adequate intake of these micronutrients among all infants. A better understanding of the impacts of BLW is needed to inform evidence-based recommendations to support and guide parents in complementary feeding methods.

[Common practices and beliefs in the preparation of complementary infant feeding in a Spanish sample: a cross-sectional study]

INTRODUCTION

complementary feeding together with breast milk should cover the nutritional needs of children from 6 months onwards. Thus, inadequate dietary practices can lead to poor nutritional intake. The objective of this study was to examine infant food handling and cooking in Spanish households.

METHODOLOGY

a cross-sectional study was carried out using an online survey in non-institutionalized adults living in Spain who usually prepare infant food for children under 2 years of age.

RESULTS

a total of 1,944 people (37.4 ± 6 years; 65.5 % women) answered the survey. Of these, 72 % prepared mainly mashed foods and 21 % used store-bought baby cereals frequently. Zucchini (39 %), chicken (62 %), hake (64 %) and banana (44 %) were the most commonly used foods. Boiling (63 %) and freezing (59 %) were the most widely used culinary and preservation practices. An inappropriate use of salt and some unsafe foods (large fish and chard) was identified, whereas olive oil and eggs were offered below the current nutritional recommendations.

CONCLUSION

the population surveyed preferred to use mashed foods to feed children under 2 years of age. Even though they were aware that homemade food is nutritionally better, on certain occasions they offer store-bought baby cereal. Furthermore, some inappropriate feeding practices were detected, highlighting the need to implement nutritional education policies regarding infant food preparation.

Knowledge and attitudes towards baby-led-weaning by health professionals and parents: A cross-sectional study

OBJECTIVE

Baby-led-weaning (BLW) is a novel model of complementary feeding. Although there is little scientific evidence to support the suitability or superiority of this complementary feeding model, BLW is followed by many families today. The aim was to evaluate the knowledge and attitudes of a group of parents and health professionals regarding BLW in Spain.

METHODS

This research was designed as a cross-sectional study in a sample of 502 parents and 364 health professionals. Two questionnaires generated and disseminated through Google forms were used. The differences between groups of professionals were analyzed using the Chi-Square test.

RESULTS

92.3% of professionals and 93.4% of parents knew about BLW. They recommend BLW "always" in 39.8% and 69.3% of the cases, and "sometimes" in 49.7% and 24.9%, respectively. Of the health professionals, 80.5% recommended starting complementary feeding as of six months, 36% of them using BLW, 24% followed traditional weaning, 3.3% bottle feeding and the remaining 36% did not indicate. Eighty-three percent recommended chewing as soon as the child showed interest.

CONCLUSION

Both health professionals and parents recommend BLW and consider it helps promote the developmental milestones of the baby. Providing nurses with an adequate number of resources to guide parents on complementary feeding will continue to improve childcare.

A quasi-experimental intervention protocol to characterize the factors that influence the acceptance of new foods by infants: mothers' diet and weaning method. Dastatuz project

BACKGROUND

Children usually refuse to eat and taste fruits and vegetables; and turning unhealthy eating habits around is an important social challenge in industrialized countries. The Dastatuz project aims to study children food neophobia and to enhance fruit and vegetable acceptance.

METHODS

A quasi-experimental, multicentre, controlled and prospective intervention study is proposed, in which early factors influencing new food acceptance will be studied. Mothers in the third trimester of pregnancy (n = 144) and their infants will be the study population. Experimental groups will be established based on mothers´ fruit and vegetable intake (standard or high intake) and weaning method (baby lead weaning vs spoon feeding). The project will assess the possible impact of maternal diet and complementary feeding on infants eating behaviour until 18 months of age. Outcome measures will comprise maternal diet and psychological features during pregnancy and breast-feeding (validated questionnaires). Compositional and physicochemical analysis of milk during breastfeeding will also be carried out. During weaning, until 18 months of age, children's diet will be assessed with 24 h recalls and acceptance of new fruits and vegetables will be studied using video recording.

DISCUSSION

If the intervention is effective, this research work would have a high potential to be transferred to future public health programs or nutrition guidelines, as a feasible solution to achieve a higher intake of fruits and vegetables among children.

TRIAL REGISTRATION

This study is registered at ClinicalTrials.gov. Identifier: NCT04262102 . Registration date: February 10, 2020 - Retrospectively registered.

Nutritional Implications of Baby-Led Weaning and Baby Food Pouches as Novel Methods of Infant Feeding: Protocol for an Observational Study

BACKGROUND

The complementary feeding period is a time of unparalleled dietary change for every human, during which the diet changes from one that is 100% milk to one that resembles the usual diet of the wider family in less than a year. Despite this major dietary shift, we know relatively little about food and nutrient intake in infants worldwide and virtually nothing about the impact of baby food "pouches" and "baby-led weaning" (BLW), which are infant feeding approaches that are becoming increasingly popular. Pouches are squeezable containers with a plastic spout that have great appeal for parents, as evidenced by their extraordinary market share worldwide. BLW is an alternative approach to introducing solids that promotes infant self-feeding of whole foods rather than being fed purées, and is popular and widely advocated on social media. The nutritional and health impacts of these novel methods of infant feeding have not yet been determined.

OBJECTIVE

The aim of the First Foods New Zealand study is to determine the iron status, growth, food and nutrient intakes, breast milk intake, eating and feeding behaviors, dental health, oral motor skills, and choking risk of New Zealand infants in general and those who are using pouches or BLW compared with those who are not.

METHODS

Dietary intake (two 24-hour recalls supplemented with food photographs), iron status (hemoglobin, plasma ferritin, and soluble transferrin receptor), weight status (BMI), food pouch use and extent of BLW (questionnaire), breast milk intake (deuterium oxide "dose-to-mother" technique), eating and feeding behaviors (questionnaires and video recording of an evening meal), dental health (photographs of upper and lower teeth for counting of caries and developmental defects of enamel), oral motor skills (questionnaires), and choking risk (questionnaire) will be assessed in 625 infants aged 7.0 to 9.9 months. Propensity score matching will be used to address bias caused by differences in demographics between groups so that the results more closely represent a potential causal effect.

RESULTS

This observational study has full ethical approval from the Health and Disability Ethics Committees New Zealand (19/STH/151) and was funded in May 2019 by the Health Research Council (HRC) of New Zealand (grant 19/172). Data collection commenced in July 2020, and the first results are expected to be submitted for publication in 2022.

CONCLUSIONS

This large study will provide much needed data on the implications for nutritional intake and health with the use of baby food pouches and BLW in infancy.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12620000459921; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379436.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/29048.

"Becoming an independent feeder": infant's transition in solid food introduction through baby-led weaning

BACKGROUND

Baby-led weaning (BLW), a method for introducing complementary foods, has become popular because it is considered beneficial for infants.

METHODS

This study investigated the experiences of mothers when using BLW in Jakarta, Indonesia using a qualitative descriptive approach. Thirteen mothers participated who had introduced complementary feeding using BLW for a minimum of 6 months. Semi-structured interviews and thematic analysis was used to work with the data.

RESULTS

Three themes were identified: avoiding being a 'picky' eater; infants gagging and choking; and becoming independent feeders.

CONCLUSION

Further research related to the growth and development of baby-led weaning infants in Indonesia is recommended.

Baby-led weaning: prevalence and associated factors in Spain

The main goals of this study are to estimate the percentage of mothers who declared feeding their children with baby-led weaning (BLW) and to characterize them. A cross-sectional survey was carried out in 2016 targeting women who had given birth in 2016 (sample size 6777) in Galicia (Spain). The questionnaire included questions regarding the mother's characteristics and behaviors, attitudes, and practices related to BLW. Prevalence of exclusive and non-exclusive BLW was estimated. Different maternal characteristics were evaluated for their possible association with BLW using a logistic regression model. The percentages and ORs were presented with a 95% confidence interval. The study included 6355 women, of which 38.6% (37.4-39.9) had heard of BLW and the overall prevalence of BLW was estimated at 14.0% (13.1-14.9). Prevalence of exclusive BLW was estimated at 2.1% (2.4-3.3). No differences were observed when age was taken into consideration. Children fed with BLW were more likely among mothers who continue with exclusive breastfeeding (OR, 4.1 (95% CI, 3.3-5.0)); live in an urban setting (OR, 1.6 (1.2-2.2)); or have a higher level of education (OR, 1.3 (1.1-1.5)).Conclusion: Full adherence to BLW seems low among mothers who claimed to have fed their children following this method.What is Known:• Baby-led weaning (BLW) has been present in our society for almost two decades, but it remains unclear how many mothers choose BLW for their children.What is New:• BLW is not a common choice for weaning in Spain, and more than half of the mothers had not heard about it.• Full adherence to BLW seems low among mothers who claimed to have fed their children following this method.

Mothers' experiences with complementary feeding: Conventional and baby-led approaches

AIM

Lifelong eating behaviours are shaped in infancy with the introduction of solid foods (complementary feeding). A conventional approach to complementary feeding, encompassing spoon feeding of pureed foods, has long been the standard. Baby-led weaning is a contemporary approach whereby the infant is encouraged to choose what and how much they eat. Mothers navigate decisions about what and how to introduce foods to their infant in diverse ways. This study set out to explore the complementary feeding approaches of women.

METHODS

A qualitative study utilising photovoice and focus groups generated data that provided insight into women's lived experiences of complementary feeding. Thirteen women were purposively sampled and data were analysed in line with descriptive phenomenology.

RESULTS

Three recurrent themes emerged from the data. Women's approaches to complementary feeding were mediated by "trust," "convenience" and making decisions that were "value based versus practical based." Trust manifested in various forms including trusting the infant, trusting women's own instincts and the tension between social pressures and trust of self.

CONCLUSIONS

Differences between women following a conventional vs baby-led approach were also seen in perceptions of convenience, and the decision-making process. This study provides insight into how and why women choose certain feeding practices and can be used to better equip health professionals to work with new mothers in providing realistic and nuanced feeding support.

Mediation Analysis as a Means of Identifying Dietary Components That Differentially Affect the Fecal Microbiota of Infants Weaned by Modified Baby-Led and Traditional Approaches

The introduction of "solids" (i.e., complementary foods) to the milk-only diet in early infancy affects the development of the gut microbiota. The aim of this study was to determine whether a "baby-led" approach to complementary feeding that encourages the early introduction of an adult-type diet results in alterations of the gut microbiota composition compared to traditional spoon-feeding. The Baby-Led Introduction to SolidS (BLISS) study randomized 206 infants to BLISS (a modified version of baby-led weaning [BLW], the introduction of solids at 6 months of age, followed by self-feeding of family foods) or control (traditional spoon-feeding of purées) groups. Fecal microbiotas and 3-day weighed-diet records were analyzed for a subset of 74 infants at 7 and 12 months of age. The composition of the microbiota was determined by sequencing of 16S rRNA genes amplified by PCR from bulk DNA extracted from feces. Diet records were used to estimate food and dietary fiber intake. Alpha diversity (number of operational taxonomic units [OTUs]) was significantly lower in BLISS infants at 12 months of age (difference [95% confidence interval {CI}] of 31 OTUs [3.4 to 58.5]; P = 0.028), and while there were no significant differences between control and BLISS infants in relative abundances of Bifidobacteriaceae, Enterobacteriaceae, Veillonellaceae, Bacteroidaceae, Erysipelotrichaceae, Lachnospiraceae, or Ruminococcaceae at 7 or 12 months of age, OTUs representing the genus Roseburia were less prevalent in BLISS microbiotas at 12 months. Mediation models demonstrated that the intake of "fruit and vegetables" and "dietary fiber" explained 29% and 25%, respectively, of the relationship between group (BLISS versus control) and alpha diversity.IMPORTANCE The introduction of solid foods (complementary feeding or weaning) to infants leads to more-complex compositions of microbial communities (microbiota or microbiome) in the gut. In baby-led weaning (BLW), infants are given only finger foods that they can pick up and feed themselves-there is no parental spoon-feeding of puréed baby foods-and infants are encouraged to eat family meals. BLW is a new approach to infant feeding that is increasing in popularity in the United States, New Zealand, the United Kingdom, and Canada. We used mediation modeling, commonly used in health research but not in microbiota studies until now, to identify particular dietary components that affected the development of the infant gut microbiota.

Impact of a Modified Version of Baby-Led Weaning on Dietary Variety and Food Preferences in Infants

The aim of this study was to determine whether food variety and perceived food preferences differ in infants following baby-led instead of traditional spoon-feeding approaches to introducing solids. A total of 206 women (41.3% primiparous) were recruited in late pregnancy from a single maternity hospital (response rate 23.4%) and randomized to Control (n = 101) or BLISS (n = 105) groups. All participants received government-funded Well Child care. BLISS participants also received support to exclusively breastfeed to 6 months and three educational sessions on BLISS (Baby-Led Weaning, modified to reduce the risk of iron deficiency, growth faltering, and choking) at 5.5, 7, and 9 months. Food variety was calculated from three-day weighed diet records at 7, 12, and 24 months. Questionnaires assessed infant preference for different tastes and textures at 12 months, and for 'vegetables', 'fruit', 'meat and fish', or 'desserts' at 24 months. At 24 months, 50.5% of participants provided diet record data, and 78.2% provided food preference data. BLISS participants had greater variety in 'core' (difference in counts over three days, 95% CI: 1.3, 0.4 to 2.2), 'non-core' (0.6, 0.2 to 0.9), and 'meat and other protein' (1.3, 0.8 to 1.9) foods at 7 months, and in 'fruit and vegetable' foods at 24 months (2, 0.4 to 3.6). The only differences in perceived food preferences observed were very small (i.e., <5% difference in score, at 12 months only). Infants following the modified Baby-Led Weaning were exposed to more varied and textured foods from an early age, but only an increased variety in 'fruit and vegetable' intake was apparent by two years of age.

MÉTODO BABY-LED WEANING (BLW) NO CONTEXTO DA ALIMENTAÇÃO COMPLEMENTAR: UMA REVISÃO

Objective:

To review the scientific findings on the baby-led weaning method (BLW) in the context of complementary feeding.

Data sources:

Two independent examiners searched the Medical Literature Analysis and Retrieval System Online (MEDLINE)/PubMed database in August 2016. No time-period was defined for the publication dates. The following descriptors were used: “baby-led weaning” OR “baby-led” OR “BLW”. Inclusion criteria were: original studies that were available in English, and which addressed the BLW method. Exclusion criteria were: references in other languages, opinion articles and literature reviews, editorials and publications that did not elaborate on the intended subject. Of the 97 references identified, 13 were included in the descriptive synthesis.

Data synthesis:

The BLW group of babies, when compared to the traditional eating group, were less prone to being overweight, less demanding of food, and ate the same foods as the family. The number of choking episodes did not differ between groups. Mothers who opted for the implementation of BLW had higher levels of schooling, held managerial positions at work, and were more likely to have breastfed until the sixth month of the child’s life. Concerns were raised about messes made during meals, wasting food, and choking, but most of the mothers recommended adopting the method. Health professionals were hesitant to indicate this method.

Conclusions:

BLW was recommended by mothers who followed the method with their own children. However, concerns have been reported, which, coupled with professionals’ fears about the inability of infants to self-feed, reflect a lack of knowledge about the method.

Impact of a modified version of baby-led weaning on iron intake and status: a randomised controlled trial

OBJECTIVE

To determine the iron intake and status of infants following a version of baby-led weaning (BLW) modified to prevent iron deficiency (Baby-Led Introduction to SolidS; BLISS) compared with those of infants following traditional spoon-feeding.

DESIGN, PARTICIPANTS AND INTERVENTION

This randomised controlled trial included 206 participants assigned to control (n=101) or BLISS (n=105) groups. Both groups received standard midwifery and 'Well Child' care. BLISS participants received eight additional visits (from before birth to 9 months) providing education and support on the BLISS approach to complementary feeding (ie, BLW modified to increase iron intake). The primary outcome of the BLISS study (growth) has been previously reported. This paper reports the key prespecified secondary outcomes, iron intake and iron status.

OUTCOME MEASURES

Intake of iron and key absorption modifiers were assessed using weighed 3-day diet records at 7 and 12 months. A venipuncture blood sample was collected at 12 months to determine plasma ferritin, haemoglobin, soluble transferrin receptor, C-reactive protein and α1-acid glycoprotein concentrations; and body iron was calculated.

RESULTS

Differences in median dietary iron intakes between the control and BLISS groups were not significant at 7 (difference 0.6 mg/day; 95% CI -1.0 to 2.3) or 12 (-0.1 mg/day; -1.6 to 1.4) months of age. Similarly, there were no significant differences in plasma ferritin concentration (difference -2.6 µg/L; 95% CI -10.9 to 5.8), body iron (0.04 mg/kg; -1.1 to 1.2) or the prevalence of depleted iron stores, early functional iron deficiency or iron deficiency anaemia (all p≥0.65) at 12 months of age.

CONCLUSIONS

A baby-led approach to complementary feeding does not appear to increase the risk of iron deficiency in infants when their parents are given advice to offer 'high-iron' foods with each meal.

TRIAL REGISTRATION NUMBER

ACTRN12612001133820; Pre-results.

Impact of a Modified Version of Baby-Led Weaning on Infant Food and Nutrient Intakes: The BLISS Randomized Controlled Trial

Despite growing international interest in Baby-Led Weaning (BLW), we know almost nothing about food and nutrient intake in infants following baby-led approaches to infant feeding. The aim of this paper was to determine the impact of modified BLW (i.e., Baby-Led Introduction to SolidS; BLISS) on food and nutrient intake at 7–24 months of age. Two hundred and six women recruited in late pregnancy were randomized to Control (n = 101) or BLISS (n = 105) groups. All participants received standard well-child care. BLISS participants also received lactation consultant support to six months, and educational sessions about BLISS (5.5, 7, and 9 months). Three-day weighed diet records were collected for the infants (7, 12, and 24 months). Compared to the Control group, BLISS infants consumed more sodium (percent difference, 95% CI: 35%, 19% to 54%) and fat (6%, 1% to 11%) at 7 months, and less saturated fat (−7%, −14% to −0.4%) at 12 months. No differences were apparent at 24 months of age but the majority of infants from both groups had excessive intakes of sodium (68% of children) and added sugars (75% of children). Overall, BLISS appears to result in a diet that is as nutritionally adequate as traditional spoon-feeding, and may address some concerns about the nutritional adequacy of unmodified BLW. However, BLISS and Control infants both had high intakes of sodium and added sugars by 24 months that are concerning.

Baby-Led Weaning: The Evidence to Date

PURPOSE OF REVIEW

Infants are traditionally introduced to solid foods using spoon-feeding of specially prepared infant foods.

RECENT FINDINGS

However, over the last 10-15 years, an alternative approach termed 'baby-led weaning' has grown in popularity. This approach involves allowing infants to self-feed family foods, encouraging the infant to set the pace and intake of the meal. Proponents of the approach believe it promotes healthy eating behaviour and weight gain trajectories, and evidence is starting to build surrounding the method. This review brings together all empirical evidence to date examining behaviours associated with the approach, its outcomes and confounding factors.

SUMMARY

Overall, although there is limited evidence suggesting that a baby-led approach may encourage positive outcomes, limitations of the data leave these conclusions weak. Further research is needed, particularly to explore pathways to impact and understand the approach in different contexts and populations.