While I have been aware of different philosophies with regards to how one should start
feeding complementary foods to babies (Should you give fruits or vegetables first?),
I was not aware of the idea of “baby-led weaning.” While it hasn’t seemed to gain
much traction yet here in the U.S., it is apparently all the rage in the UK, Australia,
and New Zealand. In the U.S., “weaning” refers to ending breastfeeding. However, in
many other countries, “weaning” refers to the introduction of complementary foods.
The whole idea behind baby-led weaning is that the baby controls what and how much
she eats, beginning at 6 months, by feeding herself.
There is no such thing as spoon-feeding or baby food. (Nor are there any airplane
spoon games.) Instead, once the baby can sit upright, you place finger foods in front
of her, and she picks up and puts into her mouth whatever she wants. The theory behind
this is that babies will become more adventurous eaters and will also learn how to
control their own intake. Of course, the first question that many people (including
me) will ask is, “Won’t the baby choke?” Some researchers in New Zealand had the same
question and studied this in a randomized controlled trial, which appears in this
Babies were randomized to either normal care or modified baby-led weaning. Parents
were provided with some guidelines to baby-led weaning, including keeping the baby
in an upright sitting position while eating, insuring adult supervision while eating,
and not letting anyone put food into the baby’s mouth (only the baby is allowed to
do that). They were also given a list of foods to avoid, including nuts, raw vegetables,
hard fruit, popcorn, and food cut into “coins.” They then collected data about the
infant’s food intake and any possible choking or gagging episodes by a combination
of questionnaire and food diary.
I was intrigued that there was no difference in the number of choking episodes in
the 2 groups. However, more than half of the infants were offered at least one food
that posed a choking risk. You will be fascinated – and surprised - to see the types
of foods that were offered to babies, and the foods that were associated with choking
episodes. It appears that babies can choke on almost anything, and this study provides
reassurance about baby-led weaning, in that the risk of choking seems to be comparable
to traditional spoon-feeding methods.
I’ll certainly be ready when a parent wants to talk about baby-led weaning after reading
this article. It also has made me rethink my anticipatory guidance about introducing
solid foods – perhaps the emphasis should not be on the way that it’s done (spoon-fed
or baby-led), but on adult supervision and what foods are inappropriate for infants.