The past decade has introduced baby-led weaning as a contemporary method of weaning that boasts many benefits, but also raises some legitimate concerns.

What exactly is baby-led weaning (BLW)? It’s a method of food introduction and progression (while still breastfeeding or formula-feeding) that focuses on self-feeding from the very first introduction of food. Traditional weaning methods rely on strained, mashed, and pureed baby foods, offered one-by-one in small increments with a spoon, and often force-fed several times until food acceptance is established. In contrast, BLW offers infants soft but whole pieces of various foods. Infants are encouraged to explore the taste and texture of food using their own hands. As they grasp the food pieces and bring them to their mouth, they are directing their own pace and acceptance of food. Several types of food may be offered during traditional family meals, so infants can decide which food to explore. They also learn to imitate the eating habits of those they’re eating with, so the weaning process occurs in a natural learning environment.

BLW starts when an infant is able to sit up and has good head control—often around 6 months, rather than the traditional weaning start age of 4 months. It encourages the development of motor skills, hand-eye coordination, and natural chewing movement. Initially, the baby does not consume a lot of food; the focus is on exploration and muscle development. Eventually, the baby learns to safely consume foods as their oral development improves and they begin to learn the process of eating.

The biggest concern with BLW is the possibility of choking since normal-sized pieces of soft foods are offered. Supporters argue that BLW strengthens oral skills and food control because the natural gag reflex is exercised, and the baby quickly learns how to manage food in its mouth. Because whole food triggers the gag reflex easier than mashed food, the reflex is often triggered at the initial stages of BLW, protecting the infant from choking and teaching the infant to control food in its mouth. In a study of 1151 women with infants 4-12 months who weaned using either strict BLW, loose BLW, or traditional weaning, it was found that only 13.6% of all the infants ever choked and there was no association between weaning method and the prevalence of choking. When BLW infants do experience an episode of choking, studies report that in all cases, infants were able to expel the food by coughing without parental intervention. To prevent choking, parents are advised to avoid giving BLW infants hard or sharp foods, like raw carrots or apples, celery, and nuts.

BLW focuses on foods that are traditionally offered at a family meal, including fruits, vegetables, meat, cheese, eggs, bread, pasta, and fish. Some health-care practitioners express concern about iron-deficiency and inadequate energy intake since iron-fortified cereals are not usually offered to infants being weaned with the BLW method. However, proponents of BLW argue that infants are fed a greater variety of foods, including iron-rich meats, and that the greater acceptance of a variety of foods results in higher intake of nutrient-rich foods and adequate energy intake. Other studies have indicated that food fussiness seems to be lower among BLW infants. Likewise, since the baby is learning to self-regulate energy intake, BLW may prevent childhood obesity. BLW infants also displayed an increased preference for healthier foods compared to the traditionally weaned infants who preferred sweeter foods, which has the potential to encourage picky eating, nutrient deficiencies and obesity.

Foods commonly offered to BLW include steamed broccoli, potato, pumpkin, carrot and soft fruits such as banana and avocado. Cooked meats, eggs, organ meats, and soft cheese are offered due to their nutrient-rich profile and higher bioavailability of iron and select other nutrients. Often family meals can be modified for the BLW infant.

As BLW grows in popularity it may play an important role in curbing the childhood obesity epidemic by teaching children better control of energy intake and forming better habits regarding food from the earliest ages. It can also support more positive health trajectories in children as it encourages a greater intake of a variety of nutrient-rich whole foods. This method of weaning can be messy, and at times, inconvenient, but it is also healthful and rewarding to both parents and infants.

Related:

• Nutrient Roundtable: Pregnancy
• Webinar: The Immune System: From Pregnancy to Allergy