Changing Colors: The Blog of Spectrum Pediatrics

April 5, 2017

Is Baby-Led Weaning Right for Your Child?

By: Heidi Liefer Moreland, MS, CCC-SLP, BRS-S, CLC

Baby Led Weaning is becoming more popular as an option for transitioning children onto solid table foods.  This involves introducing the child to bigger pieces of foods that they are allowed to pick up independently and bring to their mouths.  Initially, they develop the ability to pick up large “graspable” pieces and accurately find their mouth.  As they become more skilled, they mouth the food, and eventually learn to manage small broken pieces that break off inside their oral cavity.  Once the food is in their mouth, they develop safety skills to protect their airway, including gagging and pushing pieces out with their tongue. With time and practice, they develop the control to hold the pieces still for biting, mashing, and early chewing.  Finally, their skills are mature enough to move the bites back in the mouth for swallowing.  As they develop the skills to control the smaller pieces of food orally, their hand abilities are also becoming more refined.  These increasing fine motor skills allow them to accurately pick up smaller pieces of food, which are more easily chewed and swallowed when their mouths have become ready for them.

As a therapist, I believe there are a number of factors that indicate this is developmentally appropriate method to help children learn about the properties and management of solid foods.  These factors are typically emerging or present at the age of approximately 6 months, which is when this process is recommended to begin. Of course, it is always important to discuss this with your pediatrician, as well.  The factors to consider are discussed below:

  1. Infants develop the hand control to pick up bigger stick-shaped foods before they develop the pincer grasp to pick up smaller foods or to self-feed with a spoon.
  2. Infants are experiential learners that are self-motivated, and will continue working with tasks that remain interesting and meaningful, until they appear to be mastered.  They are not designed to learn from a “teacher” or through adult-directed learning, which is what happens when an adult feeds them.
  3. Infants have reflexes and drives that facilitate this process that are no longer present at a later age.  These reflexes include:
      • Predominant oral exploration drives the child to bring things from hand-to-mouth, rather than banging or flinging.
      • Gag reflex remains at the front of the mouth at earlier ages, and this allows for important safety responses.
      • Tongue thrust is present, which helps them expel foods that are unsafe for swallowing.
      • Lateral tongue movement to stimulation is present, which will be used to develop control of the food.
      • Brain development takes place as neural connections are made during functional multi-sensory activities.  Therefore, the learning that happens on a banana pieces may be slightly different than learning that takes place on a teething toy.
  4. Brain development for motor skills also requires fine-tuning that happens with repeated   experiences that allow for on-line adjustments.  An example that many adults may remember is the experience of learning to ride a bike.  The only way to really learn balance while pedaling is to wobble around while the body learns to anticipate and adjust for the rolling and tipping movements of the bike.
  5. Because babies are “in charge” of the process, they control how much they eat.  This is consistent with the self-regulation of hunger and satiety that is developed during nursing, and has been found to be a positive influence in the prevention of obesity.
  6. Because the baby is exploring at their own pace, children frequently become less resistant and afraid than those who are presented with foods at the pace and interest of the feeder.

 

baby eating riceAlthough this approach is likely consistent with the way infants were fed long before the development of prepared baby foods, modern child-rearing dictates that we need to investigate a process, before it is recommended to ensure that it is safe and appropriate.  There is a study that is available through the National Institutes of Health (NIH).  In this study, it looked at developmental skills and available evidence of baby-led weaning, and it indicated that this is a feasible process for children who are learning to eat.

As with many child-rearing strategies, your supervision and judgment is crucial in determining readiness and to keep the process safe.  Your child is ready when he or she is able to sit with upright head control and be stable in a chair with supports.  Although the following considerations should be addressed for all children, those with developmental delays or motor deficits may require further assistance in these areas, or might need more time to develop complete readiness.

  1. Sitting stability – If your child is very unstable, you need to wait until he is a little more steady, or make sure he is well supported.  Imagine drinking from an open cup while walking a tightrope.  It is hard to develop aim and fine oral control if you are trying hard to keep your body stable.
  2. Hand to mouth control – If your child has significant difficulty with other refined hand movements (such as reaching for objects, picking up and dropping toys, or opening and closing their hands with appropriate timing), they will likely have the same difficulty with learning self-feeding skills.  Wait until their motor control is mature enough to be a little more accurate and consistent
  3. Oral control – It is important for your child to be responsive to items in their mouth in a timely fashion, so they can expel big pieces, rather than choke.  If their motor responses are over- or under-reactive, the same is likely to be true of food items in their mouth.  Giving breakable solid foods too soon will result in a greater risk for choking, which is an obvious problem.  Additionally, too many fearful experiences with food is likely to result in more refusal later as a self-protective mechanism.
  4. Allergy precautions – If there is a high likelihood of allergies, discuss food exposure with a physician or nutritionist to determine which foods are more likely to cause allergic reactions, so you can be wise in the order of presentation.

 

child with food on faceImportant considerations in food selection:

  1. Look for foods that hold together well enough to be picked up, but are soft enough to easily fall apart in the mouth (such as baked sweet potato logs)
  2. Never leave your child alone with food items.  They are still learners, and they must be supervised.
  3. Avoid foods that become sharp when broken (such as potato chips).
  4. Avoid foods that are too sticky to be easily controlled (such as a big spoon of peanut butter).
  5. Avoid hard foods that require teeth to break down (Raw apple pieces or small raw carrots are the most frequent culprits in food related choking incidents).
  6. Avoid foods that are too slippery to be easily controlled by an immature eater (such as canned peaches).
  7. Be familiar with infant and child CPR, and to look for that in a child care provider.  It is recommended for children learning to eat solids, but also because food is not the only thing kids put in their mouth!  Here are some links for CPR information:

Looking to learn more about Baby Led Weaning? This website continues to discuss the benefits and even shares a few great recipes for your child!

Sources:

  1. How Feasible is Baby Led Weaning as an Approach to Infant Feeding? A Review of the Evidence.
  2. Web summary from book author
  3. Video
  4. Glasgow Study Reviewed

Photo 1, Photo 2, Photo 3

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