Baby-Led Weaning: The Evidence to Date

Amy Brown, Sara Wyn Jones, Hannah Rowan, Amy Brown, Sara Wyn Jones, Hannah Rowan

Abstract

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.

Keywords: Appetite control; Baby-led weaning; Breastfeeding; Choking; Complementary feeding; Eating behaviour; Energy regulation; Infant; Infant-led; Introduction solid foods; Maternal; Maternal feeding style; Nutrient intake; Responsive feeding; Weaning; Weight.

Conflict of interest statement

Conflict of Interest

Amy Brown, Sara Wyn Jones and Hannah Rowan declare they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

    1. Jones S. A history of baby-led weaning: the evolution of complementary feeding trends. Journal of Health Visiting. 2016;4(10):524–530. doi: 10.12968/johv.2016.4.10.524.
    1. World Health Organization, UNICEF. Global strategy for infant and young child feeding. World Health Organization; 2003.
    1. • Rapley G, Murkett T. Baby-led weaning: Helping your baby to love good food. Random House; 2008. This book overviews the baby-led weaning approach and examines its development. It provides an excellent overview and is the key text that many parents read.
    1. Palmer G. Complementary feeding: nutrition, culture and politics. Pinter & Martin Publishers; 2011.
    1. • Naylor, A.; Morrow, A. Developmental readiness of normal full term infants to progress from exclusive breastfeeding to the introduction of complementary foods: reviews of the relevant literature concerning infant immunologic, gastrointestinal, oral motor and maternal reproductive and lactational development. Academy for Educational Development: Washington DC, USA, 2001. This is a review paper examining the critical issue of developmental readiness for solid foods which examines the match between infants external ability to self-feed and internal readiness to digest solid foods.
    1. Rapley G. Baby-led weaning: the theory and evidence behind the approach. Journal of Health Visiting. 2015;3(3):144–151. doi: 10.12968/johv.2015.3.3.144.
    1. Rapley G. Can babies initiate and direct the weaning process? (Interprofessional health and community studies; care of the breastfeeding mother and child MSc) Kent: Canterbury Christ Church University College; 2003.
    1. Ventura AK, Birch LL. Does parenting affect children’s eating and weight status? Int J Behav Nutr Phys Act. 2008;5(1):1. doi: 10.1186/1479-5868-5-15.
    1. Schwartz C, Scholtens PA, Lalanne A, Weenen H, Nicklaus S. Development of healthy eating habits early in life. Review of recent evidence and selected guidelines. Appetite. 2011;57:796–807. doi: 10.1016/j.appet.2011.05.316.
    1. Moorcroft KE, Marshall JL, McCormick FM. Association between timing of introducing solid foods and obesity in infancy and childhood: a systematic review. Maternal & child nutrition. 2011;7(1):3–26. doi: 10.1111/j.1740-8709.2010.00284.x.
    1. •• Cameron SL, Heath AL, Taylor RW. How feasible is baby-led weaning as an approach to infant feeding? A review of the evidence. Nutrients. 2012;(4, 11):1575–609. This review papers examines evidence underpinning the different elements of a baby-led approach, e.g. ability to self-feed, delaying solids until 6 months and exclusive breastfeeding until 6 months
    1. Brown A, Lee M. A descriptive study investigating the use and nature of baby-led weaning in a UK sample of mothers. Maternal & child nutrition. 2011;7(1):34–47. doi: 10.1111/j.1740-8709.2010.00243.x.
    1. Brown A, Lee M. Maternal child-feeding style during the weaning period: association with infant weight and maternal eating style. Eat Behav. 2011;12(2):108–111. doi: 10.1016/j.eatbeh.2011.01.002.
    1. Brown A, Lee M. Breastfeeding during the first year promotes satiety responsiveness in children aged 18–24 months. Pediatric obesity. 2012;7(5):382–390. doi: 10.1111/j.2047-6310.2012.00071.x.
    1. Rowan H, Harris C. Baby-led weaning and the family diet. A pilot study. Appetite. 2012;58(3):1046–1049. doi: 10.1016/j.appet.2012.01.033.
    1. Cameron SL, Taylor RW, Heath AL. Parent-led or baby-led? Associations between complementary feeding practices and health-related behaviours in a survey of New Zealand families. BMJ Open. 2013;3(12) doi: 10.1136/bmjopen-2013-003946.
    1. Townsend E, Pitchford NJ. Baby knows best? The impact of weaning style on food preferences and body mass index in early childhood in a case–controlled sample. BMJ Open. 2012;2(1):e000298. doi: 10.1136/bmjopen-2011-000298.
    1. Arden MA, Abbott RL. Experiences of baby-led weaning: trust, control and renegotiation. Maternal & child nutrition. 2015;11(4):829–844. doi: 10.1111/mcn.12106.
    1. Brown A, Lee MD. Early influences on child satiety-responsiveness: the role of weaning style. Pediatric obesity. 2015;10(1):57–66. doi: 10.1111/j.2047-6310.2013.00207.x.
    1. • Brown A. Differences in eating behaviour, well-being and personality between mothers following baby-led vs. traditional weaning styles. Matern Child Nutr. 2015. This paper highlights that mothers who choose to adopt a baby-led approach may be different in background to those adopting a traditional approach. This difference in background might affect outcomes, indicating it is important to consider maternal background and wider feeding approach when examining the impact of a baby-led style.
    1. D’Andrea E, Jenkins K, Mathews M, Roebothan B. Baby-led weaning: a preliminary investigation. Can J Diet Pract Res. 2016;77(2):72–7.
    1. Cameron SL, Taylor RW, Heath AL. Development and pilot testing of baby-led introduction to SolidS-a version of baby-led weaning modified to address concerns about iron deficiency, growth faltering and choking. BMC Pediatr. 2015;15(1):1. doi: 10.1186/s12887-015-0422-8.
    1. •• Erickson LW. A Baby-Led approach to complementary feeding: adherence and infant food and nutrient intakes at seven months of age (Doctoral dissertation, University of Otago) (2015). This paper examines initial findings of the first randomized controlled trial that randomized parents to a baby-led or usual care approach. It examines adherence to group and intake of infants according to group.
    1. Morison BJ, Taylor RW, Haszard JJ, Schramm CJ, Erickson LW, Fangupo LJ, Fleming EA, Luciano A, Heath AL. How different are baby-led weaning and conventional complementary feeding? A cross-sectional study of infants aged 6–8 months. BMJ Open. 2016;6(5):e010665. doi: 10.1136/bmjopen-2015-010665.
    1. Fangupo LJ, Heath AL, Williams SM, Williams LW, Morison BJ, Fleming EA, Taylor BJ, Wheeler BJ, Taylor RW. A baby-led approach to eating solids and risk of choking. Pediatrics. 2016;19:e20160772. doi: 10.1542/peds.2016-0772.
    1. Arden MA. Conflicting influences on UK mothers’ decisions to introduce solid foods to their infants. Maternal & child nutrition. 2010;6(2):159–173.
    1. Wright CM, Cameron K, Tsiaka M, Parkinson KN. Is baby-led weaning feasible? When do babies first reach out for and eat finger foods? Maternal & child nutrition. 2011;7(1):27–33. doi: 10.1111/j.1740-8709.2010.00274.x.
    1. Daniels L, Heath AL, Williams SM, Cameron SL, Fleming EA, Taylor BJ, Wheeler BJ, Gibson RS, Taylor RW. Baby-Led Introduction to SolidS (BLISS) study: a randomised controlled trial of a baby-led approach to complementary feeding. BMC Pediatr. 2015;15(1):179. doi: 10.1186/s12887-015-0491-8.
    1. Moore, A.P.; Milligan, P.; Goff, L.M. An online survey of knowledge of the weaning guidelines, advice from health visitors and other factors that influence weaning timing in UK mothers. Matern. Child Nutr. 2012
    1. Rapley G, Forste R, Cameron S, Brown A, Wright C. Baby-led weaning a new frontier? ICAN: Infant Child Adolesc Nutr. 2015:1941406415575931.
    1. Brown A, Lee M. Breastfeeding is associated with a maternal feeding style low in control from birth. PLoS One. 2013;8(1):e54229. doi: 10.1371/journal.pone.0054229.
    1. Farrow C, Blissett J. Breast-feeding, maternal feeding practices and mealtime negativity at one year. Appetite. 2006;46(1):49–56. doi: 10.1016/j.appet.2005.10.005.
    1. Amir LH, Donath S. A systematic review of maternal obesity and breastfeeding intention, initiation and duration. BMC pregnancy and childbirth. 2007;7(1):1. doi: 10.1186/1471-2393-7-9.
    1. Shim JE, Kim J, Mathai RA, STRONG Kids Research Team Associations of infant feeding practices and picky eating behaviors of preschool children. J Am Diet Assoc. 2011;111(9):1363–1368. doi: 10.1016/j.jada.2011.06.410.
    1. Rogers SL, Blissett J. Breastfeeding duration and its relation to weight gain, eating behaviours and positive maternal feeding practices in infancy. Appetite. 2017;108:399–406. doi: 10.1016/j.appet.2016.10.020.
    1. Brown A, Lee M. Maternal control of child feeding during the weaning period: differences between mothers following a baby-led or standard weaning approach. Matern Child Health J. 2011;15(8):1265–1271. doi: 10.1007/s10995-010-0678-4.
    1. Brown A, Lee M. An exploration of experiences of mothers following a baby-led weaning style: developmental readiness for complementary foods. Maternal & child nutrition. 2013;9(2):233–243. doi: 10.1111/j.1740-8709.2011.00360.x.
    1. Cameron SL, Heath AL, Taylor RW. Healthcare professionals’ and mothers’ knowledge of, attitudes to and experiences with, baby-led weaning: a content analysis study. BMJ Open. 2012;2(6) doi: 10.1136/bmjopen-2012-001542.
    1. Carnell S, Wardle J. Measuring behavioural susceptibility to obesity: validation of the child eating behaviour questionnaire. Appetite. 2007;48(1):104–113. doi: 10.1016/j.appet.2006.07.075.
    1. Rodgers RF, Paxton SJ, Massey R, Campbell KJ, Wertheim EH, Skouteris H, Gibbons K. Maternal feeding practices predict weight gain and obesogenic eating behaviors in young children: a prospective study. Int J Behav Nutr Phys Act. 2013;10(1):1. doi: 10.1186/1479-5868-10-24.
    1. Ogden J, Reynolds R, Smith A. Expanding the concept of parental control: a role for overt and covert control in children’s snacking behaviour? Appetite. 2006;47(1):100–106. doi: 10.1016/j.appet.2006.03.330.
    1. Haycraft EL, Blissett JM. Maternal and paternal controlling feeding practices: reliability and relationships with BMI. Obesity. 2008;16(7):1552–1558. doi: 10.1038/oby.2008.238.
    1. Farrow CV, Blissett JM. Is maternal psychopathology related to obesigenic feeding practices at 1 year? Obes Res. 2005;13(11):1999–2005. doi: 10.1038/oby.2005.245.
    1. Wasser H, Bentley M, Borja J, Goldman BD, Thompson A, Slining M, et al. Infants perceived as ‘fussy’ are more likely to receive complementary foods before 4 months. Pediatrics. 2011;127(2):229–237. doi: 10.1542/peds.2010-0166.
    1. Brown A, Rowan H. Maternal and infant factors associated with reasons for introducing solid foods. Matern Child Nutr. 2015.
    1. World Health Organization, World Health Organization. Complementary feeding: report of the global consultation, and summary of guiding principles for complementary feeding of the breastfed child.
    1. Sachs M. Baby-led weaning and current UK recommendations–are they compatible? Maternal & child nutrition. 2011;7(1):1–2. doi: 10.1111/j.1740-8709.2010.00278.x.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel