While traditional complementary feeding (introduction to solids) is simply described as the feeding of pureed food with a spoon, Baby Led Weaning is an entirely different approach, seeing infants self-feeding from age 6 months. As Baby Led Weaning gains momentum as a more convenient option that enhances the development of fine motor skills, it is easy to see the attraction. Nutritionally speaking however, there are some differences between the two methods and with nutrition during the first 1000 days of life greatly impacting a child’s health later in life, Baby Led Weaning is definitely worth a nutritional investigation.
There are very few studies on Baby Led Weaning (BLW) available and as a result, BLW is not recommended as the gold standard by the World Health Organisation, nor by any government nutrition departments around the world. A small study (51 infants) comparing BLW with the traditional spoon feeding (TSF) method was however recently published in the British Medical Journal and confirms an obvious concern with pure BLW, namely the deficiency in iron.
Iron is a vital nutrient for optimal brain development and cognitive function during infancy and as a result an iron deficiency can negatively impact on learning ability at school and ultimately adulthood potential. Infants are vulnerable to developing an iron deficiency or iron deficiency anaemia as they transition from an all milk diet to family foods. Rapid growth and development during infancy and toddler years results in a high iron requirement for this age group. In spite of this requirement, 2014 saw a global estimate of 25 % of preschool children presenting with iron deficiency anaemia.
While the study found the BWL group and the TSF group to be consuming the same amount of energy (kilojoules / calories), the following interesting differences were found:
- The BLW group of infants were breastfed for a longer duration than the TSF group of infants
- On average the BLW infants were introduced to solids 3 weeks later than the TSF group of infants
- There was no difference in the number of infants offered sweet foods (46%) and high sodium foods (73%) between the groups
- There was no difference in the amount of fruits and vegetables consumed
- There was no difference in the amount of commercially prepared food consumed
- If introduced to iron-fortified cereal, BLW were introduce on average 5 weeks later than TSP infants
- BLW had a 1 in 5 chance of being introduced to iron-fortified cereals
- There was no difference in the age of infants introduced to red meat or the number infants not yet introduced to red meat
- More BLW infants were breastfeeding, with no use of formula milk, at the time of the study while more TSF infants were found to be having both breast milk and formula milk
- Foods with the potential to cause choking were found in both groups but were significantly different. Choking hazards in the BLW group presented as raw apples, dried fruit and raw vegetables while the TSF group of infants consumed rusks, small pieces of meat, corn kernels and crackers as potential choking hazards.
- The BLW group consumed more saturated fat and total fat than the TSF group
- The BLW group consumed less iron, zinc, vitamin B12, vitamin C and calcium than the TSF group
These findings are very interesting and motivate for a careful combination of the two methods. BLW appears to promote healthy eating behaviours such as eating more family meals with prolonged breastfeeding while TSF enhances nutrient intake, with a particular emphasis on iron, essential during this window of complementary feeding. The best source of iron when it comes to first foods is iron-fortified infant cereal, with an early introduction of pureed meat. Neither of these are the finger foods encouraged for pure BLW.
Take home message:
This transition, from 6 months to 2 years is a critical window period for establishing acceptance of healthy family foods and healthy eating behaviour. While this time includes exploration, feeding behaviour and motor skill development, nutritional intake, especially iron, must not be overlooked. Whether opting for baby led weaning or traditional spoon feeding, an infants nutrient requirements remain the same and can only be met with appropriate food choices.
Read more about baby led weaning and traditional spoon feeding as complementary feeding methods for the promotion of infant and young child health.
Serving Potential on a Plate is an complementary feeding nutr-ebook available here on sale for R90.00.
References:
CMAJ January 7, 2003 vol. 168 no. 1 : The role of nutrition in the prevention of iron deficiency anemia in infants, children and adolescents, Stanley Zlotkin
J Pediatr Gastroenterol Nutr. 2014 Jan;58(1):119-29. Iron requirements of infants and toddlers, Domellöf M1, Braegger C, Campoy C, Colomb V, Decsi T, Fewtrell M, Hojsak I, Mihatsch W, Molgaard C, Shamir R, Turck D, van Goudoever J; ESPGHAN Committee on Nutrition.
British Medical Journal: How different are baby-led weaning and conventional complementary feeding? A cross-sectional study of infants aged 6–8 months Brittany J Morison,1 Rachael W Taylor,2 Jillian J Haszard,1 Claire J Schramm, Liz Williams Erickson, Louise J Fangupo, Elizabeth A Fleming, Ashley Luciano, Anne-Louise M Heath1
