Baby-Led Weaninglntroducing Real Foods to Babies

Megan McNamee MPH, RD . www.FindYourTransi t ion.com

General Concepts:1. Wait unti l approximately 6 months to introduce sol id foods.2. Start with foods easy for baby to grip, such as sweet potato or avocado spears3. Baby feeds herself - parent's job is to offer a variety of safe, nutritious foods'4. Milk feeds continue and wil l not decrease for many months. For the f irst few months, BLW is

mainly about explorat ion, learning, and fun.

What is Baby-led Weanine (BLW)?BLW is a "way of introducing sol id foods that al lows babies to feed themselves - there's no spoonfeed ing and no purees. The baby s i ts w i th the fami ly a t meal t imes and jo ins in when she is ready,feeding hersel f f i rst wi th her f ingers and later wi th s i lverware."

Baby-led weaning:* Al lows babies to explore taste, texture, color and smel l* Encourages independence and conf idence* Helps to develop hand-eye coordinat ion* Makes p icky eat ing and meal t ime bat t les less l i ke ly

Whot about spoan-feeding?- Spoon-feeding recommendat ions or ig inated when parents were to ld to s tar t feeding at 3-4

months - p r io r to them be ing deve lopmenta l l y ab le to feed themse lves .

Now that we know feeding should start c loser to 6 months, spoon-feeding is not necessary,and some babies even re fuse i t . Fur thermore, there is no research suppor t ing purees asthenecessary f i rst step in sol id food introduct ion, and babies can become very confused whengiven lumpy foods because they're not sure whether to swal low or chew.

Research suggests that spoon-feeding can lead to overfeeding because parents can spoon in alot of food before baby real izes she isful l . This can also lead to const ipat ion. With BLW,babies gradual ly increase so l id in take, lower ing the r isk o f const ipat ion.

This doesn't meon thot you "shouldn't" do purees. lf purees seem to work better for yourboby, or if she has developmental or medical issues thot make BLW unsafe for her, then pureesmay be a smart move for you. Furthermore, purees con be given in a baby-led way - especiollyonce boby is able to feed herself with a spoon. (Think: opplesouce.)

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Wh choose BLW?Allows baby to move onto sol ids at adevelopmental ly appropriate t imewithout cutting out milk feedings tooearly.

Al lows baby to eat what and as much asshe wants, establ ish ing heal thy feedingdynamics and potent ia l ly avoid ing obesi tyand food issues later.

Allows babies to part icipate in mealt imes ata young age and makes i t easier to bepresent for social opportunit ies where foodi s i nvo lved , s ince they can jo in in the fun .

Develops hand-eye coordination, Helps prevent mealt ime batt les and pickydexterity and chewing skil ls. eat ing because pressure is removed.

Encourages conf idence, enjoyment , and aheal thy love of food, taste, aroma, andtex tu res . Mea ls a re more re laxed and fun .Baby can learn by imitat ion.

No need to buy purees or special foods - Al lows for development or strong fami lycheaper and easier for everyene. bonds, s ince fami l ies can eat together .

Potential disadvantage of BLW:o May be inappropriate for chi ldren with medical issues or developmental delayso lt's messy!o Mealt imes may take longer (which can ult imately be a good thing - slowing our rate of eating

too)o Parents mav offer less balanced meals in effort to reduce messo Have to be aware of salt content of food and offering foods that can actually be eaten to avoid

baby getting only one food group, such as carbohydrates (think spaghetti with meat sauce -baby may only get the noodles)

o Parents worry about choking

what to Expect with BLW?- Babv is included in mealt imes and, for the most part, eats what the family eats- Nobody feeds the baby - a few different foods are offered in pieces she is able to pick up and

she wil l handle food and take i t to her mouth when she is ready. This may mean baby eatsalmost nothing at the beginning as she explores, plays, and learns how to eat '

- Babv chooses how much, how fast, and whether to eat. This concept wi l l be very importantlater in l i fe and is coined the "division of responsibi l i ty in feeding" bY nutr i t ion expert El lynSatter, RD.

The porent is responsible for whot,The infont is responsible t'or how much ond whether'

Baby cont inues to have mi lk feedings from breast or formula as of ten as she wants and wi l lstart to reduce them on her own.Baby may gag, especial ly at the beginning. Gagging is not choking. Babies' gag ref lex isfurther forward in their mouth, and gagging is a way for them to protect f rom choking.

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Assessing ReadinessCurrent research suggests that most babies are ready for food around 6 months of age Althoughsome pediatricians recommend starting at the 4-6 months (and never before 4 months), the WHO,MP, UNICEF, and MFP recommend wait ing unti l around 6 months. Furthermore, according toKellymom.com there are many reasons to delay sol ids unti l around the 5 month mark.

!. Better protection from illness.2. Attows the digestive trdct time to moture. Certain digestive enzymes and stomach acid are not

readv unti l around the 6 month mark, and introducing sol ids before then can lead to digestiveupset, 8as and constiPation

3. Protects agoinst ollergies. Gut doesn't usually mature, or "close," until near the 6 monthmark. An "open gut" allows macronutrients to pass into the blood stream, increasing the riskfor al lergies. This usually also coincides with developmental abi l i ty of baby to bring food tomouth, chew, and swal low'protects baby from iron-def ic iency onemio. l t is theor ized that introducing sol ids, especial lyi ron-fort i f ied ones (r ice cereal) , actual ly decreases absorpt ion of i ron from breast mi lk 'protects boby from obesity. Early introduction of solids is related to obesity later in l i fe'Hetps mom mointain milk supply and helps space out pregnancies'Makes starting solids easier - boby can feed herself, ond ollergies are less likely.

a l l o f these cons iderat ions, i t ' s impor tant to remember that you as the parent know your ch i ldWhen they are exh ib i t ing s igns o f read iness and are near ing the 6 month mark , they may be

read for sol ids. Let your babY lead You!Not Signs of Reodiness (ttgrgqglll

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- Baby can s i t on her own or wi th min imalass is tance and holds her head uP

- Baby draws food to her mouth with herhand

- Baby suddenly s tar ts waking moreoften at night

- Baby doesn' t s leep through the n ight- Baby seems to want to nurse/ feed

moreBaby is interested in food andmeal t imes*

She reaches and grabs accuratelYBaby has stopped thrust ing tongue outBaby is interested in food andmealt im es *

* Boby moy or may not be interested in food when exhibiting other signs of reodiness. You con choose to stort(especiaily if baby is 6 months) ond see how she likes it once she con play ond explore. On the reverse side,sometimes younger bobies seem interested in food when they're usually more interested in watching you eot. lt is

not necessority o sign of reodiness, especiol ly when baby is much younger thon 6 months and is not exhibit ing other

signs. Bobies of 4-6 months are naturolly curious in everything - it doesn't necessorily mean theY're reodY to eqt.

Getting Started- Equipment: high chair or Bumbo, bib (or str ip down to diaper), cover for f loor/dog- Mealt imes are playt ime in the f irst few months. Don't worry about fol lowing a "schedule" or

eating 3 square meals per day. This t ime is for explorat ion. Include baby as often as you havea meal (as possible).

- Start with something that's easy for baby to grab in her hand yet still bite - slice of avocado,strip of boiled sweet potato, banana cut lengthwise

- Other great first foods:o Cooked broccoli floretso Chicken and meat str ips

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Signs of Readiness

o Steamed/roasted vegetable strips (squash, pumpkin, zucchini)o Whole cooked vegetables (green beans, baby corn)o Str ips of bel l pepper, raw cucumbero Hard cheese stickso Whole grain bread striPs

- Offer food when baby isn't too tired or hungry, and allow baby to explore and play with thefood. Never put food in baby's mouth for her,

- Offer a variety of foods throughout the week, aiming for different tastes, textures, and foodgroups. (ln the first 2 weeks of BLW, Hannah had eaten avocado, sweet potato, chicken, eggs,lenti ls, hummus, plum, banana, applesauce, broccol i , zucchini, kiwi, yel low squash, chickenmeatbal ls, pasture cheese, quinoa, quinoa/amaranth pasta, whole grain bread, salmon, andbrown rice.)

- Be patient. Baby will eat when she is ready. Avoid coaxing her to eat or persuading her to eatmore than she wants. Watch for s ignals that she is ful l ( turning away, dropping or pushingarou nd food, fussiness, disinterest).

- Usual ly babies start by explor ing the food and potent ial ly chewing i t , but i t wi l l l ikely fal l out ofher mouth. Eat ing t ime can be just for fun for many days or weeks without any food gett ing intheir mouth. Chewing is important when they start , even i f they're not swal lowing much,because it teaches them to do it effectively. As her chewing capabilities progress over the firstfew weeks, she will begin to bring food to the back of her mouth to swallow it.

- Offer 1or 2 pieces offood at a time so baby doesn't get overwhelmed'

Safety

Some parents are really worried about choking with BLW. In reality, babies can choke just as easily {ifnot more) with purees because parent-led feeding bypasses baby's sensitive gag reflex. Regardless, itis important to follow a few safety guidelines:

1. Si t baby upr ight and don' t a l low her to lean backwards or s lump. Even sl ight ly forward leaningis OK.

2. Do not of fer choking hazards such as whole nuts, whole grapes/cherr ies, popcorn or real lyhard foods such as chips.

3. Remove skin from sausage/meats and small bones from fish. Large bone (poultry, lamb, beef)can be helpful for baby to grab.

4. Cut bananas lengthwise and offer cooked carrot sticks instead of coins.5. No one feeds baby - including other chi ldren.6. Never leave baby alone with food.7. Make sure food is not too hot.8. Offer baby water or milk with food to help them wash down stickier foods like bread, meat

and shel l f ish.

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Gag ReflexThe gag reflex is baby's natural protective mechanismwhen eating. lt is further forward in her mouth than anadult 's and can be very sensit ive. When gagging, babywil l retch and look l ike she's vomiting/coughing. Thispushes food that wasn't swallowed forward in themouth to be spi t our or chewed. Fortunately, mostbabies don' t seem to mind gagging. Some gag morethan others - in the first two weeks of giving solids,Hannah gagged about 5 t imes.

What about breastfeeding/formula feeding?- Breast mi lk/ formula remains baby's main source of nutr i t ion. Intake wi l l l ikely not decrease

unt i l at least 9-10 months or more'- Think about adding to, not replacing milk feedings.

Drinks- Offer water in an open cup with each meal (shot glass is ideal) .- She may play with the water and wil l let you know when she wants to drink it. We offer

Hannah woter ot the end of eoch meol to make sure she hqs swallowed oll of her food.- Juice is not necessary for babies and may get them accustomed to dr inking sweetened

beverages. Frui t is a much better opt ion.

Foods to AvoidHoney (unt i l age 1): honey may contain the botul ism toxin.Excess sal t : sodium can taxing on a baby's smal l k idneys. Avoid sal t ing foods given to baby.you can add seasoning, but i f you must add sa l t app ly a f ter tak ing out baby 's por t ion.lnherent ly sa l ty foods inc lude ham/bacon, smoked sa lmon, pepperon i , sa lami , and chor izo .Cow,s mi lk (unt i l age 1): cheese lVogurt lcottage cheese are OK, but don' t of fer f lu id cow's mi lkin the form of a beverage. Smal l amounts of mi lk used to cook a dish are OK.Choking hazards: whole nuts, whole grapes or f rui t wi th seeds/stones, chips, popcorn hotdogs (not cut) , whole bananas, raw carrots; nut butters are OK, just watch baby careful lybecause they can st ick to roof of mouth.

Sugary foods: avoid candy, chocolate, donuts, cake, etc.Low-fut foods: babies need a lot of fat. Avoid fat-free yogurt or low-fat cheese.Very high f iber foods: avoid cereals l ike Fiber One or wheat germ as they can upset baby'sdigestive tract.Raw dairy, raw shellf ish, undercooked meats, or other food borne i l lness hazardsCarbonated beverages: avoid soda, seltzer, soda water, etc.Ju ice: smal l amounts o f ju ice are OK, but breast mi lk / formula and smal l amounts o f water arethe only beverage babies need. Whole frui ts are much better than juice and are lower inconcentrated frui t sugar.Caffeine

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AllergiesTradiiional feeding philosophies recommend waiting 3-4 days between introducing new foods BLW

advocates watching for allergies but suggests that this wait time is not necessary. lf baby does exhibitan allergy or intolerance, stop solids and reintroduce more slowly to identify an issue.

** l f you have food al lergies in your fami ly, you may want toproceed with more caut ion when introducing al lergenic foods andwait a few days between new foods. Allergenic foods includecow's milk, peanuts, tree nuts, eggs, wheat/gluten, soybeans,shel l f ish, non-shel l f ish, nuts, seeds, c i t rus, tomatoes (and othernightshades l ike bel l pepper and eggplant) , and strawberr ies.

Contrary to old belief, research now suggests that allergenicfoods should be offered around 5 months. Introducing allergensto babies at th is t ime reduces the r isk that baby's system wi l lhyper-react.

To reduce likelihood of allergies:- Wait unt i l about 6 months to introduce sol ids and breastfeed as long as possible '- Opt imize vi tamin D - of fer supplementat ion to babies from bir th and get 10 minutes of sun

dai ly on exposed sk in .- Take probiot ics i f nursing and consider of fer ing them to baby'

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What about Nutrition?Tpo*ntto offer a balance of foods each day so baby doesn'tlust get starch and fruit (high

carbohydrate foods); veggies, protein, and fat are important. As baby hits 9-10 months andmay take in less milk, providing a range of foods {even if she doesn't eat all of them) isimportant for diet quality.

- Aim for as manv colors as possible to maximize dif ferent vi tamins and minerals'- Whole, real foods that are minimally processed are best '- choose organic for animal-based foods and Dirty Dozen produce when possible. Try

purchasing from the farmers' market - fewer pesticides, and more fresh food !- The following nutrients are the first needed on top of breast milk:

o !g tmportant for healthy red blood cells, brain development, and delivery of oxygento t issues .Bab ieswhodon, tea t i ron- r i ch foodsmaybecomeanemicbyage l .

r tron srores in breastfed babies start depleting slowly at 6 months Delayedcord clamping improves iron stores. Offering iron-rich foods is important whenstarting solids, but you don't need to have iron-fortified foods like cereal.

' lron-rich foods: meat, poultry, fish, eggs, potatoes, whole grains, fortifiedcereals/grains, spinach, sweet potatoes, peas, kale, chard, beans, lentils' dates'figs, prunes, watermelon, apricots, peaches, tomato products (e g paste)

' pair iron-rich food with foods high in vitamin C. For example, have beef withbell peppers or beans with tomato sauce'

o A!!.g: Critical for growth and a healthy immune system. High zinc foods are also usuallyhigh in iron.

. Zinc-rich foods: meat, poultry, eggs, whole grain cereals, nuts, crab, chickpeas,lenti ls. beans.

As a general guideline, offer at least one fruit or veggie at each meal given. Also, offer at least onesource of iron/zinc per day. I personally choose one source of protein (meat/egg/ beans/nutbutter/cheese), which is also high in iron/zinc, and 1-2 veggie/fruit options at each meal. SometimesI offer whole grains too (maybe 1-2 of 3 meals).

You may only give baby one food once or twice a day at the beginning, but as you progress baby willhave more var iety in what she eats. For example, a few weeks into BLW, a menu could look l ike this:

o Breakfust:. Strip of whole grain/sprouted toast with almond/peanut butter and a few

raspberr iesScrambled or hard boi led eggs, avocado and tomatoSmal l s t i ck o f cheese , nec ta r ine and cucumber

Chunk l i gh t tuna , be l l pepper and peachLef tover gr i l led shr imp, sweet potato wedges and steamed broccol iBaked chicken st r ip , cooked carrots (not co ins) and hummus

c Dinner :. Salmon with di l l yogurt sauce, roasted beets, st icky brown r ice' Whole wheat pasta sp i ra ls w i th vegetab le mar inara sauce and whi te beansI Grass-fed beef patty, broccoli, red potato wedges

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Baby's Abi l i t iesReady:to"Star-t -Argqnd 6 44qnths

Reach and , urith Palmar Grip - Around &8 Months

and Oosins - Around 7-9 Months

Using Fingers - Arou nd S;1Q-N| gglhs

- Around g-t? Months

Silverware - Around, 11-14 MonthsMay use si lverware most of the t ime, making mealt imesvery s low, Probably prefers fork over spoon but may alsol ike us ing f ingers.

Developmental Skil lsI t 's important to give baby foods she has the developmental caPacitY to eat , as wel las foods that mavbe a bit beyond her ability. (Toblgslgpte! om The Babv-led WeaninCookbookpp. 11-131) .

Easy Foods Foods to Try

Takes toys to mouth; chewing movements; s i tsgrab foods .

Can reach for large pieces of food with whole hand butneeds i t long enough to poke ou t the top . May ho ld foodin one hand and gu ide to mouth w i th o ther hand. Tendsto crush soft foods. Food fal ls out of mouth easi ly, andshe drops food o f ten . Spends t ime examin ing and p lay ingwi th food, as we l l as pass ing hand to hand '

May grab f istful of food without much squishing andopen hand and push most of i t in mouth. May squeezefood in mouth from f ist. Wil l be better at bit ing andchewing. May want to try spoon or st ick of food as a"d ipper" for runny food, or may manage a pre- loadedspoon. continues to examin-e and experiment with food.

May use a "d ippe/ ' and p ick up/hold p ieces of food wi thf ingers. Makes careful select ions of what to eat, and inwhat order . May want to t ry us ing s i lverware, potent ia l lyscooping food with spoon or using a fork to stab wholepieces.

Long st ick-shaped pieces offood, inc lud ing F&V; toas ts ,large pastas, sof t meat Patt ies,a l l shaped in to f ingers . Longstr ips of meat.

Long st ick-shaped Pieces offood, inc luding F&V; toasts,large pastas, soft meat Patt ies,a l l shaped in to f ingers. Longstr ips of meat .

St ick shapes and c lumPY foods(see above) . Smal ler sof tfoods l ike s t rawberr ies andchunks of cooked veggies.Sl ight ly crunchier F&V.

See left

Foods that can bep icked up in c lumps(st icky r ice, cereals ,mashed potatoes,ground meat , gratedcheese) . S l ippery foodsl ike pasta wi th sauce.

Runny foods to d ip in to( h u m m u s , y o g u r t , t h i c ks o u p s ) . S t i c k s o f r a wvegg ies fo r d ipp ing .Dif ferent shapes ofpas ta (spaghet t i o r z i t i ) .

a n dsta bMay eat

Most s t ick shaPes, c lumPYfoods, sof t foods. Crunchierfoods (depend ing on tee th ) .Runn ie r foods w i th d iPPer .

Pret ty much everYth ing.

Loose foods and smal lp ieces ( r ice, peas,ra is ins , c rumb ly b read) .Sma l le r chunks fo rscooping wi th spoon orstabbing wi th fork.

Ful l var ie ty of texturesand shapes so tha t shecan lea rn to managewi th s i lverware.

F u l l v a r i e t y o f s h a p e sand tex tu res .

Can p ick up smal l p ieces of food wi th thumbforef inger - gra ins of r ice and crumbs. Mayaccurately with fork and scoop with spoon.more food purposeful ly and play less.

to make BLW easier:

Everything.

Offer dippers for sauce/dips- breadst ick, celery, carrot .

Pre- load a spoon to he lp wi th runny foods.Use a cr inkle cut ter for s l ippery f ru i ts.Serve cooled smooth soups and yogurt in a cu

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Serve runny foods on gnocchi or mashed potatoes/sweetpotatoes/parsni p/cau l i f lower.Get an easy-to-clean high chair and long l leeve bib.Make soups and breakfast cerea ls ext ra th ick .Add r ice or smal l pasta to sou

Types of FoodsAdapted from The

Vegetables

Baby- led Weaning Cookbook, p 19-22.How to Prepare

Green beans, asparagus, snow peas: t r imBroccoli, caulif lower: offer as florets (with a "handle")Potato, sweet potato, squash: sticks or wedges with some skinOther f arge vegetables: cut into th ick st ick shapes (2" x/ , - To"\

Veggies con be steamed, boiled, grilled, roosted, stir-fried, or baked. Should be firm enough to hold but softh to munch (not ol dente). Smoll veggies like peas con be squashed toqe;thq v/!9n nickgd up.

Cucumber, bel l pepper: cut into th ick str ipsCelery: remove coarse stringsLettuce: of fered in str ips or rol led-up leaves (baby may not be able to eat but wi l l want to t ry)fomatoes: ha lved/quar tered; cut cherry tomatoes in ha l f

Start wi th skins on so they're easier to grab, even for pineapple and kiwi . Remove pi ts and wash thoroughly. Canoffer in halves or quarters or leave whole (not smal l p ieces). Try sof ter f ru i ts f i rst , and take a bi te out to helpbaby get going.

- Avocado, pineapple, melon: cut in wedges- Nectar ines, apr icots: cut in hal f- Blueberr ies: smash sl ight ly- Grapes: cut in hal f- Strawberries, raspberries: offer whole (remove stem from strawberries to create a hole for baby to stick

thumb in to )Banana: cut in ha l f /s t r ipsOffer large pieces that baby can holdTwisty shapes ( fusi l l i , r igatoni) may be easier for baby to hold and hold sauce betterMay not want to add oi l because i t makes pasta s l ipperyTry wi thout sauce f i rst , then try sauce on side, then sauce on pastaOpt for whole grain pastaSt icky r ice, sush i r ice , and r isot to may be eas ier becausethey stick together better

on spoonEventua l ly baby wi l l p ick up ind iv idua l gra ins and/or putOffer in large str ips, on the bone, or in patt iesMake sure the meat is very tender (stewed instead of gr i l led or tough)Baby wi l l eventual ly graduate to ground meatCh icken: tear a long the gra in so i t s tays in one p iece ; cons ider th igh meat ins tead o f b reas t , and removebones/gristleToast bread; try offering whole grain varietiesFlat breads (pi ta, tor t i l las, wraps) are easier than "regular" breadCut bread into f inger shapes, str ips, or smal l t r iangles

Snacks may not be necessary unt i l a t least 9-12 months - mi lk feeds usual ly serve as snacks unt i l then. Try tohave heal thy opt ions on the go to avoid buying processed foods.

Frui t and vegetable str iPsCheese piecesStr ips of meat or chickenWhole grains (dry cereal , r ice cake, toast)

Fru i t

Rice

Meats

Sources:The Baby-led Weoning Cookbook by Gil l Rapley and Tracey MurkettWeaning Made Eosy by Dr. Rana Conwaywww. analy t ica larmadi l lo .co. u kwww.kel lymom.comwww. ba byledwea n i n g. co m

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Snacks