Saturday, July 21, 2012

Baby Lead Weaning

I have mentioned baby lead weaning a couple of times and I know its not a common phrase here in the U.S., although it is growing. It is a method of introducing babies to food that flies in the face of traditional American knowledge. The phrase itself (weaning) is British, as this process of introducing solids is called weaning in the U.K. So - what is baby lead weaning then and how is it different than the "normal" way of introducing food? I am going to do my absolute best to show both sides and separate the fact and conjecture. That said, as I chose Baby Lead Weaning, that bias is bound to show in this post.

Traditional American knowledge says that you introduce food around 4 months. This is typically started with rice cereal or some other single grain cereal being spoon fed. After this is introduced, parents then are encouraged to add pureed baby foods one at a time - spoon  feeding each food several times before moving onto more variety. [for absolute accuracy just want to add that more recently pediatricians have recognized that 4 months might be too early and many parents wait until 6 months for this entire process to start] Eventually the child should be eating all sorts of purees, and then be introduced to finger foods like teething crackers, cereal, etc. Solids are introduced later (I am not actually sure when), either by phasing them in starting with chunkier purees or other ways (again, I am not sure exactly).. The basic underlying ideas of this traditional approach are (1) the earlier you start babies on solids the more they will grow and better they will sleep (2) you need to introduce foods slowly to make sure babies are not allergic to things and (3) babies will choke if they are given solid foods too earlier. They need to practice with purees first.

In baby-lead weaning, you introduce solid table food when the baby is at least 6 months old, capable of supporting themselves sitting (either on their own or being held by a parent), and capable of bringing items to their mouths.  The food is typically either presented to the baby in large pieces that are easy to grab to begin with, or in soft forms like apple sauce, yogurt, etc. As the baby gets older you can present the food in a wider variety of forms (smaller pieces etc). You never spoon feed the child. They also are in control of when to reduce and give up breast feeding. The basic underlying ideas of baby fed weaning are (1) the baby should be in control of what goes into their mouth (2) babies should eat what the family is eating for the most part, and eat w/the family as part of the family (3) babies are designed to learn to eat solids at their own pace if they are allowed to do so.

Most American parents do not realize there is a decision to be made when it comes to introducing food. The traditional American method is very well engrained in the entire medical system and social structure here. But Baby Lead weaning is not some hippie alternative lifestyle. It is promoted by the National Health System in the UK and other European countries. Because the American method is so well engrained, if you do choose baby lead weaning you get a lot of questions and judgement from other parents (and even pediatricians!).

Won't your baby choke? -
Fact: A 6-8 month old's gag reflex is farther forward on the tongue than older babies and adults. Additionally, the jaw and tongue motions required to move a large piece of food from the front to the back of the mouth are the same motions required for chewing.
Conjecture: The gag reflex being farther forward discourages babies from putting things too far into their mouth and they will not be able to move big bites to the back of their mouth until they learn to chew. The forward gag reflex also gives baby a window of time to learn deal with solids without being as at risk for choking. If they miss this window, and get used to food being swallow-able without chewing, choking would seem more likely.

All babies will have to face a choking hazard at some point. There is no actual research/statistics on whether babies are more likely to choke if they start solids at 6 months or after months of puree at 9 months. The main precautions to take against choking at any age is to make sure the child is sitting upright while eating and that you always watch your child eat.

Aren't you worried about allergies?
Fact: Prior to 6 months, the intestine is not well developed and can have reactions to more types of food than at an older age.
Conjecture: Most of the fears concerning allergies are resultant from people starting babies on solids too early. A four month old may appear to have allergies to something because their intestine is underdeveloped to deal with it rather than because it is an actual allergy.

I guess my basic take away for this question is research shows food should not be introduced until 6 months, whatever method you want to use to introduce it. I cannot speak to the wisdom of avoiding certain foods until a child is older, but if you choose to do this, you can do it under either method of feeding. You also can easily modify baby lead weaning to introduce foods more slowly if you are more comfortable with it.

How do you know he is getting enough/the right things to eat? 
Fact: A study back in the 30s (granted, a long time ago, but as I said the research on this topic is very limited) allowed babies to choose their own foods from among healthy options for one month, and at the end of the month all of the babies had chosen a balanced diet for the course of the month and were healthier than at the beginning of the month. Also, a recent study in the UK showed baby lead weaning resulted in lower childhood obesity than other methods of introducing food.
Conjecture: Babies will crave what their body needs. If given healthy options to eat they will choose what they need. Also, as they are in control of how much they eat, they will learn from a very early age to judge how full they are and reduce over eating for their life.

There is not much research on exactly what babies need when in terms of calories and vitamins at what ages, but in terms of Baby Lead Weaning, as long as the baby is allowed to continue breast-feeding at will, they will be getting enough calories whether they be from food or milk. Regardless of feeding method, vitamin supplements are always an option if you are concerned about it.

And finally, the big question: Why did we choose baby lead weaning? I admit this was more my decision that DHs, though if he were not comfortable with it we would modify it so he was. Anyways, baby lead weaning just makes sense to me. There has not always been blenders and food processors around. Mothers have been living without these things for thousands of years. Clearly when humans were evolving, they had a way to learn to eat solids that did not involve purees. In my mind, this either means something like baby lead weaning was going on, or Alicia Silverstone-esque feedings were happening (eew?). Of course this alone (evolutionary design) is not enough to mean that baby lead weaning is any better than the traditional American approach, but I have not seen any real evidence as to why the traditional American approach is better either. I like the basic theory and ideas behind baby lead weaning. I like that you trust nature and the baby to know how and what to eat. I like that you don't fight the baby to make them eat, or force them to eat. I like the idea that Benjamin is learning about family dinner time and table manners and healthy appetite control without us making any special lessons/allowances. And now that we are actually doing it, I love that it forces us to cook more healthy meals, to sit down and enjoy each others company, and I love how much Benjamin enjoys it. I love that if we are out and about and grab lunch I can just hand Benjamin a chunk of green pepper from my subway sandwich and let him go at it. It really works great for us.

I am not saying baby lead weaning is for everyone, but I do advocate people making an active informed choice about how to introduce solids to their child, and not to just assume that their is only one way.

No comments: