Baby Led Weaning (or starting solids) book review and nutritionist weighs in (with her 7 month old daughter!)

Baby-led Weaning is not about weaning in the sense that we think of it. For the British authors, it means the introduction and transition to solids from breast milk or formula.Basically, the authors (both mothers, one a public health nurse, the other a writer) say that healthy babies do not need to be spoon-fed- ever, and make the case that BLW is the way to go- it makes for less stressful feeding, and makes kids less picky, develop earlier, be happier at the table...The gist is babies will show they are ready for food by grabbing it and putting it into their mouths.  "All you are doing (and asking them to do) is to miss out on the puree stage." I won't go into the details about what to introduce and when (this isn't a BLW  how-to, more a brief examination) but they advocate having Baby eat what the family is eating, join in with family meals, while continuing to breast or bottle feed. (There is a lot I love about this model, mostly because it is very familiar to what Ellyn Satter has been saying for forty years. In fact many phrases are very similar to those in Child of Mine or on Ellyn's website.)  In my opinion, many of the benefits attributed to BLW, are more about following the child’s lead with feedingand maintaining the Division of Responsibility, which by necessity with the little ones, BLW does.Here are some concerns where they seem to not follow the DOR or model I work in:• they seem to endorse grazing, as long as it's healthy (letting the toddler help herself to "healthy" foods anytime as long as she sits down at the table...) • there seems to be little acknowledgment that temperament can play a big role. ("the third baby became a noticeably "better" eater... less fussy and more adventurous. The parents had discovered BLW...") I know lots of families, some with three kids all raised the same way with food,  yet one child is especially cautious and more picky than the other two. It is more complex than the book gets at...• seems to recommend a one-size-fits all in terms of foods to offer and may be falsely reassuring in terms of choking risks. I worry if the child is on the mother's lap (as they seem to endorse) that she might not notice right away if the infant is getting into trouble with choking. Children develop at different rates with their oral-motor skills, and parents should tailor foods offered to the child (Child of Mine has an excellent resource on when to offer what kinds of foods based on what your little one can do.) I know my M was not a muncher, but would chomp off huge bites with teething or other crackers and have some trouble. Each child is unique. Hydee too had concerns about offering large chunks of meat and other foods in terms of choking. (see below) Again, BLW may be fine for some children, but not necessarily all. (Note, gagging and choking are different...)

If it's not BLW, it's forcing or pressure?

I bristled at the assumption that you can't follow a child's cues when bottle feeding. It is easier to get pushy with a bottle vs. breast, but if you are tuned in to your child, you can feed skillfully from a bottle.They suggest that spoon feeding equals forcing or over-feeding. "Being spoon fed by someone else means the baby is not in control of how much she eats." They infer that parents who spoon feed all play games, pressure, force,  don't expose the child to a variety of tastes and have a miserable time with a child who will invariably end up picky. Not true. It is easier to push a spoon-fed baby, but a tuned-in parent lets the baby decide how much to eat, spoon-fed or not. The horror stories about spoon-feeding  in the book could have been addressed by following the baby's cues and following the DOR, or doing BLW.I was surprised that the book never mentioned Ellyn Satter or the Division of Responsibility in feeding (which I imagine the authors MUST be aware of and if not, then they haven't done their research.) Because,  every benefit and success story they mention about BLW  also holds true if you follow the Division of Responsibility and Ellyn's trust model of feeding, spoon or not.  You can use a spoon and purees and follow a child's cues with pace, quantity and which foods.  Is it easier to get pushy with a spoon vs BLW? Yes, but it is not a given.I think of the video of 8 month-old Elsa in Ellyn's first Feeding with Good Sense video series (hey, another video is coming soon!!!) Elsa sits at the table with her parents, feeding herself all the foods the family eats, very skillfully. Elsa was spoon-fed but would look just like any of the BLW babies described in the book.Another concern, which also came up in a recent study from Maternal Child and Health journal is that children who are more slow to develop may have nutritional deficiencies, particularly iron. "UK researchers - led by child health specialist Professor Charlotte M Wright from the University of Glasgow, Scotland - recommend combining self-feeding with solid finger food with traditional spoon feeding."As for the "anecdotal" evidence that BLW babies develop hand-eye coordination, writing and language sooner because of handling foods? It is perhaps more likely incidental, or an indicator of developmental readiness, not cause and effect, and parents who chose BLW are different in many ways* that could also compound differences.In a bit of a twist, the one study cited in support of the child choosing what to eat and how wonderfully the children did with it– many of those children were spoon fed by adults, and all the children (even the spoon-fed ones) were willing to try new foods...It is also curious to me that the book talks a lot about obesity, but doesn't mention that crossing the division of responsibility with feeding or getting pushy with foods can make a child eat less and weigh less than is healthy for her, which I commonly see in my practice.The BLW book doesn't give much guidance for parents once kids are their own little people, once they are past sitting on a lap or high-chair having roasted vegetable sticks  put on their trays...Or that once the baby is past the spoon that parents can still be pushy with enforcing rules about eating this before that, pushing foods etc... It doesn't review normal eating and growth which is so critical for many parents to trust a very large or very small child with eating...I just worry that this will be another book that guilts mothers– if you were unable to breast feed for whatever reason, if you spoon-fed, if your child is slow developmentally... There is more than one "right" way to feed a child if you are following the Division of Responsibility with feeding (implied and incorporated in BLW.)Here's what FFD's pediatric nutritionist, Hydee Becker RD says who has read the book and is currently "weaning" her second child."They do seem to think that anyone who doesn't use BLW will end up force-feeding in some way.  That is so silly!  I am still spoon feeding R iron fortified rice cereal and some other foods usually daily.  I have to say that what is really happening is I am loading up the spoon and then she quickly takes it from me and jams it in her own mouth.  The reason I am doing some purees is because I really, really think she needs the iron.  I'm not that great about giving her the iron supplement (it stains big time so I just give it to her when she is in the bath...and that is only about twice a week).  Also I don't have the nerve to give her the big hunks of meat they suggest!  And I have trouble believing the authors when they say that the baby will get the iron they need by getting the juice out of the big hunks of meat.  (As an aside I do think some of the nutrition info is incomplete).  So I put the meat we eat through the food mill.  It is too difficult for her to eat this as a finger food.  Sometimes I spread the milled meat on her toast or I put it on the spoon.  I wait for the tilt of the head or the grab of the spoon or the swatting away of the spoon and I think other parents should too... My conclusion is parents should do what they feel most comfortable with either BLW or conventional feeding practices AND do what is going to work best for their child.  Some babies want to do it themselves.  Others want to be/ need to be spoon fed.  Either/ Or/ or both is just great as long as the DOR is observed! " I love the description Hydee gives of following her daughter's cues...Here's what another reader said about BLW: Baby-Led Weaning made our mealtimes enjoyable because our daughter was eating right along with us, and by 9 months, she was pretty much eating what we were eating.  It has also helped me to realize that I don't need to be worrying about how much my daughter eats.  We had the DOR down without knowing that phrase :)I agree with Hydee. If you want to do BLW, go for it. Get the book, but also get and read Child of Mine for a more complete picture and more concrete help for transitioning into the next phases of feeding.Moms, what are your experiences?*"Those participants who used a BLW method reported little use of spoon-feeding and purées and were more likely to have a higher education, higher occupation, be married and have breastfed their infant. BLW was associated with a later introduction of complementary foods, greater participation in meal times and exposure to family foods. Levels of anxiety about weaning and feeding were lower in mothers who adopted a BLW approach."