Baby Led Weaning, "starves children and leads to underweight!!"
Did that headline get your attention? I had a little fun with that one. The real headlines? "BLW prevents obesity!"Of course, because that seems to be the only way to get attention these days. What if the headline had said, "BLW starves babies and makes them underweight!" Equally as valid sensationalism given the conclusions of the actual study.But, I digress...This article about Baby led weaning is intriguing, but leaves me with lots of questions! If you aren't familiar with BLW, take a minute to read my post from last year which is a primer. It was my most commented on post ever!Remember, my conclusion is that you can do either BLW or spoon-feed and have a healthy feeding relationship that supports healthy growth, if you follow your child's lead!"Researchers analysed two methods of weaning - baby-led weaning with finger foods, versus traditional spoon-feeding by parents. The sample included 92 children who had been weaned on finger foods and 63 who were traditionally spoon-fed. Parents filled in questionnaires on how their children had been weaned, including how often they ate certain foods.""Some 94% of youngsters in the baby-led group had never choked as a result of being given solid foods." "Our results suggest that infants weaned through the baby-led approach learn to regulate their food intake in a manner which leads to a lower BMI (body mass index) and a preference for healthy foods like carbohydrates.The actual article at least acknowledged: There was an increased incidence of (1) underweight in the baby-led group and (2) obesity in the spoon-fed group. No difference in picky eating was found between the two weaning groups. (surprising, since the book claims BLW means less picky eating, and I actually thought it might lead to greater variety as well...)There is a major problem with these types of studies, with small numbers especially as they look at the children in one point of time, not at the growth patterns over time... Perhaps the "underweight" and "overweight" kids were healthy and growing at a steady rate... Perhaps kids in the "normal" group were dropping percentiles, or increasing...So I did a little more digging, and found a few other things. The age of the groups of children at testing were very different. The BLW group was on average 32 months old, the spoon-fed group was 40 months. Big difference. BLW babies were breast fed for 23 months vs 9 months for spoon-fed. No report of choking in the spoon-fed. (A 6% incidence of true choking may be higher than acceptable, but the study is too small, 1 kid essentially...)This chart was also interesting for several reasons. The increase in "underweight" was significant, but also look at how the NHS (National health service in England) and the CDC have chosen different arbitrary cut-offs for "underweight" and "overweight" and obese, and how different the conclusions might be based on that!
| Baby-led group (n=63) | Spoon-fed group (n=63) | |
| WHO z-score† | ||
| −3 | 1 (1.6%) | 0 (0%) |
| −2 | 2 (3.2%) | 0 (0%) |
| −1 | 5 (7.9%) | 3 (4.8%) |
| 0 | 39 (61.9%) | 40 (63.5%) |
| 1 | 15 (23.8%) | 12 (19.0%) |
| 2 | 1 (1.6%) | 8 (12.7%) |
| 3 | 0 (0%) | 0 (0%) |
| NHS percentiles | ||
| Underweight (<2) | 3 (4.7%) | 0 (0%) |
| Healthy weight (2–90) | 51 (81.0%) | 53 (84.1%) |
| Overweight (91–97) | 9 (14.3%) | 2 (3.2%) |
| Obese (98+) | 0 (0%) | 8 (12.7%) |
| CDC percentiles | ||
| Underweight (0–4) | 6 (9.5%) | 1 (1.6%) |
| Healthy weight (5–85) | 49 (77.8%) | 47 (74.6%) |
| Overweight (86–95) | 7 (12.7%) | 8 (12.7%) |
| Obese (96+) | 1 (1.6%) | 7 (11.1%) |
What I am getting at (not really sure what that is as I rush to get the first draft of my special needs chapter of my book done) is that these are complex issues, often not acknowledged in press releases or the headline-grabbing articles. We do need to be careful we aren't causing more harm than good, and can't just gloss over an increase in underweight without comment. Every child is different. Some children will thrive self-feeding, others may benefit from spoon-feeding, and often, a combination is the right approach. Supporting parents in being responsive, and not trying to get children to eat more or less than they might want is the way to go.(Oh, and I love how they defined "carbohydrates" as "healthy" when I see carbs so often being blamed for the all nutritional ills...)What do you think?