Lecture 13: Baby-Led Weaning

Question 1

What are the two forms of baby-led weaning?

Answer 1

Parent-led and baby-led

Question 2

What is baby-led?

Answer 2

Baby feeds themselves from the start, rather than being spoon fed

Question 3

What is parent-led?

Answer 3

Generally referring to spoon feeding

Question 4

What are the MOH texture recommendations?

Answer 4

• Pureed (6-7mo)
• Mashed/Finger Foods (7-8mo)
• Chopped (8-12mo)
• Family Foods (>12mo)

Question 5

Who was baby-led weaning documented by originally?

Answer 5

Gill Rapley

Question 6

Why is baby-led weaning not currently recommended by MOH?

Answer 6

There is lack of evidence around the safety of it

Question 7

What are the key features of baby-led weaning?

Answer 7

Baby-Led = self feeding
Family foods = same as the rest of the family
Mealtimes = family sits together
Milk Feeding = milk feeds continue on demand

Question 8

Why is it important that baby and family sit together at meal times?

Answer 8

So they baby can learn from family members

Question 9

What are the potential risks of BLW?

Answer 9

• Iron deficiency
• Zinc deficiency
• Growth faltering due to inadequate energy intake
• Choking

Question 10

What are the potential benefits of BLW?

Answer 10

• Energy self-regulation
• Lower risk of obesity
• Better diet quality
• Motor development
• Convenience

Question 11

What are some areas for improvement regarding the foods infants are consuming?

Answer 11

• Over half eating choking risk foods
• Far too much sugar and salt

Question 12

What does BLISS stand for?

Answer 12

Baby-Led Introduction to Solids Study

Question 13

What was the BLISS study objective?

Answer 13

To determine whether a novel approach to CF using foods that an infant can feed themselves, can prevent the development of overweight in infants and toddlers without detrimental effects on their iron status or growth

Question 14

What type of study was BLISS?

Answer 14

An RCT with 200 infants

Question 15

BLISS modified BLW to address what?

Answer 15

• Growth faltering
• Iron deficiency
• Choking

Question 16

What interventions did the intervention group have? (BLISS group)

Answer 16

• Standard ‘Well Child’ care
• Group education
• Lactation visits
• Bliss visits
• Many more check ups

Question 17

What interventions did the control group have?

Answer 17

• Just standard ‘well child’ care
• Measurement visits
• Only 3 check ups (vs.7)

Question 18

Did bliss demonstrate proposed concerns regarding growth faltering?

Answer 18

Energy intakes were similar, no concerns around growth faltering

Question 19

Did BLISS demonstrate proposed concerns regarding iron deficiency?

Answer 19

No differences in iron intake or iron status
- Bliss were offered resources on high iron foods which maybe increased their levels to the same as spoon fed

Question 20

Did BLISS demonstrate proposed concerns regarding choking?

Answer 20

No difference in the risk of choking

Question 21

What other positive outcomes did BLISS demonstrate that may benefit infants?

Answer 21

• Less fussy
• Enjoyed food more

Question 22

What does FFNZ stand for?

Answer 22

The First Foods New Zealand Study

Question 23

What were the aims of FFNZ?

Answer 23

To describe in NZ infants:
- Relationship of BLW and baby food pouch use
- Diet
- Sustainability attitudes, knowledge and behaviours
- Cost of CF

Question 24

FFNZ aimed to explain the relationship of BLW and baby food pouch use with….

Answer 24

• Nutrient and food intake
• Choking
• Oral motor skills
• Iron status
• Growth
• Dental health
• Eating behaviours

Question 25

How did FFNZ collect data?

Answer 25

• Used 24 hour recall
• Collected anthropometry
• Questionaries
• Taking photos of teeth
• Blood sample for iron

Question 26

What did FFNZ find about energy intakes and growth?

Answer 26

Energy intakes higher in BLW, but no difference in growth (BMI z-score)

Question 27

What did FFNZ find about food enjoyment benefits?

Answer 27

Slightly more satiety responsive

Stopping when they no longer want what they see

Lower food fussiness

Less likely to be selective or restrictive

Question 28

What did FFNZ find about the risk of iron deficiency?

Answer 28

No difference

Question 29

What did FFNZ find about choking risk?

Answer 29

Not sure yet!

Question 30

What does the MOH recommended to parents to do BLW safely?

Answer 30

• Baby should be able to sit unassisted, pick up food and bring it to their mouth
• Start with soft foods
• Reduce risk of choking
• Offer iron-rich foods daily