Baby Led Weaning, often seen as BLW, is a reawakening of very old weaning practices. At the turn of the century, Gill Rapley, Deputy Programme Director of UNICEF's Baby Friendly Initiative, and former UK health visitor, midwife, NCT breastfeeding counselor and lactation consultant, conducted research into the weaning of breastfed infants.
Research Base
Gill Rapley's research built upon World Health Organization (WHO) research that showed that babies should be exclusively breast- or formula-fed for the first six months of life. Rapley's 25 years of service as a Health Visitor had taught her that by 6 months, babies are capable of feeding themselves appropriately-prepared foods, so this formed the basis of her research.
The rationale was that breastfeeding babies have regulated their own food intake their entire lives, and are capable of doing so through the weaning process and into adulthood.
Developmental Pre-requisites
Around 6 months, babies are in the oral fixation stage, where their eye-hand coordination has developed sufficiently that exploration begins with the mouth. By this age, babies typically sit up unaided and develop the skills to move food through their mouth, make chewing actions, lose their tongue-thrust reflex and the gag reflex retreats through the oral cavity. These are the developmental milestones necessary to enable a baby to successfully and safely eat unaided.
Suitable Foods for Self-Feeding
Six-month olds have not yet typically developed a pincer grasp necessary to pick up small objects. Nor have most 6-month olds developed object permanence. Suitable foods for self-feeding should be soft, and served in batons that the baby can hold and see, or trees like well-cooked cauliflower or broccoli.
Six-month olds may have a few incisor teeth, but most do not yet have molars for grinding food. Their gums are hard, which enables even toothless babies to bite surprisingly well, but masticating ability is limited. First foods should be soft; preferably so soft that an adult can mash it on the roof of their mouth with just the tongue. This allows the baby to chew the food into smaller pieces and helps prevent larger pieces becoming stuck, leading to choke.
BLW and Choking
If a baby is fed developmentally-appropriate food, the risk of choke with a BLW baby is actually lower than for a puree weaned baby. Putting food into another person's mouth, especially with a spoon, is a choke hazard, and the practice is counter-indicated in geriatric care facilities and hospices. If food is introduced too far aft in the oral cavity, it is difficult for the receiving person to control the food in their mouth. With BLW, the baby has not developed the skills to get the food into the mouth until the skills to move it through the mouth, chew and swallow have also developed.
As long as the food offered to a baby is developmentally-appropriate and no assistance is given in getting the food into the mouth, the risk of choking is at worst the same with BLW as any other method of weaning.
BLW As the Natural Approach
BLW is popular with parents who adhere to some or all of the tenants of Attachment Parenting, as it fits well with their philosophy. BLW is a method of weaning based on a baby's development, that capitalizes on their curiosity and nascent need for exploration. In what for many babies is a pre-mobile stage, BLW can help ease some of the frustration associated with the desire to explore and the physical incapability of doing so.
Letting the baby take the lead and dictate the pace, the struggle for the spoon and airplane game of "open wide" is obviated. There is no forcing or cajoling of the baby to eat, no power struggle, and now worrying if you have satiated your child's hunger, or over satiated it. This greatly reduces the likelihood of negative food associations, and toddler who won't eat lumps.
BLW is flippantly called the "lazy" way to wean, because BLW parents are spared the effort of making pureed foods, and feeding their babies while their own food gets cold. BLW graduates typically have more refined palates, being accustomed to "adult" food from an early age.
BLW Guidelines
Gill Rapley publishes her BLW guidelines on her website,
http://www.rapleyweaning.com. The guidelines include:
Eat as a family.
This allows the baby to mimic chewing actions to reach for food when ready to start eating.
Ensure the baby is upright; supported if necessary.
An inclined repose makes it more difficult to control food in the mouth and can pose a choke hazard.
Offer foods that can be held in a fist.
This allows a baby that has not developed a pincer grasp or object permanence to pick up food and move it to the mouth.
Offer a variety of foods.
Initially, the focus is on learning through discovery and the nutritive benefits are minimal compared to the learning experience.
Don't try to help the baby eat.
A baby will eat when developmentally capable, and not before.
Don't expect your baby to eat anything at all in the beginning, or meaningful amounts for some time.
Initially there is little distinction between food and toys to a baby. There are numerous skills to master in the eating process, and swallowing is the last. Most babies can be sustained on milk alone for the first year at least.
Never leave a baby unattended while eating.
Choke is improbable, but always possible.
Don't offer foods that are obviously dangerous.
For example, nuts, uncut grapes, uncut cherry tomatoes, hard candy, etc.
Watch the salt and sugar.
While babies can manage with most textures and flavors of adult foods, their kidneys are unable to process the salt content of pre-processed and fast foods. Refined sugars are empty calories.
Offer water in a cup with meals.
More important for formula-fed babies who don't have the benefit of manipulating the foremilk/hindmilk balance, water after a meal cleans food off young teeth and helps prevent tooth decay.
Useful BLW Links
Gill Rapley's site, with links to her DVD and book: http://www.rapleyweaning.com
BLW forum: http://forum.babyledweaning.com
There is a Baby Led Weaning group on facebook.