Traditional or Baby Led Weaning - what's healthy?
Oh those precious moments of embarking on the wonderful explorative journey of solid food with your infant, while trying to decipher the best way to do this for your child. The current standalone methods of choice are Traditional Led Weaning, or what is called Baby Led Weaning. Alternatively you can also, of course choose to do a bit of both. But are these methods really the right overall choice for your infant’s digestive biology? This is one of the most important question that needs to be answered, because the way your child receives solid food effects there health and development in so many ways, inclusive of sleep, their comfort levels, weight gain, bowel motions, behaviour and how well they continue to drink their required breast milk, or formula. So, before we delve into my thoughts and the facts on both of these methods, let’s define these two forms of introducing solid food.
Main features of traditional weaning
- infant's fed pureed food at around 6 months old
- the infant is offered soft lumps within this and soft finger foods around 7-8 months
- more textured food is slowly added to this at around 8-12 months (1)
- baby joins in with family meals
- food is placed into baby’s mouth
- baby may be enticed to eat
- baby will be fed from a spoon the majority of time
Main features of baby led weaning
- no puree’s or mashed food
- only finger food or chunky food is offered from around 6 months
- infant is not spoon fed
- infant ‘chooses’ what to eat and how much
- infant joins in with family meals
- infant is not coaxed to eat at any point
So with those outlined, let’s now take a closer look at your child’s digestive capabilities at six months old and onwards.
Basic facts about an infant’s digestive ability
For the first six months of life your baby has only been processing liquid through their digestive tract, and it naturally takes them a while to be comfortable with that feeling while adjusting to the changes within your breastfeeding diet, or their formula. At six months research shows us that a baby’s digestive system is developed enough to START receiving solid food. Now I want to emphasise the word START here, because biology also shows us that an infant’s digestive tract does not function the same as an adults until two-and-a-half years of age! Yes, it takes two and a half years before your child’s system can process the array of diet that an adult has in a healthy manner.
One of the main organs that needs to develop further for weaning is the pancreas. “The human pancreas appears anatomically and histologically (microscopic structure) mature by full term, but enzyme secretion is still immature, and readily influenced by several exogenous (external) and endogenous (internal) factors.”1
At around six months of age, small, very gradual changes begin to happen in an infant’s pancreas. Slowly their pancreatic juices begin to evolve, and this is important because this fluid is made up of digestive enzymes that help break down carbohydrates, proteins and lipids (fats) when the food is in the duodenum, after it has passed from the stomach. These pancreatic enzymes are also boosted by the child’s full-term provision of digestive enzymes, which exist in both their saliva and breast milk.
The USA National Pancreas Foundation outlines this slow maturing of digestive capabilities of the pancreas by saying, “The exocrine pancreas is not fully developed at birth. In fact, all healthy infants show some degree of maldigestion due to the fact that the pancreas is immature and does not have the same ability to produce enough enzymes. This is particularly true for starch and fat digestion. However, the pancreas matures after birth and by two years of age it is functioning in the same way as an adult pancreas.”2 As an aside, it always annoys me this particular stance of view when the newborn or infant is projected as lacking because they do not ‘have the same ability’ as an adult. When in actual fact they are not immature at all, or born lacking, they are perfect for their age and stage of the life cycle. It is us adults that need to learn how to nurture alongside their innate gifts of nature from birth without the thought process that they are lacking. Small rant over, moving on…
Research on the early developing digestive system also shows us that “Corticosterone (a hormone secreted by the adrenal cortex) and thyroxin (the main hormone produced by the thyroid gland, acting to increase metabolic rate and so regulating growth and development) appear to have important and synergistic roles in modifying the secretion of pancreatic enzymes, especially around the time of weaning when serum concentrations of the hormones and the numbers of pancreatic receptor sites are at their highest.”1
Furthermore, some research on rats points to pancreatic enzymes changing in pattern and the extent of secretion when weaning occurs. For example, an increased carbohydrate diet resulted in increased amylase activity which aids the breakdown of carbohydrates. The same was found with fat and a number of other nutrients. However, research also concludes that, “Although dietary factors may modify the pancreatic exocrine response at weaning, they do not appear to be the primary signal for the postnatal increase in pancreatic enzymes.1
A persistent increase in amylase activity was noted in rats undergoing prolonged nursing even though they were obviously not ingesting dietary starch.3 It is more likely that dietary factors modulate an inherent genetic programme of postnatal pancreatic development.”4
So with these facts alone known about enzyme development in the pancreas, we begin to see that the introduction of solids and the continuum of these is a fine intricately woven precision of nature’s gifted biology from six months of age. This research places a definitive reason on why an infant simply is not ready to digest chunky food, finger food, or eat the same meals as adults when starting solids as Baby Led Weaning suggests. Thus pureed sloppy food is more conducive to healthy digestive function in the early months of weaning.
In addition, these facts about the pancreas also shows us that newborns are not biologically ready for solid food until 6 months of age, just as the World Health Organisation's guidelines recommend. The subject of how early to introduce solids deserves a separate blog though - one that is on my list to write. For now though, let’s continue looking at more developmental facts that define which of these methods, if either, are best for your baby.
Cognitive developmental facts
So one of the reasons given for BLW is that baby chooses what to eat, chooses when they are full, and the offering of choice is seen as a beneficial practice. However, do they really choose? Can they choose? I find this reasoning somewhat questionable when we shine a spotlight on a six month old child’s physical and neurological development.
We all know that around six months newborns LOVE to place things in their mouth. They increase their chewing skills (thus stimulating more saliva to breakdown solid food) while exploring the world via their innate hand-to-mouth reflex. When we combine this inbuilt urge of placing things into their mouth, the natural reflex of swallowing that comes with this, and the known science that it can take 15-20 minutes after food is first eaten for the ‘full’ range of satiety signals to reach the brain5, then the question is again, can they really choose when they are full, or are they actually being driven by their innate hand-to-mouth reflex, therefore, running the risk of overloading their system?
At six months a newborns stomach can hold around 120mls, and science tells us that for babies and infants the pace in which food is passed through the system is directly driven by the amount given. Therefore, if an infant cannot recognise they are full until 15-20 minutes after eating, and their hand-to-mouth exploration has them eating more food than their stomach can hold, the duodenum, intestines and bowel would probably have to cope with abnormal processes causing discomfort, unsettled behaviours and sleep, constipation, bloating, stomach and intestinal pain etc – often labelled as the witching hour.
So this innate reflex, along with the infants suck/chew reflex that is set in motion whenever anything touches the vicinity of their mouth, naturally lends itself toward parents actually having to choose how much is enough for our children based on what we know about biological capacities and capabilities, along with what is nutritionally beneficial for them. Infants simply do not have the full ability required to distinguish when they are full at 6 months of age. Nor do they have the complete ability to choose. A study published in 2017 on an “Infants Understanding of Preferences When Agents Make Inconsistent Choices”6 eludes that an infant’s brain may be developed enough to have them choosing at around eight to nine months if/when the environmental stimulation is consistent.
This understand of neurological and physical development therefore shows us that with any kind of weaning the adult needs to make the decisions on quantity and nutrients based ideally on what we know about digestive development, thus the suggestion with the Baby Led Weaning method that the ‘infant chooses what to eat and how much,” isn’t actually appropriately based on an infant’s cognitive development.
Same could be said on the other spectrum of a baby not having enough food, or correct nutrients if they are left to ‘choose’ how much they have and are not spoon feed what they require for their age and stage. Currently no large well-designed study has investigated the risk of failure to thrive in infants following BLW, although one small study suggests that it may be an issue for some infants.7 It is uncertain whether an infant’s physical stamina could impact on their self-feeding ability, or energy intake. At greatest risk of failure to thrive would be infants whose self-feeding skills are less than optimal and who are left to their own devices, receiving no assistance from their parents, which is in encouraged in BLW.8
The lack of dietary intake or growth information means it is not known whether BLW infants are meeting their energy requirements. It is feasible that lack of awareness of suitable BLW foods means some infants may receive insufficient energy for their needs.8 It is also important to be aware of how much sugar and salt is being fed, given that BLW advises feeding the same food as the family is eating.
Oral developmental facts
As we know, our teeth are the first part of the digestive processes for solid food. “Food is first bitten by the incisor teeth at the front of the mouth. Then the canine teeth (next to the front teeth) shred the food into smaller parts as it is passed back to the bicuspids, which continue tearing it into smaller portions. Finally, the molar teeth (in the back of the mouth) finish the grinding and crushing of the food.”9
Your child’s first molars (chewing teeth) will usually come through between 12-18 months of age – perhaps nature is trying to tell us something here? One paper I found contradicted the ‘whole food’ suggestions of BLW stating that, “most infants at six months do not possess the oral function to break up soft food in their mouth and move it around in order to swallow it.”8 We also know that chewing stimulates a nervous impulse that causes the secretion of gastric juices, thus preparing the digestive system for the food that is being swallowed. One must again then question whether Baby Led Weaning is aligned with the oral development of the infant.
When we look at the method of traditional weaning we know that this form of introduction has worked well for generations, and most parents and health professionals still work with this method. No research shows any ill effects of traditional weaning, and no questions of concern are outstanding with this approach especially if the pureed foods are homemade and nutritional.
When we look at the research around BLW we actually find that there is no substantial, long term research too back up this form of solid introduction, and there are quite a lot of well researched, biological reasons why this method of weaning is not appropriate for our infants from 6 months. However, there does obviously come a time when some of the methods of Baby Led Weaning may take place. While there is very little research to back up BLW I know from my own experience that the lack of official research doesn’t necessarily mean something doesn’t work, so when I started this article I did so with an open mind. However the fact remains that positive outcomes occur time and time again in my practice when I return six to nine month old babies to a very basic, pureed but may be textured diet (depending on age). Marry this with the information I have discovered about BLW and I find myself reiterating again, ‘let’s place our feet into theirs a little more.’ What’s the rush? It’s not like they are never going to eat chunky foods if you don’t give them at six months, so why not introduce solids in a way that gently teaches their digestive system how to process solid food? And why not introduce them to a spoon and the exploration of using their hands – where is the harm in doing both?
So, with these two methods in mind, and the information that we do currently know about an infant’s physical development, I have created a new method of weaning called Bio-logical Weaning (Life-logical Weaning). This method teaches parents what, when and how much to introduce from six months to one year of age based on an infant’s capabilities, capacities and nutrient requirements –continuing on with my overall philosophy of Bio-logical Care.
Bio-logical Weaning is also all about “Plain + Slow = Gain + Grow”. We don’t need to be in a hurry for our children to like a variety of food. In fact I believe the more time we give them, the less aversion they have to food for they don’t begin to associate food with discomfort. Remember, it takes two-and-a-half years for a child’s digestive system to work like an adults and it’s time for us to respectfully nurture within their innate development.
If you would like to read more about Bio-logical Weaning and receive a guide that outlines what foods to introduce and why, how much is appropriate, when to introduce certain foods, and the effects this may have, along with how to nurture your infants through possible natural effects, then please enter your details here to pre-order your digital copy of my Bio-logical Weaning Guide Booklet at the cost of NZ$25.95. Available on the 10th of November 2019.
- Archives of Disease in Childhood 1993; 68: 62-65 REGULAR REVIEW Ontogeny of human pancreatic exocrine function P McClean, L T Weaver
- Peter R. Durie, M.D., FRCPC Professor, Department of Pediatrics University of Toronto Division of Gastroenterology/Nutrition Head, CF Research Group, The Research Institute The Hospital for Sick Children
- Lee PC, Kim OK, Lebenthal E. Effect of early weaning and prolonged nursing on development of the rat pancreas. PediatrRes 1982;16:470-3
- Weaver LT, Landymore-Lim L, Lucas A. Neonatal gastrointestinal growth and function: are they regulated by composition of feeds? Biol Neonate 1991 ;59:336-45.
- British Nutrition Foundation
- “Infants’ Understanding of Preferences When Agents Make Inconsistent Choices” by Yuyan Luo, Laura Hennefield, Yi Mou, Kristy vanMarle, and Lori Markson in Infancy. Published online May 26 2017 doi:10.1111/infa.12194
- Townsend E., Pitchford N. Baby knows best? The impact of weaning style on food preferences and body mass index in early childhood in a case-controlled sample. BMJ Open. 2012;2:e000298. doi: 10.1136/bmjopen-2011-000298. [PubMed] [Cross Ref]
- Cameron S., Heath M., Taylor R. How feasible is Baby-Led Weaning as an Approach to Infant Feeding? A review of the Evidence
- Clearly Healthy Me
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