Parent-led or baby-led? Associations between complementary feeding practices and health-related behaviours in a survey of New Zealand families

Abstract

ObjectiveTo determine feeding practices and selected health-related behaviours in New Zealand families following a ‘baby-led’ or more traditional ‘parent-led’ method for introducing complementary foods.Design, setting and participants199 mothers completed an online survey about introducing complementary foods to their infant. Participants were classified into one of four groups: ‘adherent baby-led weaning (BLW)’, the infant mostly or entirely fed themselves at 6–7 months; ‘self-identified BLW’, mothers reported following BLW at 6–7 months but were using spoon-feeding at least half the time; ‘parent-led feeding’, the mother reported not having tried BLW; and ‘unclassified method’, the mother reported they were not following BLW at 6–7 months but reported the infant mostly or entirely fed themselves at 6–7 months.Results8% were following ‘adherent BLW’, 21% ‘self-identified BLW’ and 0% were following the ‘unclassified method’. Compared with ‘self-identified BLW’ and ‘parent-led feeding’, a higher proportion of the ‘adherent BLW’ met the WHO recommendations to exclusively breastfeed for 6 months and to introduce complementary foods at 6 months. The ‘adherent BLW’ group was more likely to have family foods (p=0.018), and less likely (p=0.002) to have commercially prepared baby food. Both BLW groups were more likely to share meals with the family compared with ‘parent-led feeding’. In contrast to ‘self-identified BLW’ and ‘parent-led feeding’, the ‘adherent BLW’ group did not offer iron-fortified cereal as a first food.ConclusionsThis study suggests that although many parents consider they follow BLW, a very few are following it strictly. The extent to which BLW was followed was associated with potential benefits (eg, sharing family meals) and risks (eg, low iron first foods) highlighting the importance for health professionals and researchers of accurately determining the extent of adherence to BLW.

No difference in self‐reported frequency of choking between infants introduced to solid foods using a baby‐led weaning or traditional spoon‐feeding approach

“…The findings support previous smaller studies (5,(8)(9)(10) suggesting BLW may not increase choking risk. The findings support previous smaller studies (5,(8)(9)(10) suggesting BLW may not increase choking risk.…”

“…In two studies in New Zealand, although approximately onethird of babies in both studies (8,9) experienced at least one choking episode, there was no difference in occurrence between infants following a baby-led or standard weaning approach (9) . In two studies in New Zealand, although approximately onethird of babies in both studies (8,9) experienced at least one choking episode, there was no difference in occurrence between infants following a baby-led or standard weaning approach (9) .…”

Baby‐led complementary feeding: Randomized controlled study

“…A randomized, controlled selection method is important because parents who follow BLW have been shown to differ from parents following the traditional methods of complementary feeding in demographic, psychological and parenting characteristics known to also be associated with bodyweight . Two cross‐sectional studies have investigated rates of obesity in infants following BLW .…”

Baby-Led Weaning: The Evidence to Date

“…Data has to rely on self-identification of choking (as against gagging) and self-report. One study examining rates in New Zealand found no difference in choking incidences between groups [16], which was supported in the larger-scale BLISS trial work [25]. However, the BLISS data noted that choking occurred at least once in all weaning groups at a rate of 35% of infants.…”