A review of Baby-led Weaning By Gill Rapley & Tracey Murkett 2008 Vermilion London
The idea of baby-led weaning includes two important ideas:
1 The baby leads decisions on what food it is interested in. The author recommends providing a variety of foods to the baby at family meals so the baby chooses what it will experience, play with, and taste, proposing that with this method the baby will enjoy food, obtain adequate nutrition, and not have any eating problems;
2 Spoon-feeding of babies is more likely to produce problems such as over feeding, eating problems, and is seen as much more effort for the parents.
This is a useful book as it describes in detail one overall approach to food management. But is it baby-led? All the food provided for the family has to be changed to suit the baby’s needs – cooked to the sizes baby can hold or manage with hands, be salt and sugar free, have fibre and fat content changed. The parent chooses, provides and places within reach the variety of foods she wants the child to choose from, and the child chooses. Only at that point of choice does the baby-led concept enter. All other aspects are parent led. (As with Clara Davis’ much earlier research: see Chapter 1 of Fussy Baby).
Other environmental factors are worthy of note. The baby may be in a high chair or sit on the parent’s knee. This can be a pleasure but having all family meals oriented towards all aspects of the baby’s needs would not suit all families. Over time there might be the temptation to slip back into usual habits, which are not geared for the important task of providing food that is specially prepared for a baby’s eating development or nutrition.
My cautions about Baby-led weaning
The book notes how well the babies described manage and enjoy a variety of strong tastes such as spice. As someone who sees many babies who have adverse reactions to foods, or are very cautious, I am tempted to wonder if there is a selection process whereby parents who choose to use Baby-led Weaning are those who have adventurous babies with no food sensitivities, so all usually goes well. Parents whose babies do not manage so well or who have food sensitivities may not have problems realised until months after a muddle happens. Similarly there is little attention to the other reasons families can have babies who develop slowly on solids.
For those adventurous babies with no other food-sensitivity or developmental problems, parent-led management might well involve no more than structuring the baby’s alternatives and environment sensibly and responsibly. Development will then occur through the baby’s choices between the offered alternatives.
But for babies who start to encounter problems, parent-led management requires more attention and care. This is where ideas in the idea of eating development described in Fussy Baby can be helpful. The ideas sits between no-problem introduction of solids and extreme food refusal
Understanding and Managing Extreme Food Refusal in Toddlers http://www.infantandtoddlerforum.org
At the other end of the spectrum are the babies with extreme food refusal. We can see that these babies do choose. They choose not to eat what is offered, and by the time they are toddlers the problems have become severe. Information provided is concerned with many possible reasons for the problem. These include food phobia, rigid eating patterns – restricted choices re colour, ASD (Autism Spectrum Disorder), sensory sensitivity – touch, taste, smell, and particularly, texture.
Suggestions to help with extreme food refusal usually aim to solve problems more by progressive desensitisation than from an eating development point of view.
Using the concept of Eating Development described in Chapter 2 of Fussy Baby parents, with the help of professionals where necessary, can watch what is happening in infancy so that muddles are seen early and are solved before problem habits are formed.
Sensory integration, oral motor and other physical developments
Some children have significant physical developmental problems such that they are unable to manage eating. They may need medical assessment and specialist help from physiotherapists, speech therapists, or occupational therapists with regard to being able to sit well and hold food, being able to manage to move food in their mouths and swallowing. These therapies have developmental components as does eating development. Both are about learning. The therapies are important as they deal with all the muscular, physical and sensory developments that are needed in order for the child to be able to eat. They provide help so that the child can manage the food. Mothers can obtain answers in what they can do for the various problems.
The concept of eating development can help eating progression for each baby
Fortunately most problems are not so severe and can be solved using eating development ideas. Where the specialist therapies are used they are better if informed by the ideas of eating development. Eating development as described in Fussy Baby looks at all aspects of the food as well as the child and how these interact. It then allows action depending on where the child is up to in the various learning paths of acceptance of taste, temperature, or other progressions.