Tools for Practice Outils pour la pratique


#265 “Does baby know best?”: Benefits and harms of baby-led weaning for transitioning to solid foods


CLINICAL QUESTION
QUESTION CLINIQUE
What impact does baby-led weaning have on infant growth, iron intake, and choking?


BOTTOM LINE
RÉSULTAT FINAL
 Transitioning infants to solid foods using a baby-led weaning approach (with parental education) results in up to 0.7kg less weight gain at 12 months than traditional spoon feeding. This is of unknown clinical significance. There is no difference in iron intake or choking episodes.



CFPCLearn Logo

Reading Tools for Practice Article can earn you MainPro+ Credits

La lecture d'articles d'outils de pratique peut vous permettre de gagner des crédits MainPro+

Join Now S’inscrire maintenant

Already a CFPCLearn Member? Log in

Déjà abonné à CMFCApprendre? Ouvrir une session



EVIDENCE
DONNÉES PROBANTES
Systematic review of 10 observational studies and 1 randomized controlled trial (RCT).1 Observational data too heterogeneous to combine. 
  • Focusing on RCT: 206 children, baby-led weaning versus traditional spoon feeding, starting at 6 months of age (multiple publications with multiple outcomes):2-8 
    • No significant difference BMI at 12 or 24 months.3 
    • No significant difference in: 
      • Dietary iron intake, hemoglobin, or ferritin.4 
      • Choking events.5 
    • Limitations: Open-label study, intervention group had 8 additional educational contacts, written materials, cook-books, and complementary packets of iron-fortified cereal.2 
RCT not included in above systematic review, 280 children, 5-6 months of age.9 After 12 months: 
  • World Health Organization child growth standards: 
    • Baby-led weaning: 98% normal weight, 2% "underweight" (2 standard deviations below the mean). 
    • Spoon Feeding: 87% normal weight, 13% "overweight" (more than 1 standard deviation above the mean). 
  • Spoon-fed babies gained 0.7kg more weight than baby-led. 
    • Clinical significance unknown. 
  • No significant difference in: 
    • Dietary iron intake, hemoglobin or ferritin levels. 
    • Choking episodes. 
  • Limitations: Open-label study; baby-led weaning group had 4 additional group training meetings and 6 home visits. 
Context: 
  • Baby-Led Weaning is an alternative approach to transitioning to solid foods which promotes infant self-feeding. 
  • Key features include infant participation in family mealtimes and offering baby-fist sized strips of food, so babies feed themselves when they begin solid food, at around 6 months of age.9 
  • Theories supporting baby-led weaning suggest improvement in family dynamics, decreased parental stress and improved relationships with food though no high-quality evidence supports this.1 
  • Family physicians may be asked to provide guidance on baby-led weaning, including knowing when to start solids, foods with higher choking risks (examples: nuts, grapes, raw vegetables, raw apples, and anything cut into “coin” shape) and to continue breast or formula-feeding during this transition.5 


Gilbert Bretecher June 5, 2023

baby led weaning to solid food okay.


Latest Tools for Practice
Derniers outils pour la pratique

#363 Making a difference in indifference? Medications for apathy in dementia

In patients with dementia, how safe and effective are stimulants, antidepressants, and antipsychotics for treating apathy?
Read Lire 0.25 credits available Crédits disponibles

#362 Facing the Evidence in Acne, Part I: Oral contraceptives and spironolactone in females

How effective are combined oral contraceptives (COC) and spironolactone for treating acne of at least mild-moderate severity in females?
Read Lire 0.25 credits available Crédits disponibles

#361 Preventing RSV Infections in Infants

How safe and effective are monoclonal antibodies to prevent respiratory syncytial virus (RSV) infections in infants?
Read Lire 0.25 credits available Crédits disponibles

This content is certified for MainPro+ Credits, log in to access

Ce contenu est certifié pour les crédits MainPro+, Ouvrir une session


Author(s)
Auteur(s)
  • Jessica Kirkwood MD CCFP (AM)
  • Stephanie Liu MD CCFP MSc
  • Erin Manchuk BScPharm BCGP
  • Tina Korownyk MD CCFP

1. D'Auria E, Bergamini M, Staiano A, et al. Ital J Pediatr. 2018; 44(1):49.

2. Daniels L, Heath AL, Williams SM et al. BMC Pediatr. 2015; 15:179.

3. Taylor RW, Williams SM, Fangupo LJ, et al. JAMA Pediatr. 2017; 171(9):838-846.

4. Daniels L, Taylor RW, Williams SM, et al. BMJ Open. 2018; 8(6):e019036.

5. Fangupo LJ, Heath AM, Williams SM, et al. Pediatrics. 2016; 138(4). pii:e20160772. Epub 2016 Sep 19.

6. Daniels L, Taylor RW, Williams SM, et al. J Acad Nutr Diet. 2018; 118(6):1006-1016.e1001.

7. Williams Erickson L, Taylor RW, Haszard JJ, et al. Nutrients. 2018; 10(6). pii:E740.

8. Morison BJ, Heath AM, Haszard JJ, et al. Nutrients. 2018; 10(8). pii:E1092.

9. Dogan E, Yilmaz G, Caylan N, et al. Pediatr Int. 2018; 60(12):1073-1080.

Authors do not have any conflicts of interest to declare.

Les auteurs n’ont aucun conflit d’intérêts à déclarer.