Redefining weaning – Baby-Led Weaning in an Indian context
Posted on Friday, February 08 2019 10:29:00 AM in JOURNAL by Aparna Vasudevan
When my child was around five months old, I stumbled upon a new (to me!) method of weaning on a Facebook support page. There were various videos and pictures of babies eating on their own. Were they eating purees? NO. Were they eating mashed food? NO. They were eating regular food, just the way we eat food, only that the food was being presented to them in an age appropriate fashion. I was hooked! It was compelling - I didn’t need to run behind my child with a spoon and bowl of mashed food in my hand and I didn’t need to puree food with a blender separately for my child! The general consensus on the Facebook page seemed to be that, as parents, our only job was to present healthy options, as a balanced meal, and let baby decide what and how much to eat. Intrigued, I decided to take the plunge into the world of Baby-Led Weaning with my soon to be six month old child.
What is Baby-Led Weaning?
Baby-Led Weaning, hereon referred to as BLW, is the process of weaning that follows and respects the baby cues, while introducing the child to family foods as first foods. It bypasses the more conventional route of starting weaning with purees and mashed food, while also allowing the child to control what and how much the child eats. Baby led weaning allows the child to self-feed from the age of six months when babies are ideally developmentally ready for solids.
Why should I choose BLW?
I know you must be asking yourself – “Why should I choose BLW”? Here’s why BLW is the best choice for you when it comes to weaning your child to solids:
- There is no baby food prep, you save time – No separate cooking and blending foods for the baby.
- You do not need any special equipment, you save money – No blender, no fruit meshes – you do not need to spend on a bunch of frivolous equipment that you will have no use for in a couple more months.
- It helps you to cut out processed foods from your baby’s diet – You do not need to buy purees, or instant cereals, which are loaded with sugar and preservatives.
- Builds hand-eye coordination of the child – When you let baby handle the food pieces, it helps the baby to improve his hand-eye coordination.
- BLW helps you to introduce the child to a wide variety of family foods - A child who is being BLWed with a balanced variety of food, has a head start when it comes to family foods, because they can be introduced to a wider variety of foods rather than being limited to the usual mush of cereals, grains and purees of veg and fruits that are the norm.
- BLW gives the child the control and decision making skills – The baby decides what and how much is eaten, not the parent. In the long run, the baby learns to read his own hunger cues, and self regulates his intake, leading to a more positive attitude towards food.
When to start Baby-Led Weaning?
Now that you have decided to wean your child, you will need to check your child’s readiness for solids, and also for self feeding. Check for the below.
- Baby should be at least six months old – this is the World Health Organization’s recommendation on weaning guidelines.
- Baby shows interest in your food, often reaching for or grabbing food off your hand or plate.
- Baby should be able to hold a sitting position for some moments while retaining trunk control, without slumping to the side. The baby need not have started sitting up on their own.
- Baby has lost tongue thrust, which means they stop pushing the food out with their tongue when offered with a spoon.
- Baby is willing to chew – This doesn’t mean baby needs teeth for BLW; babies can masticate food with their strong gums, even without teeth!
Weaning basics and how to get started with BLW
Now that your baby exhibits all the signs of readiness for solids, let us quickly learn a few basics of weaning and help you getting started with BLW.
- Give up control – This is THE BLW mantra! Do not focus on the quantity or the component of the meal that is being eaten. A tbsp of food is a complete meal for a one year old. Do not be tempted to feed the baby or insist on finishing the portions served.
- Have baby join at mealtimes – If your family eats at the table, it would be a good idea to invest in a high chair or booster chair, so that baby can eat with the family at the table. And if you all eat on the floor, give baby a plate and have them sit with you on the floor.
- Offer small portion sizes and minimum varieties and keep replenishing what are finished – Large portions and too many different varieties of food will overwhelm the child.
- No distractions – That means no screens, no toys and no reading too. Meals are for eating and focusing on the meal will help the baby to understand his hunger and satiety cues better while avoiding choking.
- How many meals? – At six months, we start with one meal, at any convenient time of the day, and keep adding a meal or snack for every forty days or so. At 1 year, baby needs to be having 3 meals and two snacks in a day without dropping their feeds.
- Do we continue to offer milk? – Yes, breast milk or formula continues to be an important part of your baby’s diet, since milk is the primary source of nutrition for a child who is younger than one year. Nurse 15-30 min before offering food.
- What foods do we offer the baby? – We offer a balanced diet from our family foods, while focusing on iron rich foods, paired with Vit C rich foods. Pairing iron with Vit C helps your body to absorb iron better from the food.
- Pairing Vit D with Calcium increases the bio-availability of calcium.
- Do not add salt – Your baby will receive enough sodium from breastmilk or formula, and vegetables have naturally occurring sodium too. Your baby’s kidneys are not mature enough to process excess sodium from salt.
- Do not add sugar – Your baby’s insulin resistance is still under-developed. Adding sugar also sets up the baby’s preference for sweet food, leaving the baby to not appreciate savory food.
- Flavoring – Add flavorings like garlic, ginger, pepper, cumin, hing etc. Babies love flavors and tangy foods even when the food is not salted!
- Do you add chillies? – We recognize that Indian food is high on spice, but that should not prevent you from letting your child try out a bit of spice. Ideally start spicing with very little black pepper, and gradually move to green chillies and finally to red chillies, provided the baby is able to handle the heat.
- Allergens – Introduce common allergens (shellfish, fish, nuts as powder, eggs, milk, etc) separately at six months preferably during the day time. This offers you the option of seeking medical intervention, if required, more easily. The most recent studies show that delayed introduction of specific highly allergenic foods may increase the risk of food allergies and recommends early introduction of allergens to prevent allergies in infants and children.
- Ideally, we recommend delaying introduction of fruits by a month or so to avoid setting up baby’s preference for sweet foods.
- Use lot of good fats – Ghee, butter, seed and nut oils are great sources of fat for the baby, and adequate fat helps in brain development.
- No honey until child turns one – Honey, a potential source of the spore, Clostridium botulinum may cause infant botulism.
- Never pair calcium with iron – Calcium impairs the absorption of iron by the body when offered together. This is especially important for very small babies whose iron stores start getting depleted at around six months.
- Do not offer cow’s as a drink before baby turns one – While milk can be an ingredient in your cooking, avoid offering cow’s milk as a drink before your baby turns one – cow’s milk may cause anemia, diarrhea, vomiting, intestinal bleeding and the overload of protein in cow’s milk is harmful for your baby’s kidneys. Cow’s milk is tailored to be suitable for calves and not for human babies.
- What about other sources of dairy? – Paneer and other low sodium cheeses, curd, plain yoghurt etc., are great dairy based sources of nutrition. Curd is also a natural probiotic. You should however, limit consumption of all dairy based products to below 350ml in a day to avoid anemia or loss of appetite. Choose full fat varieties for your child since fats are good for brain development.
- Water – Water may be offered to the baby to cleanse the mouth after meals, and when baby indicates thirst, but do not go overboard. Water has no nutrition and an overload of water may cause water intoxication in babies. Offer to nurse instead if baby indicates thirst.
- What about cutlery and crockery? – Babies love to imitate adults, so by all means, offer a thick handled spoon and fork to the child. You may also preload the spoon with food to offer the baby, but be prepared for the spoon to be flung to the ground. Bowls of food may also get upturned for a while – your baby is exploring and playing with his food which needs to be encouraged.
- Juices and other watery foods – Juices are not nutritious, and loaded with sugar minus the fiber of the fruit. They are terrible for the milk teeth of the baby and you should avoid juices and replace with servings of fruits instead. Watery foods are not nutritious when your baby’s intake is minimal, and hence, it is recommended to give thicker porridges instead.
Progression of foods
- Between 6 – 7 months – offer long strips of vegetables from your gravies, or just plain steamed; wedges of finger foods like idly, dosa, roti, paratha, dipped in gravies; balls of thick dal/sambar and slightly overcooked rice – adapt your family food in an appropriate manner. The baby will use their palm/fist to handle the food, which is why longish wedges are easier to handle.
- Between 7-9 months – also start offering smaller bits of food – babies develop pincer grip around this time and are developmentally ready for self feeding smaller pieces of food.
- By one year – baby should be completely on family food.
Choking vs gagging
First off, a little bit about gagging. When you start off with BLW, you will see that your baby gags. A LOT. Gagging is a protective reflex that helps the baby to keep bigger pieces of food near the front of the mouth while allowing very well-chewed pieces to be swallowed. At six months, the gag reflex is further forward in your baby’s mouth, while it moves farther back on your baby’s tongue as they age. When your baby gags, do not freak out! Gagging will teach them to manipulate the bigger pieces of food and bring them back to the front to chew or spit out. When your baby gags, NEVER try to help them by pushing your finger in their mouth, you could push it in further and cause choking.
While gagging is audible, watch out for choking because it is silent. Choking is when the air tube gets blocked by a piece of food, mostly round and hard. Choking can be avoided in the following ways.
- Let baby feed himself and avoid the urge to put pieces of food in the baby’s mouth.
- Watch your baby while he eats and avoid the urge to do your chores at meal times. Better still, eat with the baby always.
- While not mandatory, using a five point harness high chair can help prevent slumping and reclining. You could also hold the child erect in your lap.
- Watch the food sizes and avoid round items like grapes, cherries, whole nuts, peas, cherry tomatoes, chick peas and similar foods. Slice grapes, cherries, tomatoes into smaller slices, powder the nuts and use them in food, and slightly smash the peas and chickpeas so that they are not round anymore.
- Steam hard foods to make them softer – Fruits like apples when offered as raw slices are a huge choking hazard. Steam the apples to a softer consistency or grate them when offering.
- Learn CPR and First Aid so that you are prepared to deal with choking when it happens.
Dealing with the mess!
BLW babies tend to explore their food unabashedly as they eat and it does tend to get really messy. But the mess gets easier and easier to handle and clean up, trust us. Babies are constantly learning new textures and tastes and while they are allowed to explore, food gets flung on the ground and smeared on the face and hair constantly. But this is a necessary bridge to cross that makes your baby adventurous when it comes to food. Keep a washcloth handy or hose down the child in the bathroom after every mealtime. Laying a washable mat on the floor under the high chair helps too, as does having a dog lapping up the flung bits of food.
Happy baby-led weaning!
Resources for BLW:
- “My Child Won’t Eat” by Carlos Gonzalez
- Baby-Led Weaning India (self-fed babies) – Facebook group offering peer to peer support in India