Baby-Led Solids Pt. 3: Breastmilk, Safety & Special Situations

HOW DOES B.L.W. WORK WITH BREASTFEEDING?

SAFETY TOPICS

• Won’t the Baby Choke?
• Choosing Healthy Foods

SPECIAL SITUATIONS

• Additional Water
• Groups at Risk of Poor Infant Feeding Practices
• Premature/Slow-Developing Babies
• Vegetarian Babies

BLW RESOURCES

**Catch up on Pt. 1 (What is BLW & When To Start) and Pt. 2 (Play With Your Food!)**

How Does BLW Work with Breastfeeding?

Despite its name, Baby-Led Weaning (BLW) is just an approach to introducing solid foods, not a method of cessation from the breast (or bottle).

“Weaning” is the process of tapering off breastfeeding or formula that begins with the first taste of solids and other liquids. This process occurs in tandem with continued breastfeeding for several months or years depending on the mother and child. North Americans refer to weaning as the tail-end point of transition, whereas for those living elsewhere the term refers to the entire process of weaning from the first taste of solids to the last taste of breast milk.

Think of BLW as ‘Baby Self-Feeding’ or ‘Baby-Led Solids,’ if that helps minimize the confusion!

Breastfeeding is the natural and ideal precursor to BLW because breastfed babies are already accustomed to a variety of flavors through mother’s milk and have developed the physical ability to chew by suckling at the breast. Exclusively bottle-fed babies and formula-fed babies can benefit by practicing BLW, too.

If a baby is under twelve months of age, always offer breast milk (or formula, if you don’t breastfeed) before offering a solid food so she’s satiated. If hungry, she’ll have a rough time figuring out how to eat the food and will get more easily frustrated. It’s best to allow her to explore the food when satiated, calm, and willing to investigate all aspects of the food.

According to world health authorities, it’s best to keep breast milk (or formula) as the primary source of nutrition for one full year. At the one year appointment, discuss with the baby’s doctor about when it will be best to prioritize solids over breast milk, especially if other liquids such as water have been introduced. Make sure the doctor has been properly educated about and is supportive of BLW.

Don’t be concerned that your baby will lose interest in the breast once she’s led into the grand world of finger foods. Losing interest in breastfeeding will happen naturally  with time, and at this age she won’t consume enough solid foods to fully satisfy her appetite for nutrition. Plus she still has a vital need for mother intimacy that cannot possibly come from a tomato slice slathered in hummus.

Safety Topics

WON’T THE BABY CHOKE?

Well, it’s thought that babies who are given complementary foods via the BLW method are actually less likely to choke than their puree-fed peers. The reasoning is that they aren’t able to move food from the front to the back of their mouths until they’re able to chew, and we know they’re ready to chew because BLW babies are given the opportunity to get comfortable with solids at their own pace.

When a child is truly choking, he will make no noise as no air can pass through an obstructed airway. Gagging, spitting, coughing, and sputtering don’t indicate true choking but instead serve as auditory clues that the child is figuring out where the food should and shouldn’t go.

Liquids (purees) move more quickly than solids when swallowed, further increasing risk of choking. If some solid food does move too far back, the whole bolus is expelled with the gag reflex, whereas liquids/purees may not be entirely expelled.

So let’s also consider the anatomy of an infant’s mouth (Maternal and Infant Nutrition and Nurture: Controversies and Challenges, p. 275-298). The gag reflex in a baby under the age of one is located near the middle of the tongue, as opposed to an adult in whom the gag reflex is present at the back of the tongue. This is a biological protection agent for infants: when too large of a piece of food hits the center of the tongue, the gag reflex is triggered well in advance of any true potential for choking.

This gag reflex progresses to the back of the tongue by one year of age, by the time that babies are well-aware of the boundaries of their mouths. So, theoretically this suggests that a baby who has not adjusted to eating solid foods on his own and was primarily spoon-fed purees is at greater risk of choking and aspiration after the age of one.

I know, it’s scary to hear little bub gag a bit on a few blueberries or slice of cucumber. But this is a normal way that a child learns to move food around his mouth (you may have a baby who never gags too, and that’s also normal).

Safety Measures:

• Infant should NEVER be left unsupervised with food!
• Infant should always be seated upright, preferably in a secure chair or held in a parent’s lap.
• Infant should have good head control and body stability before self-feeding should be attempted (most babies have full head control by 3-4 months so this criteria should have been fulfilled by the start of BLW).
• Some foods are considered obvious choking hazards and aren’t appropriate to offer a child who is still figuring out how to eat. These include but aren’t limited to: whole nuts, full-sized grapes and cherry tomatoes, coin-shaped hotdog slices, raw carrots, sticky foods like dates, cherries/olives with pits, etc.
• Always remove pits, stems, and any inedible skins from fruits and vegetables before offering them.
• Avoid any foods that may trigger allergic reaction in susceptible families (eggs, cow’s milk, soy, peanuts/peanut butter, gluten/wheat, shellfish, some berries, etc).

Infant CPR Links:

• Conscious Choking poster – American Red Cross
• Infant CPR Be Prepared guidelines – American Red Cross
• Pediatric First Aid/CPR/AED – American Red Cross
• “Prevention of Choking Among Children” – AAP policy statement
• Take an Infant CPR class! Find a class here or call (800) 733-2767 (800-RED-CROSS)

CHOOSING HEALTHY FOODS

Parents should always make healthy, whole foods available for baby to choose from and put the processed crap out of sight, out of mind.

“Leave the selection of the foods to be made available to young children in the hands of their elders, where everyone has always known it belongs,” said late pediatrician and researcher Clara M. Davis.

So in other words, you better know what you’re doing! (No pressure, right?).

Good First Foods

Try these! — Banana chunks, soft pear, steamed or baked apple, avocado slices, peach/nectarine slices, ripe mango or juicy melon slices, carrots that are steamed well enough to smush easily between fingers, steamed/baked sweet potato or butternut squash, steamed/trimmed green beans, peas, roasted bell peppers, tender broccoli with the stem left on as a ‘handle,’ cooked asparagus spears, cooked black beans or chickpeas, organic brown rice, etc.

Also, aromatic spices are okay, but salt is not.

Feel free to add yogurt, hummus, cream cheese or other healthy ‘spoonable’ foods to fruits and vegetables. As baby begins to manage spoons well, he can scoop them up himself.

Some parents like to offer ‘pre-loaded’ spoons, however it should be noted that nothing is ever put in or near the baby’s mouth for him — it’s always up to him to take what he wants.

Check out these tasty Baby-Led Weaning Recipes and Infant Finger Food Recipe ideas, and the Baby-Led Weaning recipe archive.

Foods to Avoid

Just say no to these, and these too!

Restrict or seriously limit salt, added sugars, preservatives, refined flours, caffeine… Yep, this means you may want to think twice before letting baby get a mouthful of a sugary First Birthday smash cake (how about you make a special breast milk ice cream, yogurt, or smoothie treat instead?).

Fruit juice is a no-no, too. Same goes for obviously hazardous first foods (see Safety Measures above). Skip the cookies, sugary breakfast cereals (check the nutrition label!), chocolate anything, fast food, fried food, candy of any kind (including lollipops), etc.

Honey is never safe for a baby under the age of one due to risk of botulism.

Safe Food Prep

Use sanitary, hygienic food preparation practices. Be extra careful when slicing and dicing to avoid cross-contamination. Wash your hands, rinse the produce, keep bowls and plates clean, use fresh foods and restrict or limit packaged/microwavable items.

You should also look into which foods can be offered raw and which should be cooked, both for safety and health reasons. Check out this BLW food prep guide, Fruits and Vegetables for Baby – Do They HAVE to be Cooked?

Links:

• Infant Food Preparation guidelines – Foodsafety.gov
• Safe Food Handling Fact Sheets – U.S. Dept. of Agriculture

Special Situations

Additional Water

Breast milk is 88%-90% water. If baby seems thirstier due to hot weather, illness, or another reason, you can simply nurse more often, if possible. Don’t default to water as it’s void of calories and nutrition.

Many parents assume that babies need additional liquids once they start solids (at some point after six months), but this is not true. Giving water or other drinks with or between the child’s solid meals is a matter of family choice, but as long as the child is breastfeeding at least three times per day, there’s no actual need to give extra liquids.

Note: It may be advised that formula-fed babies, however, are on a case-by-case basis given additional water.

Always make sure that any water is given to a child is safe to drink. You can boil and cool the water to kill any potential contaminants.

Groups at Risk of Poor Infant Feeding Practices

Babies fed formula (exclusively or supplementary) are more than twice as likely to be fed solids too soon. Mothers who are younger, unmarried, or less educated are also more likely to introduce solids before their babies are ready. Mothers who have infants diagnosed with reflux may be advised to add rice cereal to baby bottles to help keep sustenance down (though this is medically unsupported and harmful, according to many experts).

How can these groups become educated in proper, healthy introduction of solids to babies? Community doulas have been found to be helpful among the population of young African American mothers in regard to complementary solid feeding with breastfeeding. WIC provides free materials (handouts, CDs, DVDs) in its program for African American fathers to learn how to support breastfeeding partners.

WIC Breastfeeding Peer Counselors can assist mothers in making good feeding decisions for their babies (contact a State Breastfeeding Coordinator here). WIC also offers free Infant Feeding Classes in some regions (contact your state agency here to find out what they offer).

Premature/Slow-Developing Babies

The small number of babies who develop more slowly than normal babies may need to follow a special feeding routine when starting solids, which may or may not include BLW. It’s best to get opinions from a few trusted medical caregivers who are intimate with the status of your preemie’s development.

The authors of Baby-Led Weaning write:

“Some babies have medical or developmental problems that prevent them from picking up food or chewing it. Others, who were born prematurely, may need solid foods before they are physically able to feed themselves. If this is the case for your baby, she may need to be spoon-fed, at least at first. But, as long as it’s safe, it is still a good idea to encourage her to handle food, to help her develop some of the skills that she finds difficult.”

Vegetarian Babies

“Vegetables and kids … the two are hardly ever seen together. But raising a child as a vegetarian is not as unnatural as it may sound. Actually, kids are almost natural vegetarians. Many have a hard time chewing tough things, which often eliminates meat, and they love animals. Once they make the connection between the hamburger and the cow, many pass on the meat.” – Sue Gilbert, MS nutritionist

Good news! Vegan and vegetarian babies can thrive after starting animal-friendly, cruelty-free solid food diets, too. As we like to say in our own house: “Animals are for loving, not for eating.” ❤

“Populations the world over have been raising healthy vegetarian children for hundreds of years. Yet in Western cultures, the idea of vegetarianism for children is often received negatively or at least with some doubt. Even longtime vegetarians and vegans who know quite a bit about maintaining a good nutritional balance for themselves, begin to doubt their ability to raise healthy vegetarian or vegan children. Why is this?

Lack of support, knowledge, and experience are the major factors. If you have never been around vegetarian children, you may wonder if it is even possible to raise healthy children this way. In general, health professionals are not well informed about vegetarian diets, fueling the fire of doubt. In the face of such adversity one would do well to remember that even the American Dietetic Association approves a vegetarian diet for all ages.” – Melanie Wilson

Links:

• “Do babies need meat?” – Sue Gilbert, MS nutritionist Q&A
• “Guidelines for Proper Nutrition for Vegetarian Kids” – Sue Gilbert, MS nutritionist
• “Raising a Vegetarian Child” – Melanie Wilson
• “Vegan Babies and Toddlers” – articles at Veg Family

BLW Resources

Links:

• Baby-Led Weaning web site
• “Cultural Aspects of Starting Solids” – Michelle Brode
• “Finger Foods” – Kellymom
• Solid Foods and the Breastfed Baby – Kellymom
• “The Truth About Baby Food Jars” – The Alpha Parent
• “What to Feed the Baby when the Mother is Working Outside the Home” – Jack Newman, MD