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By Lesley Duval
DEFINITION: Baby-led weaning (BLW) means that, instead of spoon-feeding purees to your baby, you instead present them with "real" foods, and allow them to feed themselves with their own little hands. It has nothing to do with weaning (from breastmilk or formula) except insofar as the fact that you are allowing your baby to control how much solid food they consume and thus, ostensibly, how and when they wean themselves (though from my own experience, nursing past 12 months has very little to do with consuming calories and everything to do with emotional attachment - but that's another email for another day!) There are a zillion purported benefits to introducing solids this way, which I won't bore you with here since you've already decided to take this path - but suffice it to say that this is a great way of getting your child off on a great foot with his/her relationship with food. By allowing your baby to guide the process, you are automatically eliminating the power struggles that so often plague families in their fights around food. BLW'ed babies tend to become great, exploratory, robust eaters, often with a much greater tolerance for (and interest in) sitting at the table for longer stretches of time.
IS IT SAFE? Unequivocally, yes. This is how babies have learned to eat since the dawn of time. It was only earlier in the 20th century (I forget when - I want to say depression era), when doctors started recommending that babies should be given solids earlier than 6 months. (The recommendations went as young as 2 months). At such a young age, babies lack both the motor coordination as well as the maturity of digestive system to pick up, eat, and process actual solid foods - so doctors advised parents to give their babies diluted cereals in milk and super liquidy purees, which of course had to be either spoon-fed or bottle-fed. So, the massive industry of baby purees and baby cereals was born, and the dogma of "this is how babies must eat" stuck, even though the APA and WHO subsequently revised their position to recommend that babies receive only milk/formula until 6 months of age. By 6 months, babies' motor coordination and mouth/swallowing muscles are much more developed, and they are absolutely capable of feeding themselves "real" foods with their own two hands (just like they did before Gerber).
WHAT ABOUT CHOKING? Introducing solids in this way is actually much safer, since it teaches babies to properly chew and maneuver food to the back of the throat safely. Up until now, your baby has only ingested anything by virtue of the sucking reflex, which moves things very rapidly from the front of the mouth to the back, skipping over the gag reflex area. This can cause issues when baby starts sucking down lumpy purees: the lump can get sucked to the back of the throat very quickly, skipping over the gag reflex on the baby's palate, and cause choking. (Apparently the gag reflex starts out very far forward on the palate, and doesn't move back until much later, like one year old.) So the theory goes that giving your baby real solids in this way requires them to properly use the muscles of the mouth, and thus actually prevents choking.
GAGGING IS NOT CHOKING. Gagging is actually the best means of preventing choking. Your baby will gag on foods, quite a lot in the beginning. Not only is this completely normal and fine, but it actually teaches him/her how to eat properly. The easiest way of differentiating between the two is sound: gagging makes noise; choking is totally silent (as the airway is blocked). Being a paranoid first-time parent, I took the infant CPR/first aid class before starting solids (which in hindsight I don't feel was necessary or especially helpful). I do think it would be wise for all parents to know how to do the baby Heimlich (google video search it if you're unfamiliar - but basically you want to hold your baby at an upside down angle across your lap, and then you use your thigh as the compressor on his/her chest and hit your hand on their back to smack it up). The most important takeaway is that you should NEVER slap your baby on the back while they're sitting upright - whether they are gagging or choking, this could potentially move the blocking object further down their throat. If your baby is gagging, the best thing for you to do is make a coughing sound yourself, so that they will mirror you and cough up the food. Again, this sounds scary and it will be scary the first couple of times, but this IS ultimately a safer way of teaching your baby how to not choke on food in the long run.
In terms of choking hazard foods, keep in mind that it needs to be something pretty solid, that can't really be mushed, and that's large enough to fully block the airway. To gauge size, think of things that would get stuck inside a roll of toilet paper - so pretty large and spherical, like a large whole grape or a hot dog. Meat is something a lot of parents worry about - I'll talk more about how you can introduce meat safely below. But anyhow the point is: a blueberry is not a choking hazard. I've seen so many parents painstakingly cutting tiny blueberries in half, and I wonder if they have any idea how large their baby's airway actually is...!
BUT WILL MY BABY EAT ENOUGH THIS WAY? Unequivocally, yes. This is where the term "baby-led weaning" actually comes from, as you are allowing your baby's own instincts and abilities to guide his/her transition to solid foods. Early in the process, your baby will continue to get all the calories and nutrients he/she needs from milk or formula (until around 8-10 months). Food up until this point is really just for tasting and exploring, and developing new motor skills. Breastmilk or formula is far and away the most nutrient-dense substance you can possibly feed your baby, and iron doesn't begin to become an issue until around 10 months (when the stores your baby was born with actually start to deplete). Though I will here note that some babies love solids from the get-go and eat a LOT of them. Also no cause for alarm here. So long as your baby is healthy and thriving, he/she is perfectly capable of dictating the balance between solids and milk. By around 12 months (on average), most babies will start consuming significant calories from foods, at which point he/she will gradually start to demand less and less milk/formula, and the weaning process will (ostensibly) happen naturally and according to the baby's own pace. (I still disagree with the the idea that a BLW'ed baby will just spontaneously initiate total weaning, but like I said, 'nother convo for another day!) But again, the overall thing to take away here is that your baby is much more in tune with his/her own needs than we are at this point - so if you let your baby be the guide and relax about how much he/she is actually "eating", you'll be fine!
WHAT FOODS ARE OK? Everything! There's no rule that says that baby's first foods need to be avocados, bananas, and butternut squash. Literally, everything is on the table - and the more variety, the better. If you missed the recent study on nut allergies (and all allergies for that matter), apparently early introduction to all foods, including nuts, is now being recommended in an attempt to avoid allergies - going totally contrary to recommendations that have been pushed for decades. But again, I'm not a doctor - so will leave it up to you how/when you want to introduce possible allergens. (We gave our daughter everything, including nuts, milk, honey, and probably some shellfish by accident, long before her first birthday.) Anyway you generally want to avoid giving your baby too much salt or sugar early on - but generally speaking, whatever you're eating, your baby can eat, too. A big upside is the social education this provides. Instead of meal time for baby consisting of one parent struggling to get a spoon of puree into baby's mouth while the other parent prepares the grown-up food - the whole family sits down to eat together, as a family, and everyone feeds themselves independently. Baby learns by watching mommy and daddy eat - not just in terms of learning how to eat things ("oh that's what that shiny spoon thing is for!") but also in terms of learning that food is delicious, and exciting, and fun!
OK I BELIEVE YOU, BUT WHAT DOES AN ALLERGIC REACTION LOOK LIKE? There are mild allergic reactions, and there are major ones. You only need to worry about the major ones, wherein your baby's throat swells and he/she has difficulty breathing. It's always a good idea to have some Infant Benadryl on hand in case this happens (followed by a trip to the ER). Mild allergic reactions, however, don't require anything except a mental note. Most babies have mild allergic reactions to a number of foods when they're first introduced. Some of the most common ones are strawberries, tomatoes, and nightshades (eggplants, etc). Your baby will develop red splotches on his/her face, neck, and chest, but they should dissipate within an hour or two. If you know what triggered it, keep a mental note and just watch for the reaction the next time they eat the food. There is no need to avoid foods that triggered these light reactions, though - in fact, many people believe that the more often they're introduced, the less likely the baby is to develop an allergy later in life (see above). If you feed your baby like I fed mine, you will likely have no idea what triggered the reaction - so again, there's no cause for concern unless you see your baby experiencing difficulty breathing. And then the action steps are: Benadryl immediately, and get to the ER.
WHAT FOODS SHOULD I START WITH? The first and easiest things for baby to navigate are "sticks" of food - think of things that he/she can easily pick up in his/her fist, with enough protruding from either end so that he/she can still take bites. Steamed/roasted/lightly sauteed vegetables are an easy place to start: broccoli (the floret is super fun for them to suck on), carrots, sweet potatoes, parsnips, asparagus. braised fennel, beets, turnips, etc. You can also give them slices of mushier things with the skin left on (obviously well-scrubbed): avocado, papaya, mangoes, bananas, orange slices, etc. It's also fun to do "sticks and dips" with either a firm veggie or a crusty pieces of bread: white bean puree, babaghanoush, hummus, etc. Cooked fish is terrific - it's generally solid enough for them to grasp, but breaks apart easily in their mouths. For other meats, it depends on whether or not your baby has teeth. Pre-teeth, they'll just be sucking the juices out of the meat, so it's best to cut meat into long strips, cutting WITH the grain so that it won't break apart in their mouths. Strips of steak, duck breast, pork, etc. All the iron is in the blood anyway, so just think of it as an iron lollipop! Once they have some front teeth and can tear things, you can move on to giving them the actual bones (chicken legs, spare ribs, lamb chops, etc) with most of the big hunks of meat already removed but enough left on that they can practice really tearing off bites. And once baby masters the "pincer grip" (forefinger and thumb) you can give them small cut up bites of meat as well.
WHAT ABOUT YOGURT AND OATMEAL AND SUCH? You'll be shocked at how early on they can navigate a spoon! Get them one of those silicone baby spoons, dip it into some yogurt, and hand it to your baby. Chances are, he/she will figure it out pretty quickly!
HOW MANY FOODS SHOULD I OFFER AT A TIME? It's best to offer a variety of healthy choices at every meal. Don't get hung up on what foods "should" be offered at a given mealtime - there's no reason you can't offer meat and vegetables at breakfast. Give some choices, but not an unlimited number of them. Try to include different types of things from different food groups at all meals. Babies will often go on "binges" wherein they'll only eat protein for 3 days, and then only eat carbs for 3 days, and then only eat fruits for 3 days. This is totally normal. Just go with it. The best rule of thumb I've heard is to view your baby's diet from a 2 or even 3 week perspective. If they're getting enough variety within that time, it's fine - no need for the variety to be happening on a daily basis. Also remember that your baby actually knows what he/she needs - so just as long as salt and sugar aren't clouding judgement, you can truly let your baby be your guide. Our own daughter is a protein fiend - can't explain it but clearly it's something she needs way more of than the average baby. One other thing to play around with: some babies can get visually overloaded when there are too many things on their plate. So it may be best for you to just put a couple things in front of your baby at a time.
WHAT IF MY BABY TOTALLY REJECTS SOMETHING? This will of course happen, an infinite number of times. Just keep reintroducing the food every now and again. And be sure it's something your baby sees you eating, too. Most babies don't really begin to develop taste preferences until around 12 months, so the beginning is often your best chance of getting them acclimated to as wide a range of tastes and flavors and textures as possible.
ANY SPECIAL GEAR? I highly recommend getting a high chair that pulls up to the table, so that your baby can be a proper part of the meal. Clip-on high chairs are a great option, or any high chair that does not have a tray (or has a removable tray). I also recommend giving your baby a plate as early as possible (something made of hard plastic, that's not breakable) to teach him/her that plates are for eating off of, and not for hurling discus style across the room. Lastly, I suggest giving your baby a fork and spoon at every meal, even if they don't get used. It's all about giving them the chance to imitate your actions.
FINALLY, EAT TOGETHER AS MUCH AS YOU CAN. My single biggest piece of advice would be to eat with your baby as often as humanly possible. Make mealtime a family affair as often as you can - and/or ask your caregiver to eat when your baby is eating. Have your baby participate in grown-up lunches and dinners as often as you can, both in and out of the home. The rewards are so, so entirely worth the altercations to your schedule - I promise!
