Baby Led Weaning, by Rapley and Murkett (Book Review Pedcast)

Baby Led Weaning

by Rapley and Murkett

Vermilion Publishers-2008
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Who would have ever thought that feeding an infant solid foods, the way your great grandparents did, would be a cutting edge medical controversy in the 21st century–but it is. So says the authors of Baby Led Weaning, by British authors Rapley and Murkett. 20th century western society has been all about controlling the introduction of solid food to babies when it is time for them to get more that breastfeeding can offer. It is generally accepted that solid foods, also called complimentary foods, are needed by babies for good growth beyond six months of age. Standard 20th century dogma says that these first foods should be pureed and fed to the infant on a spoon, by his or her parents, introducing one new food at a time, without the addition of spices, salt, or added flavoring that would be normally added to the food. Home cooked fresh foods were the opposite of what babies were expected to eat for much of the 20th century America.

The Baby Led Weaning advocates think 20th century health experts got infant feeding all wrong and argue that letting a baby feed themselves, real food, on their terms, when they are ready, will reverse many of the feeding problems that have become so common among toddlers and children today. They argue that when a baby feeds real solid food to themselves they are more willing to explore new foods, learn to deal with different textures and tastes, regulate their intake of calories, master the social aspects of feeding earlier, and are less apt to become obese or develop an eating disorder when older.

As a pediatrician, I see a few things that are worrisome about the BLW approach. The most obvious problem I see is choking and aspiration of food. The authors discuss this at length, realizing that this issue is at the forefront of criticism of the BLW method. An infant can gag on a pureed food but choking to death, I think not, unless they have a swallowing problem. The BLW advocates give many guidelines how to avoid serious choking events but the risk is still there. And here is something in the BLW recommendations that is contrary to current medical thought–the authors recommend that parents give their babies water at all ages, something that is known to, albeit rarely, cause serious metabolic problems in infants less than six months of age. this risk is well documented in the pediatric literature. They also advocate ad lib salt intake, a situation that many pediatricians don’t agree with due to an infant’s limited ability to get rid a lot of extra salt. And finally, what about the infants that are just poor at feeding themselves? I fear that these children are at risk for nutritional deficiencies at a time when their growth is supercharged. there is evidence here as well that this can happen on occasion.

Except for these reservations, I must say that the BLW method of feeding a newborn seems natural, may lead to less texture aversion among toddlers, may result in better acceptance of a wider variety of flavors and textures in older children, and lead to fewer “picky eaters” and “eating disorders” throughout childhood. The book is well written and full of practical suggestions and encouragement for parents who are looking for an alternative to traditional feeding practices for their infants. I give this book 4 out of 5 Doc Smo stars.

Smo Notes: