More and more babies are starting solids using the baby-led weaning (BLW) method developed in the UK by Gill Rapley and Tracey Murkett.
Baby-led weaning (BLW) is popular worldwide, including in the United States. While the word “weaning” might be interpreted as the gradual removal of breast milk, in the UK, where this feeding method originated, weaning means to start solid food.
Children using baby-led weaning eat whole foods, which are provided in graspable shapes and dissolvable forms (think sticks of cooked veggies or soft bread) that baby can manage to eat on his or her own.
One of the best things I see happening with the BLW approach is the development of self-feeding and eating regulation skills in babies. That is, the ability to start and stop eating according to one’s own appetite.
IS BLW ADEQUATE IN NUTRITION FOR BREASTFED BABIES?
A pilot study out of New Zealand shed some light on the delivery of iron for babies who are using the BLW approach. In their study of 23 families, babies were divided into two groups. One group (the BLISS group) received guidelines and education about high iron foods, energy dense foods, and foods that may cause choking prior to starting solids using BLW. The other group proceeded with BLW without any specific nutrition or choking education.
Even though the study was small, the researchers found some interesting things. One, parents who were educated about iron, calorie density of foods, and choking hazards offered their babies more iron-containing foods which led to more iron consumed, though it was not statistically significant from the control group. They also gave their babies more calorie-dense foods and steered clear (mostly) of choking hazards. Educated parents also introduced more food variety to their babies than those who approached BLW without special instruction.
In both groups, however, iron intake fell short of the nutrient requirement as outlined by the Institute of Medicine (IOM). Although the researchers did not specify how much iron each group consumed during the study (this was difficult to quantify in the study design), they did note that BLW-educated parents served 20.1 grams of red meat per day (2.4 servings) compared to the non-educated parents who offered only 3.2 grams of red meat (0.8 servings) per day. More research needs to be done, especially on nutrient intake with BLW.
WHY IS IRON IMPORTANT FOR YOUR BABY?
At birth, babies are endowed with iron stores from their mother. This iron “load” is generally sufficient to get them through the first 6 to 8 months of life, depending on a few things: mom’s iron stores and iron status during pregnancy, whether baby was born prematurely, and the timing of the umbilical cord clamping. Early clamping reduces blood volume delivery to baby while delayed clamping (2-3 minutes after birth) allows baby to receive about 30-50% of total blood volume from the placenta.
From the fourth month and on, a baby’s iron stores are used rapidly because he is experiencing tremendous growth, and as such, expanding his blood volume quickly, and developing his own iron stores.
Experts note that iron deficiency may be difficult to assess during this period due to these rapid changes in body composition. In children under age 4 who live in industrialized countries like the United States, it’s estimated that about 20% are iron deficient. More than 9% of the US population is iron deficient.
The Risks Associated with Iron Deficiency
When a young child is iron-deficient or has iron deficiency anemia, a negative impact on their health may occur, including changes in their immune system, delayed mental development, and below average school achievements. There is a preferential use of iron in the body to make hemoglobin (a protein found in red blood cells which carries oxygen to cells and organs in the body), which may direct iron away from the brain, especially if iron intake is low.
The American Academy of Pediatrics (AAP) now recommends screening for iron-deficiency anemia at 12 months, stating, “There is growing evidence that iron deficiency and iron deficiency anemia have long-term effects on behavioral and neurodevelopmental issues that can appear one to two decades after the anemia is treated.”
Ensuring Adequate Iron Intake
Although breastfed babies get iron from breast milk, and it is well-absorbed and utilized, at 6 months, the iron content from breast milk declines while baby’s iron requirements increase. Specifically, a baby’s iron requirements jump from 0.27 mg per day (Adequate Intake) at 0-6 months to 11 mg/day from 7-12 months (RDA).
Complementary foods, otherwise known as solids, should begin at 6 months to help ensure babies receive enough iron.
Spoon feeding methods encourage the use of iron-fortified cereals or pureed meat as a first food for baby. If you are using a baby-led weaning approach, you’ll want to ensure you’re providing iron-rich food sources every day or routinely supplementing with iron. In fact, the AAP recommends that an iron supplement be given starting at 4 months for all breastfed babies.
To match iron requirements, offer two servings of iron-rich foods per day for your baby transitioning to solids, regardless of whether he or she is following spoon-feeding or BLW methods.
4 tablespoons of iron-fortified oatmeal with an egg yolk (7 mg iron)
Meat puree with green beans (3 mg)
The following list shows the iron content of common iron-containing foods (from the USDA Nutrient Database), but you can see that portions are much bigger than a young baby (or even older baby in some cases) would likely eat.
Iron content (milligrams)
Beef (1 ounce)
Lamb: (1 ounce)
Black or pinto beans
Cheerios (1 cup)
Tofu (1 cup)
Chicken, dark meat (1 drumstick)
Egg (1 large)
Spinach (1 cup)
Lentils (1 cup)
*Heme sources of iron (from animal sources) are more readily absorbed than plant-based sources; you can increase the absorption of iron from plants by adding a source of vitamin C (citrus fruit, for example).
Until we have more studies about the adequacy of nutrient ingestion with BLW and a better way to educate all parents about adequate nutrients no matter the route (BLW or spoon), I favor a combined approach that includes spoon-feeding and hand-held solids for baby, while selecting iron-rich food sources.
This combined feeding approach will help optimize self-feeding and self-regulation, while also optimizing adequate nutrition.
Jill Castle is a registered dietitian nutritionist and a childhood nutrition expert. She’s the author of The Smart Mom’s Guide to Starting Solids and co-author of Fearless Feeding: How to Raise Healthy Eaters from High Chair to High School. You can find more information about Jill on her website, listen to her podcast,The Nourished Child, and check out her many nutrition resources for parents.