Baby-Led Weaning

: o estado da arte

Abstract

Baby-Led Weaning (BLW) is an alternative method to introduce complementary feeding that differs from the traditional weaning style by beginning the process with whole foods, cut into appropriate shapes and textures instead of traditional puréed or mashed foods. It is a method that can only be started at 6 months of age and it is recommended as a first approach only in children with normal development for their age. With the BLW method it is the child who self feeds, controls what he or she eats, the quantity and pace of ingestion, and the role of the parents is to present an adequate and varied selection of foods and supervising the meal. The selected foods are the same ones that are presented to the other family’s members and therefore the integration of the child into family meals starts from the beginning of their weaning. This method is chosen by parents who believe that it is simpler and more practical to apply, that it brings development advantages, allows the learning of healthy eating habits, a better hunger and satiety mechanisms’ regulation and that this will translate into health gains that will extend through the child's life. For parents, the method has few drawbacks. For health professionals, although they recognize that the method may have its advantages, there are risks that make them skeptical when it´s time to recommend it as a weaning method. Such risks are dietary disadvantages: energy and nutrient deficits (iron especially), excess fat, and saturated fat in particular, early contact with sugar, salt and processed foods and increased risk of choking. Research conducted so far showed that parents who choose BLW have different backgrounds from those who opt for the traditional weaning method: they have a higher level of education and socioeconomic status and have a less anxious and controlling personalities, which can also influence the favorable outcomes attributed to the method. It is also common practice among those who apply it to respect the six month World Health Organization (WHO) recommendations on exclusive breastfeeding period. Research and data on BLW are still incipient and are based essentially on observational studies, with small samples. More experimental studies with longer follow-up periods are necessary to properly assess its potential benefits or risks. Recently, the results of an important randomized trial that intends to evaluate the advantages of this method have been released and, in opposite to what observational studies seemed to suggest, BLW does not seem to be associated with lower body mass index. On the other hand, it also does not seem to be associated with a greater risk of vomiting and choking, therefore, there is a need to further investigate this form of weaning, with randomized studies, larger sample sizes and longer follow-up times of to better assess its risks and benefits.

Date of Award	30 May 2018
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Elisabete Pinto (Supervisor)