BABY-LED WEANING: DON'T CALL IT A COMEBACK; IT'S BEEN HERE FOR YEARS!

You often hear the phrase, “Food before one is just for fun.” While this is usually said with the best of intentions so as not to add any additional stress to parents’ plates, when it comes to proper infant oral development, food before one is more than just fun.

Food before one is an opportunity to enhance oral motor skills, aid in sensory experiences, decrease allergy risk, and develop nutrition, social connection and relationship building. Infant feeding of solid foods before the age of one is such a foundational activity that it doesn’t have to be stressful. There are lots of often underutilized resources and support systems available for new parents. We will share a few of them along the way.

THE HISTORY OF BABY-LED WEANING

Let's kick things off with the history of the baby-led weaning. Perhaps it's obvious and goes without saying, but our ancestors didn’t have access to blenders, food processors, or pouched puree baby food. The original concept of baby-led weaning didn’t have a technical name since it was the natural way of life.

The term baby-led weaning was coined by Dr. Gill Rapley, Ph.D., MSc, in the early 2000s. Dr. Rapley has extensive experience in infant feeding as a health visitor, midwife, breastfeeding counselor, lecturer, writer, and researcher. The baby-led weaning method empowers parents to introduce solid table food to babies from the start of natural weaning (around 6 months of age) and allows babies to feed themselves (self-feeding) rather than the conventional spoon-fed weaning with pureed or processed baby food.

HOW TO HAVE AN AIRWAY-MINDED APPROACH TO BABY-LED WEANING

Isn’t this the Children’s Airway First Foundation? What does introducing solids have to do with the airway? So glad you asked!

Check out just a few of our Airway First podcast episodes:

• Dr. Ben Miraglia (Episode 17)

• Dr. Mary Bourke (Episode 49)

• Airway Health Solutions - CAFF Parent’s Town Hall (YouTube Video)

• Tasha Turzo (Episode 9)

In these episodes, our medical experts explore the oral motor benefits of baby-led weaning. Form follows function, meaning the function of the muscles guides the growth of the bones. In the case of baby-led weaning, the activation of the muscles involved in chewing is essential for facial growth and jaw development. Optimal jaw development is crucial for airway health and development.

Strengthening the tongue and other orofacial muscles also helps to create adequate tone in some of the muscles that help to keep our airways open at night. Establishing tone in these muscles is important since they become more lax during sleep.  

WHAT ARE SOME ORAL AND FEEDING MILESTONES?

Oral motor and feeding milestones are often overlooked. Pediatricians may ask about your baby’s rolling, sitting, or crawling progression but typically aren’t asking if they can lateralize their tongue (move side to side) or if they have mastered more mature chewing and swallowing patterns. These milestones are very important for children’s airway health and overall development.

Progression from reflexive or immature normal jaw patterns to mature patterns:

• Chewing

  • Phasic biting

  • Munch chewing

  • Diagonal chewing

  • Circular rotary chewing and controlled sustained biting

• Lips

  • Baby can seal lips

  • Lips work as a unit with the tongue, palate, and cheeks

  • Baby displays active lip movements

  • Baby can strip food from a spoon

  • Baby shows improved lip closure

  • Baby can chew with lips closed

• Tongue

  • Cupping

  • Protrusion & retraction

  • Lateralization

  • Baby can use tongue to sweep food from lips

  • Baby uses tongue tip elevation during swallow

You can check your baby's milestone progression by using Hallie Bulkin’s Feed the Peds screener.

WHEN DO YOU START BABY-LED WEANING?

Most babies are ready to begin around 6 months of age, as this is when we typically see the signs of readiness. There’s no need to rush into starting solids until your baby shows readiness signs! This ensures safety and helps set your baby (and you) up for success.

Here are a couple of the signs that indicate your baby is ready:

• Can sit independently

  • Baby can sit upright with minimal support. You know what they say, “Steady at the hips, steady at the lips!”

• Head control

• Baby should be able to hold the head steady for meals

  • Picks up items & brings items to mouth

  • Baby is showing an interest in food, whether watching you or attempting to snatch your snacks!

If your baby has been advised to start solids before 6 months, without readiness signs, or to add rice, baby cereals, or other thickening agents to assist with reflux or other symptoms, a speech-language pathologist who specializes in oral motor and feeding will be an important asset on your care team.

BON APPETIT, IT’S TIME TO EAT!

Tapping into ancestral wisdom and our airway-minded approach to solids, choosing foods that offer both a nutritional impact and that help oral motor development are important things to keep in mind. Explore ways to incorporate foods your family enjoys as well!

For oral motor and feeding development, access the Solid Starts First Foods database to review age-appropriate ways to serve a variety of foods. Following your baby’s lead and allowing them to explore different foods will help with the development and movement of their tongues, lips, and jaws. Serving various foods will also benefit your baby’s nutritional health and help prevent picky eating.

Resistive foods are often overlooked as some parents may worry about choking while others aren’t aware that resistive foods can be served in age-appropriate ways. Not to discount purees, yogurts, or similar textured foods – these can be loaded onto a spoon (or pre-spoon!) and babies can feed themselves. However, these foods do not help with jaw development and growth.

When following the baby-led weaning approach, try avoiding spoon-feeding and wiping the spoon on their gums as it is drawn out of their mouth. The goal is to provide your baby with foods they can handle and eat on their own.

When thinking of resistive foods, just think of ones that may provide a little more effort to eat. Solid Starts provides the following suggestions:

• Mango Pit

• Corn on the Cob

• Chicken Drumstick Bone

• Spare Rib Bone

• Pineapple Core

PREPARING FOOD FOR BABY-LED WEANING

Sometimes, there is apprehension about serving babies table food in age-appropriate ways from the beginning and only using puree-type foods because parents may feel they are less likely to choke on pureed textures. However, when we allow babies to lead the way and feed themselves, it decreases the risk of choking and helps aid in jaw growth and development.

Additionally, bigger, resistive foods are less likely to cause choking as they cannot be shoved into a baby’s mouth. They trigger the biting and tongue lateralization reflexes and provide more sensory input to the brain.

Setting up an appropriate mealtime environment will further help set you and your child up for success when it comes to starting solids:

1. Find a stable high chair where they can sit with their knees, hips, and ankles at 90 degrees

2. Minimize the distractions from screens, toys, and even pets

3. Portions can be tricky to figure out – start small and serve more as needed, as too much food can be overwhelming for our new eaters

4. Go with the flow and embrace the mess!

RESOURCES FOR BABY-LED WEANING

If you feel overwhelmed or unsure about how to proceed with baby-led weaning, consult with your pediatrician or a speech-language pathologist near you who specializes in feeding. Feeding is such an important skill, and having the tools to help your child develop these oral motor skills is essential to lifelong jaw and airway health!

Here are signs your child could benefit from feeding therapy:

• Becomes upset at mealtimes

• Isn’t growing

• Refuses to eat anything but their favorite foods

• Gags or vomits frequently

• Gags or chokes on liquids

• Long meal times frequently lasting over 30 minutes

• Consuming primarily milk or liquids beyond 12 months of age

Solid Starts and My Munch Bug – Melanie Potuck has additional recommended products that can help make things easier or more exciting at mealtimes:

1. https://solidstarts.com/readiness/

2. https://www.instagram.com/mymunchbug_melaniepotock/

Solid Starts offers a free app for parents to see the various ways to see MANY foods based on age! They also have amazing information and courses on their website and Instagram account.

My Munch Bug: Melanie Potuck on Instagram at @mymunchbug_melaniepotuck and website https://mymunchbug.com/.

For infants that may need an adapted approach to baby-led weaning, there are resources out there for kids with all different abilities on jillrabin.com and on Instagram @jillrabinablw.