Introducing solids, research, and guilt

Last week the British Medical Journal published an interesting study comparing outcomes for children who have experienced different styles of weaning, entitled Baby knows best? The impact of weaning style on food preferences and body mass index in early childhood in a case–controlled sample.

This sparked my interest for a number of reasons, one of which was a response on twitter complaining that research showing ‘pureed foods will make your babies overweight’ just makes parents feel guilty. This commenter went on to complain that the study, of 155 families, was an unrepresentative snapshot; and that was interesting too, because the study showed two main results: Baby-led weaning (BLW) babies were more likely to be underweight, AND puree-weaned babies were more likely to be obese in later childhood. So actually, you’re damned if you do and damned if you don’t, and guilt is once again a diversion from the actual information.

As I have written before, parents are entitled to information so that they can make decisions. The study is available in full on the BMJ website, so we really cannot get away with blaming the media for misrepresenting the facts. It’s quite easy to read, too.

I dusted off my memories of the ‘understanding research’ BA module I did last year, and had a good look at the article. I noticed that there were one or two flaws, but as far as preliminary research goes, it gives some interesting starting points. I thought that the sample size of 155 was not problematically small, but I noticed that the samples seemed to be drawn from quite different pools: mumsnet for the BLW families, and the local toddler lab for the puree families. However the researchers matched the samples for social status and all the usual factors.

The families self-reported on weaning styles, and the researchers acknowledge this as a weakness, since there is no strong definition of baby-led weaning, and it is not a discrete question. Many babies will experience some purees and some finger foods, in varying quantities. This could be addressed by a larger, prospective study following cohorts of children from birth well into childhood.

I also noticed that although the matched sample shows no significant difference between breastfeeding rates in the two groups, it is not clear whether or not the researchers controlled for duration of breastfeeding. The reason this interests me is that baby-led weaning does work well with (but isn’t restricted to) babies who continue to breastfeed well into toddlerhood. This is because if the baby is self-feeding, they are unlikely to consume very much for the first few months, and so will continue to rely on milk as an important source of nutrition probably until they are around a year old. I am just speculating here, but maybe the longer-term breastfeeding family can be a bit more relaxed about how much the baby eats; the researchers do state that BLW is is associated with reduced maternal anxiety about weaning and feeding and a maternal feeding style, which is low in control. I would posit that this is more likely to be the breastfeeding mother, but further research is certainly needed in that area!

I feel strongly that this is another area of parenting where the word ‘should’ does not apply. Many families need some support to find a style of introducing solids that works for them, and there are so many other complex factors, particularly relating to maternal control, that will affect the outcome for the child. As with breastfeeding, few people make the decision based solely on the publicised health outcomes: cost, expediency, social expectations and pressures will all play a part.

I’m starting to do a lot of Introducing Solids Workshops for parents over the next few months, and find the area really interesting. If you are interested in coming along to a workshop in Wokingham, Bracknell, Reading or Bagshot, get in touch.