27 Feb

My experience of baby-led weaning

Now that we are advised to wait until around six months to start, our babies have better co-ordination and more mature stomachs than they did at four months, and so it is possible to skip the stage of aeroplaning mush into their mouths and then scraping it off their chins, and offer finger food right from the start. This is known as baby-led weaning (BLW), and the main principle is that the only person to put food in the baby’s mouth, is the baby himself.

I started weaning my son the traditional way, at 23 weeks, with great excitement and anticipation of him quickly becoming as much of a food-lover as I am. I did consider the baby-led weaning approach, but felt that it would not work for us, because I would be returning to work a month later, and therefore no longer had the opportunity to breastfeed on demand. As with most things, my son had a completely different agenda to me, and resolutely refused to contemplate the spoonfuls of delicious runny baby rice that I offered him. For a few days he had some interest in pear, carrot, and potato; but as soon as the novelty wore off, he closed his mouth, turned his head away, and cried; and that was his final say in the matter.

BLW puts the baby in charge of his own eating, on the basis that if parents offer a range of interesting, nutritious, and suitable food, then the baby can choose what he eats, and this allows him to move gently towards a solid diet. The goal is not to force your baby to eat, but to let him experience the tastes and textures of food at his own pace. It encourages the development of motor skills, and because the baby quickly moves on to eating the same food as the rest of the family, he also benefits from learning social skills at shared mealtimes, when he can participate in eating actively, rather than passively. As long as parents can relax and accept that it might take longer for the baby to consume significant quantities of food, this approach is more fun, less stressful, and much, much messier than traditional weaning on purees. At this stage, milk is still the most important source of nutrition, so it doesn’t really matter how much solid food baby eats, as long as he gets plenty of milk.

The BLW philosophy is to follow the child’s cues, and start when he indicates he is ready to try some solid food. First signs of readiness include losing the tongue-thrust mechanism (where anything put into the mouth is pushed back out again), having the ability to sit unsupported, and starting to develop a pincer grip with the thumb and forefinger. Our experience was that this tentative ability came on very quickly, when sufficiently motivated by such interesting items as peas and roast potatoes.

The first foods we offered were fruit, rice cakes, and steamed or roast chips of vegetables. We found that if you leave the peel on hard fruit like pears, the baby can pick them up more easily, and will suck the flesh and spit out the peel. Of course you should never leave your baby unattended while eating, but don’t be too alarmed by a little bit of gagging: this is a normal part of learning to manipulate food in the mouth, and is not the same as choking. We moved on to breadsticks and toast, pieces of cheese, and small lentil patties (an early favourite). Breakfast cereals were less successful in our case, but could work well with a different baby (my constantly teething son liked his food to be soft but still insisted on using his own hands, hence breakfast usually consisted of one weetabix with 2oz milk – perfect finger-mush). Later on we tried poached fish and chicken, and finally just shared our own meals with him.

He didn’t really start to eat well until he was nearly a year old, but mealtimes where I could relax and let him dictate how much he ate were always the most pleasant ones. He has always eaten better at the family table than on his own, and we have the attitude that there are no things he doesn’t like, just things he doesn’t like YET. Around 12 months he started trying to feed himself with a spoon, and over the past year he has progressed to a fork, and now likes to wave a (baby-friendly) knife around while he eats as well.

At two years old, my son has eaten (and likes) a far more varied diet than I remember as a youngster (or even in my twenties!), from olives to salsify. He also eats things that I don’t like much, like spinach (mixed with cream cheese and combined with pasta makes a good mushy, messy finger food) and fish.

There have been many ups and downs, especially when he is teething, poorly, or tired. Some days he eats more, and some days he eats less, and some days he has a healthy diet, and some days I let him have a sausage roll. I try to look at the bigger picture, and consider that overall he has a good diet and enjoys his food, which, looking back, is what I wanted in the first place.

BLW works well in a family where the parents feel able to relinquish control over what the baby eats. You decide what to offer, and he decides what to accept; there is no batch-cooking of mush, no counting spoonfuls, and no train-coming-through-the-tunnel-and-INTO-your-mouth! It is important to be able to top up with milk on demand, but at least that way you can be sure that the little tummy isn’t filling up with less-nutritious solid food, to the detriment of milk, which still provides the main source of calories and other nutrients that the baby needs to in order to grow.

June 2008

21 Feb

Support, Advice, and Parental Instinct

As a breastfeeding counsellor, I am sometimes asked why my antenatal classes do not go into great detail about problem solving when things go wrong. The pat answer to this, of course, is that every new family is unique, and I can’t possibly account for all the possible scenarios. I’m also wary of introducing a lot of potential pitfalls, and therefore undermining my own work to show that breastfeeding can be a straightforward experience, and that being well-prepared with an understanding of how it works is more useful than being armed with copious detail about problems that may not occur.

This is a dilemma for me, because to be realistic about breastfeeding as experienced by the majority of new mothers in the UK, I have to acknowledge that there are challenges. So one of my main objectives is to raise awareness of the huge amount of support available to new parents. If time permits, we compile a list, and the group is always impressed by how many people they can think of who might be able to help them over the first few weeks of their babies’ lives. Here are some of the ideas I usually see:

The real trick, though, is in figuring out which of these are sources of trustworthy information (or practical help); and which are, probably with the best intentions in the world, recycling myths and misinformation, or unhelpfully comparing your baby with theirs. But each of these different sources of support has its function, whether it’s sympathy and a cup of tea, the loan of a dvd box set to while away a marathon feeding session, or reassuring confirmation that what you and your baby are going through at any particular stage, is completely normal.

It can also take courage not to follow advice that does not feel right, especially when it comes from a figure of authority. So another of my objectives, both antenatally and postnatally, is to empower new parents to have confidence in their own parenting. We are among the first generations of parents to raise our children in isolation form the extended family, and there are huge commercial interests in undermining parental instincts.

It’s tough being a new parent in the 21st century, but remember that there are reliable sources of help, many of which are under-utilised. So don’t feel you have to struggle on alone, but do pick your support carefully.

Originally written as a guest post for the liberating blog, Free Your Parenting.

13 Feb

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.

08 Feb

Book Review: The Oxytocin Factor, by Kerstin Uvnas Moberg

On the whole, this is an interesting book exploring the magic of the hormone oxytocin, its widely varied effects, and the gaps in our knowledge about it.

The author describes the ‘calm and connection’ system, and contrasts this with the ‘fight or flight’ system, which has already been widely researched. She posits that modern life gives little opportunity for human beings to enjoy the various conditions of rest, relaxation, and pleasant interactions, which cause a natural increase in levels of oxytocin.

The book is divided into parts, and begins with an explanation of the physiological processes involved in the calm and connection system. All this makes a lot of sense, although much of it is based on research with rats.

The section on the effects of oxytocin is the most interesting part of the book. It shows that oxytocin increases sociability, curiosity and nurturing behaviour, and decreases anxiety and fear. It enhances recognition and calm, and alleviates pain. It improves the ability to learn; and, in different circumstances, either raises or lowers blood pressure. It moderates body temperature and enables a mother to moderate her baby’s body temperature. It regulates appetite and makes digestion more effective. It aids growth and healing, and the flow of breastmilk, and the contractions to birth our babies. All of these different effects have the result of enabling animals to grow and to reproduce.

The chapter on breastfeeding is fascinating. However I noticed here and elsewhere some remarks that I know are not supported by evidence, including that mothers who have had a c/section have more difficulties in breastfeeding, the assumption that colic is a stomach disorder, and the assertion that breastfeeding women must avoid alcohol. This leads me to wonder how much of the rest of the content of the book is actually based on real evidence of human experience and behaviour.

Certainly the final section of the book is almost entirely based on speculation about the gaps in our knowledge, and uncritically discusses the role of oxytocin in acupunture and other complementary medicine.

I found much that was useful in this book, particularly on the subject of bonding, and specifically in relation to fathers, which is very relevant for me in my work. However I found the speculation in the final chapters vague and disconnected. I was surprised, given the original assertion that modern life is not conducive to natural oxytocin release, to read that the author is looking forward to oxytocin being available as an drug that can be administered for various conditions. I had expected the book to conclude that human beings need to use our knowledge of natural oxytocin to engage in more behaviour, or create more circumstances, where oxytocin is naturally maximised; not just to pop a pill to achieve all those beneficial effects.


To order The Oxytocin Factor with a 25% discount, just follow the link and use the discount code KH25 at the checkout.