BLW method, an update on the Baby Led Weaning method

There are many different approaches to introducing food to your baby. But one of the most notable could be BLW. That is why the midwives at Happymami have put together the following post for you: An update on the Baby Led Weaning (BLW) method, with everything you need to know.

BLW method, Baby Led Weaning

For the introduction of food to your baby, the most conventional approach is based on texture. You start with smooth purées at 4-6 months, move on to lumpy purées at 6-9 months, and then the first soft solids from 9-12.

But in recent years a new approach to introducing foods to your baby, or rather an old method of feeding, has been gaining ground, especially in the countries of northern Europe.

What is the BLW method?

Baby Led Weaning (BLW) is based on introducing solid foods directly, without going through the purée stage, and letting your baby control and self-regulate their own food intake. It is a more natural way of feeding, one that adapts to your baby and requires more patience and trust from the caregivers. In reality, although it seems like a “modern” method, it is the common way of introducing food in our species for millions of years.

Benefits of the Baby Led Weaning (BLW) method

It has been suggested that Baby Led Weaning (BLW) can promote better nutritional patterns, as well as a lower risk of overweight, greater psychomotor development, and even improved language development.

However, there is not yet enough evidence to confirm or refute these claims conclusively, and some sources even contradict some of them.

Since no lower proportion of overweight was observed in the BLW group compared with the purée group, the apparently logical reduction in the risk of overweight that the self-regulation of intake achieved with the BLW method should bring is called into question.

This may not be the case in babies, as they are thought to have a natural tendency to overeat, due to the high energy demands at this age for growth or immunity.

How to start the BLW method?

Starting the BLW method requires planning and knowledge. Follow these steps to get started safely and effectively:

1. Make sure your baby is ready

Before you start, check that your baby shows the signs of readiness:

• They are at least six months old.
• They can sit without support and hold their head upright.
• They show an interest in food and put objects in their mouth.
• They have lost the extrusion reflex (the urge to push food out with their tongue).

2. Prepare safe, healthy food

Choose soft foods that are easy to grasp and adapted to the size of their hand (usually in the form of sticks or strips). Some examples are:

• Cooked vegetables (carrot, broccoli, courgette).
• Ripe fruit (banana, avocado, pear).
• Soft proteins (shredded chicken, boneless fish). Avoid hard, small, round foods such as nuts or whole grapes, to prevent the risk of choking.

3. Create a safe environment

• Sit them in a highchair with a straight back.
• Make sure they are always supervised while eating.
• Don't rush them; let them explore the food at their own pace.

4. Trust the process

• Let your baby get messy and explore. It is part of the learning process.
• At first, it is normal for more food to end up on the floor than in their mouth.
• Don't force your baby to eat; respect their hunger and fullness cues.

5. Consult a professional

Talk to a paediatrician or nutritionist to make sure your baby is getting the nutrients they need, especially iron and vitamin C.

6. Avoid foods that are not recommended

• Honey (until their first birthday).
• Cow's milk as the main drink (until they are one).
• Foods with salt, added sugar or processed foods.
• Foods with allergenic potential, unless your paediatrician advises otherwise.

BLW can be a fun and educational experience for both the baby and the parents. With patience and knowledge, you can build a positive, healthy relationship with food right from the start.

Is there a choking risk with the BLW method?

On the other hand, the BLW method raises concerns among some clinicians and parents because of its potential risk of choking or malnutrition, but most current studies have not found differences in these aspects either compared with feeding purées.

Moreover, to overcome both problems, BLISS was designed in 2015: it is basically an improved version of BLW, with the same philosophy, but emphasising three aspects: always eating a source rich in iron; always eating a source rich in energy; and training and emphasis on choking, as well as the foods that cause it.

With regard to choking, it is true that starting BLW at a more immature age might logically seem to carry a greater risk of choking, but purée feeding also carries an increased risk, since babies do not learn to swallow solids properly and tend to keep solid food in their mouth for longer.

The reality is that the studies carried out show no differences in the incidence of choking between one method and the other.

It is important to distinguish between full choking and gagging. Full choking means the airway is completely blocked, and the baby will not make a sound, nor cough, nor cry, nor be able to breathe, and will put their hand to their throat, with their lips turning increasingly blue. In that case, you must carry out resuscitation manoeuvres.

But if your baby can cough forcefully, is breathing and crying, you should do nothing, because if we shake or hit them we will stop the child from managing the resolution of the event, and may even cause choking ourselves.

What stands out about the Baby Led Weaning (BLW) method

An undeniable advantage of the BLW/BLISS method is that we avoid the step from purée to solid (difficult for some children), and it is also perceived as more pleasant and cheaper by parents.

So, in conclusion, given that both methods are safe, and that neither seems to have particular health advantages or disadvantages over the other, parents should be free to choose whichever method they prefer, in complete freedom.

Aspects to highlight of the Baby Led Weaning (BLW) method

1. It is your baby who sets the pace and the amount. So you do not “feed” the infant; it is they who decide how much to eat, which foods (from those we offer), and whether they want to do it or not. From birth, children are able to regulate their energy needs. The way to do it is to put the foods in front of the little one, within reach of their hand.
2. They eat the same as the family, and with the family. Eating is not merely an act of nutrition in our species, as we said earlier, but a social act. As you do not have to feed them, with this method your baby takes in food that is more similar to the family's, and integrates better into the mealtime ritual. In fact, in studies carried out with families, greater enjoyment at mealtimes has been demonstrated.
3. When to start is not a chronological criterion, but depends on the baby's maturity: they must be able to sit and hold their head firmly, pick up objects and bring them to their mouth, and the extrusion reflex must have disappeared. This developmental stage is usually reached around 6 months of age (remember that the introduction of food cannot be delayed beyond 6-7 months of age, as milk is not enough to meet the needs for certain nutrients). BLW is not recommended before 6 months, as the gag reflex is still very immature (if you want to start at 4-5 months, you can use a protective feeder net). It does not matter if the teeth have not yet emerged, because unlike elderly people who no longer have teeth, babies do have them (even if they are hidden under the gums) and are able to mash soft foods.

Safety of the Baby Led Weaning (BLW) method

As we have seen, the BLW method is safe and there is no greater risk of choking, but a few simple rules must be followed:

1. There must always be an adult watching the baby, and their attitude should be calm and confident. You should taste the food to make sure it is good, soft and easy to chew.
2. You should not give foods that carry a risk of choking. Even though the risk of choking is the same with both methods. The most worrying thing seen in studies is that up to two thirds of parents in both groups offer foods with a high risk of choking. Regardless of the method used, the important thing is not to give these foods.
3. All foods should be at least the size of the baby's palm (avoid small objects), as well as of a soft consistency (if the raw ingredient is hard, it can be cooked).
4. Spoons, or putting foods into the mouth, are forbidden. It is the baby who must put the foods into their mouth so that they can manage the depth. At most, you can “present” the foods by bringing them close to the little one's mouth, but they must never be put inside it by mum or dad.
5. It is very important to distinguish between the gag reflex and choking. It is normal for your baby's gag reflex to be stimulated, or for them to feel nauseous and start coughing or retching, as this reflex is further forward at this age and they are still learning to control the depth. But that is not choking.
6. In some cases BLW may not be indicated: babies with conditions of the central nervous system, malformations, or premature babies; babies who already choked on milk, or who have an irascible temperament; or parents who are unsure about the method, whose anxiety increases the risk of choking.

Be a role model for your baby

Bear in mind that with this BLW method babies will follow a diet more similar to their parents' than with the traditional purée method, with parents being a role model.

This exposes them to eating a less suitable diet if the parents' diet is not entirely correct.

In fact, current evidence shows that poor dietary habits are not “spontaneous” but induced by the model, or the indulgence, of the parents. Therefore, it is important that if you follow the BLW method, the diet of the whole family is as good as possible.

Breastfeeding and BLW

It is likely that babies fed with breastfeeding find it easier to adapt to the BLW method than those fed with formula, since breastfeeding itself, thanks to its wide variety of flavours (depending on what the mother has eaten), prepares the baby better to seek out new flavours; moreover, feeding at the breast trains the mouth muscles to swallow correctly more than bottle feeding does.

However, there is no scientific evidence that babies fed with a bottle do not have the skills needed at 6 months to follow the BLW method.

General points to bear in mind when introducing food to your baby

1. Complementary feeding is the introduction of all foods other than milk. Its importance lies in the fact that the first years of life are the most critical period in our physical development, laying the foundations for whether or not we will suffer future conditions, as well as establishing food preferences for the rest of our lives.
2. You start at 4-6 months of age, with exclusive breastfeeding being sufficient until 6 months of age. But more important than chronological age is psychomotor development: we will start when your baby brings their hands to their mouth, sits correctly (even if they need support), and begins to show an interest in food.
3. Foods should be introduced in small, increasing amounts of a single new food over a few days (although we can mix a new food with those already tolerated previously).
4. Feeding is a social act. It should be as similar as possible to the family's, both in content and timing.
5. Do not delay the introduction of foods that are potentially allergenic (egg, soya, peanut, wheat, nuts, fish and shellfish), even if there is a family history. Once introduced, they should be offered frequently.
6. These foods should not be restricted in mothers either during pregnancy, nor during breastfeeding (except in the case of allergy or medical advice).
7. Delay the introduction until…:
   1. 9 months: plain unsweetened yoghurt or cheese (cured or pasteurised); green leafy vegetables (lettuce, chard…).
   2. 12 months: unadapted animal milk; honey and preserved foods; salt and salted foods (a small amount until 2 years).
   3. 2 years: sugar, sweeteners or products containing them.
   4. 3 years: round and/or hard foods that can cause choking (whole nuts, peanuts, raw apple or carrot, sausages, whole grapes…).
8. There are two methods of introduction by texture: introduction with purées, or directly with solids (BLW or BLISS), with no medical advantages or disadvantages demonstrated in current studies. What really matters is not the method but offering a quality diet and avoiding foods with a high risk of choking.

Frequently asked questions

What does the WHO say about the BLW method?

The WHO does not mention the BLW method specifically, but it promotes the introduction of complementary foods from 6 months alongside breastfeeding. It recommends offering healthy foods and respecting the baby's hunger and fullness cues, principles that are in line with the BLW method.

Does the BLW method have any disadvantages?

The BLW method can pose challenges such as:

1. Choking risk if safety measures are not followed (supervision and suitable foods).
2. Food waste because babies tend to play with food at first.
3. Nutritional deficiencies if a balanced diet rich in iron and other essential nutrients is not ensured.

These disadvantages can be minimised with correct implementation and professional guidance.

What is BLW and what is it for?

BLW (Baby-Led Weaning) is a method of introducing solid foods where the baby eats autonomously, handling and exploring pieces of food. It helps to encourage independence, develop motor skills and promote a positive, healthy relationship with food from an early age.