Author Dr. J. Hower, paediatrician from Germany
What effect does a baby-led approach to the introduction of solids have on infant growth and becoming overweight?
Most infants are introduced to solid foods in the form of purées or, less frequently, finger food after the age of 6 months, as a supplement to breast milk or formula milk.
An alternative feeding approach is BLISS (Baby-led Introduction to Solids), which should encourage babies to regulate their intake of solids (finger food) by themselves. In contrast to adult-regulated spoon-feeding, according to this concept, this method can potentially achieve a better self-regulation of food intake and possibly a reduction in the prevalence of obesity. This method of “baby-led weaningb” has gained in popularity over the last 15 years, mainly in Great Britain and New Zealand.
Taylor et al. have now, for the first time, carried out the BLISS randomized clinical trial addressing the question of whether this approach leads to a sufficient energy intake, and a lower body mass index (BMI) than the traditional spoon-feeding method carried out by adults.
Study design: In the randomized clinical trial, 206 first-time mothers were recruited for the intervention study in late pregnancy and surveyed by means of a diet questionnaire.
The mothers in the BLISS group were accompanied by breastfeeding advisors, to maintain exclusive breastfeeding for as long as possible and to delay the introduction of solids until the age of 6 months. The primary target outcome was to record the BMI Z-score at 12 and 24 months of age. The secondary target outcome was to record the self-regulation of energy intake and the eating behaviour of children at the ages of 6, 12 and 24 months.
Outcome: Out of the 206 study participants (average age 31.3 years), the results of 166 child subjects at an age of 24 months could be evaluated. The mean scores (average BMI Z-score) between the control group and the BLISS group did not differ significantly at an age of 12 months, nor at 24 months. Parents in the BLISS group reported that after 12 and 24 months there was a lower satiety reaction and more enjoyment with food. These infants also seemed to be more decisive in their choice of foods. The estimated difference in energy intake was 55 kJ at 12 months and 143 kJ at 24 months.