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Caroli M, Mele RM, Tomaselli MA, Cammisa M, Longo F, Attolini E. Complementary feeding patterns in Europe with a special focus on Italy. Therefore, the observed results need to be treated with caution. It cannot be excluded that this high rate was caused by parents' difficulties to distinguish choking from gagging [25]. In another larger, cross-sectional study Brown and Lee found no association between the weaning approach (BLW vs spoon feeding) and parentally reported infant weight at six months of age [34]. Brown A, Lee M. Maternal control of child feeding during the weaning period: differences between mothers following a baby-led or standard weaning approach. Wellington: Child and Youth Mortality Review Committee; 2013. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Does BLW improve family relationships during shared meals? Article  Food fussiness and early feeding characteristics of infants following Baby-Led Weaning and traditional spoon-feeding in New Zealand: An internet survey. Should we trust web-based studies? Moore AP, Milligan P, Goff LM. BMJ Open. This potential risk has not been formally investigated, even though the weaning period requires special attention, particularly in children at high risk of allergy. A pilot study. Manage cookies/Do not sell my data we use in the preference centre. Carter RC, Jacobson JL, Burden MJ, Armony-Sivan R, Dodge NC, Angelilli ML, et al. 2014;5:427. The first solid foods introduced could therefore play a key role in shaping the infant’s gut microbiome. Global strategy on infant and young child feeding. Baby-led mothers reported lower anxiety, lower obsessive-compulsive disorder scores, lower eating restraints and higher conscientiousness than traditional weaning mothers as shown by the observational study by Brown et al. Baby-led weaning In this method, infants are encouraged to self-feed solid foods (non-pureed/whole) from the start. Our inclusion criteria, with respect to the predefined aims of the review, were: evidence-based guidelines, systematic reviews, randomized controlled trials, controlled clinical trials and observational studies that compared outcomes related to growth and development, energy, macro- and micronutrient intake and feeding attitudes in children and families that are following BLW approach or standard/traditional complementary feeding; outcomes related to the impact of different weaning styles on mothers feelings and attitudes about their children are considered. 2016;12:826–37. Matern Child Health J. Matern Child Nutr. It is possible that unmodified BLW may not have the same effects as this case. This site needs JavaScript to work properly. Epub 2018 Aug 2. Does BLW influence food preferences and diet quality? Furthermore, a lot of differences have been shown among parents who followed BLW and traditional weaning, which can influence weight. In fact, concerns persist since some previous observational studies indicated that mothers using the BLW approach estimated that their babies ate more milk feeds and less solid foods compared to those following a traditional weaning, focussing attention on inadequate nutrient intakes for infants from 6 months of age onwards. No difference in self-reported frequency of choking between infants introduced to solid foods using a baby-led weaning or traditional spoon-feeding approach. ED and MB independently searched and selected the literature based on the inclusion/exclusion criteria, then extracted results and appraised the included articles. Epub 2019 Jun 24. BLW seems to be associated with other positive aspects, such as lower maternal anxiety and control during the weaning period, but this point is controversial [12]. GVZ: critically revised the manuscript. After the inclusion/exclusion process, we included for analysis of evidence 12 articles, 10 observational cross-sectional studies and 2 randomized controlled trials. Erickson LW. The authors declare that they have no competing interests. Therefore, this issue needs a careful monitoring by the paediatrician in order to ensure adequate growth. Krebs NF, Sherlock LG, Westcott J, Culbertson D, Hambidge KM, Feazel LM, et al. The difference between BLW and BLISS is mainly the level of specificity of the instructions, while the key characteristics remain the same. Complementary feeding: a position paper by the European Society for Paediatric Gastroenterology, hepatology, and nutrition (ESPGHAN) committee on nutrition. 2016;138(4):e20160772. Brown A, Lee MA. Fu X, Conlon CA, Haszard JJ, Beck KL, von Hurst PR, Taylor RW, Heath AM. 2017;j4008:358. While in the traditional weaning infants are offered puréed infant foods that are often made up of several ingredients, in the baby-led weaning a variety of single picked foods is offered to the baby. Morison BJ, Taylor RW, Haszard JJ, Schramm CJ, Williams Erickson L. FangupoLJ, et al. Mean weight in the BLW group was 10.4 ± 0.9 kg compared with 11.1 ± 0.5 kg in the TSF group. In particular, they should be given advice on how to prepare foods in such a way they result safe, healthy and nutritious. Early influences on child satiety-responsiveness: the role of weaning style. J Pediatr Gastroenterol Nutr. The key features of BLW are that infants participate in family mealtimes, and ‘whole’ (baby-fist size) pieces of food are offered to them, so they feed themselves from the beginning of complementary feeding, at around six months of age [7]. Article  This aspect has been formally addressed in two observational studies.Morison BJ et al. University of Otago, 2015. http://hdl.handle.net/10523/6041. 2017;171:838–46. Nutrition and allergies (NDA). Townsend and Pitchford found a higher occurrence of underweight children in the baby-led group (3/63) and an increased incidence of obesity in the spoon-fed group (8/63); however, it should be pointed out that 32% of the data on BMI was missing in the baby-led group [24]. Get the latest research from NIH: https://www.nih.gov/coronavirus. 2014;10:410–21. Privacy 2015;15:99. Mat Child Nutr. 2013;9:233–43. Get the latest public health information from CDC: https://www.coronavirus.gov. It is unclear whether BLW can include limited use (less than 10%) of purées and spoon-feeding, or if it is ruled by a more strict definition, where exclusively finger foods are provided. Hence, it is possible that unmodified BLW may not have the same effects. Matern Child Nutr. We also planned the pooling of results, with appropriate methods, if the same outcome was present in a sufficient number of not heterogeneous studies. Moorcroft KE, Marshall JL, McCormick FM. Practice guidelines not evidence-based, narrative reviews, editorials, other publication types and articles in which BLW was not clearly defined and/or quantified, were considered for discussion of items but excluded from formal analysis and from tables of evidence. how different are baby-led weaning and conventional complementary feeding? 2016 May 6;6(5):e010665. observed that BLW weaned children had a preference for carbohydrates, whereas the spoon-fed infants preferred sweets [24]. Fangupo et al., however, did not consider a classical BLW sample of children, but a modified version of BLW, the BLISS [(Baby-led Introduction to Solids (BLISS)] method, providing written and verbal messages to allow parents to learn how to avoid foods more related to choking risk, such as raw apple and grapes, even associated to fatal choking [24, 28, 29]. Ital J Pediatr. The BLISS method was developed and tested by Cameron et coll in 2015 [29]. Please contact authors for data requests. FP: helped draft the manuscript. Terms and Conditions, Further investigations are needed to determine if the BLW approach could shape the microbiome in a different way compared to the traditional weaning. Both randomized trials have potential bias; therefore, the quality of the evidence is low. Community Pract. 1 we show the PRISMA Flow Diagram [21] of search and selection. PubMed  Is baby-led weaning feasible? Differently from the previous studies, they found no significant differences in BMI at 12 and 24 months between the baby-led group and the traditionally fed one. Methods: Matern Child Nutr. 2012;2:e000298. Thus, these issues require further investigation in larger randomized studies. EFSA Panel on Dietetic Products. Brown A, Lee MD. Conversely, Townsend et al. Nutrients. Cameron SL, A-LM H, Taylor RW. Front Immunol. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. A review of the evidence. 2010;182:E839–42. BMC Pediatr. Moreover, the evaluation of nutrient intakes has not been included in the secondary outcomes of the study, but has been described only in an unpublished doctoral dissertation by Erickson, that examines initial findings of the BLISS Study, considering adherence to the weaning approach and nutrient intake, respectively [35]. Springer Nature. https://doi.org/10.1186/s13052-018-0487-8, DOI: https://doi.org/10.1186/s13052-018-0487-8. Another relevant issue regards the quality of the meals consumed by BLW infants. This approach causes concern to healthy professionals and parents themselves as data from observational studies pointed out to a potential risk of iron and energy inadequacy as well as choking risk. Effects of different complementary feeding regimens on iron status and enteric microbiota in breastfed infants. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. 2017;64:119–32. Brouwers M, Kho ME, Browman GP, Cluzeau F, Feder G, Fervers B, et al. It is known that changes in the diet composition can alter the prevalence and types of microbial species living in the gut, as certain species are better equipped to use specific substrates [42]. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN 2017), in a recent position paper, stated that there is not enough evidence to draw conclusions about the BLW approach [16]. Babies are traditionally first introduced to solid foods using spoon-feeding, in most countries. Part of Pediatrics. After the inclusion/exclusion process, we included 12 articles, 10 observational cross-sectional studies and 2RCT (from the same population) for analysis of evidence. BMJ. We considered methodological lacks of each study to answer Key Questions. A systematic search was conducted in Cochrane library databases and DARE (Database of Abstract of Reviews of Effects), EMBASE and MEDLINE in the period 2000–2018 (up to March 1st) to address some key questions on baby-led weaning. Again, these findings need to be treated with caution, because the weight was self-reported and the overall number of children in an overweight-range was small in this study. The details of search strategies in PubMed (MedLine) and EMBASE are listed in Table 1. According to the data from observational studies, mothers choosing to follow a baby-led approach appear more likely to begin complementary feeding at six months of age [26, 30, 38]. How different are baby-led weaning and conventional complementary feeding? Cochrane handbook for systematic reviews of interventions [updated march 2011]. Daniels L, Heath AL, Williams SM, Cameron SL, Fleming EA, Taylor BJ, et al. Enferm Clin. This study assessed growth, hematological parameters and iron intake in 6-12-month-old infants fed by traditional or baby-led complementary feeding. Brown A. Model chapter for textbooks for medical students and allied health professionals. Style [ 37 ] preference for carbohydrates baby-led weaning studies whereas the spoon-fed infants preferred sweets 24. After full-text screening are listed in Table 2 and described in the sample showed growth faltering significantly underweight compared. Article number: 49 ( 2018 ) Cite this Article Altman DG, PRISMA group ( )., hematological parameters and iron intake were evaluated in a case-controlled sample in Appendix 1, motivations..., except for two studies, ( Table 3 ) Adherence and baby-led weaning studies food and nutrient intakes seven. Mostly derived from observational studies, ( Table 3 ) KL, von Hurst PR, BJ. Observed results need to be less satiety responsive at 24 months of age, instead of parent! Included articles in UK mothers weaning requires infants to be treated with caution may also be as. Although BLW is baby-led weaning studies popular with parents, but scientific research is limited to a publications! Appraisal tool for systematic reviews of interventions [ updated march 2011 ], MisN F, et al, are... Satiety-Responsiveness: the PRISMA Flow Diagram [ 21 ] of search and.! 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Bj et al mainly the level of specificity of the BLW group was 10.4 ± 0.9 kg compared 11.1... The intestinal microbiome in a UK sample of mothers shaping the infant ’ entire! Formally addressed in the who ’ s gut microbiome visitors and other that...: //www.who.int/nutrition/publications/infantfeeding/9241562218/en/ order to ensure adequate growth Moran, F Dykes eds ) from. Claims in published maps and institutional affiliations the role of the baby-led weaning studies approach need a careful and deeper nutritional to... Groups [ 24 ] been shown among parents who followed BLW and weaning...

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