BLW: When to Start

Every day, I have parents email or message me asking if they can start BLW with their child. Be it as early as four months or more commonly sometime around five months old, parents feel their child is ready and are eager to get started (albeit often unsure of what that actually looks like). Many parents may or may not have read the posts I have shared so far on how to safely introduce solids (as shared if you scroll down here), so I thought it might be helpful to review some of the key concepts that dictate the timing for when solids are introduced using BLW (since these aren’t the same as when you offer purees).

 
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Unlike the more forgiving nature of offering soft, smooth purees by spoon, the BLW approach requires developmental readiness to promote safe and successful feeding experiences (as discussed here).

This post will address what age you can safely start BLW.

Exclusive Breastfeeding to Six Months

While there is much debate on when the best time to start solids is, most BLW experts posit that infants be exclusively breastfed to six months. While some families may be offering bottles of breastmilk or formula (instead of or in addition to nursing), nursing is considered to most ideal way to feed during the “preparation phase for self-feeding” (anything prior to six months of age). Beyond the nutritional advantages of breastmilk over formula, a comprehensive study on BLW suggests that,

“A breastfed infant is better able to self-regulate their intake by feeding for as long and as often as they need, in contrast to a bottle fed infant who is offered a set amount of milk predetermined by the caregiver, and is therefore a more passive participant.”

Self-regulation of intake by the infant is a core tenet to BLW. While it can be established after solids are introduced, BLW considers it ideal to establish this approach to feeding and eating as early as possible, for both parent and child. This said, my first two children were both bottle fed, so I fully recognize and honor that in many families, predominantly nursing may not be the norm nor even a reality. If/when this is the case, that does not mean your child will be any less able or equipped to eat successfully with a BLW approach. It only means that as a family, practicing infant-led feeding approaches may require just that - practice. Letting your child decide if/when and how much to eat will be a life skill infants can develop in infancy and use in each developmental stage moving forward.

Self-Feeding from Six Months

Parents are encouraged to wait until six months of age before starting BLW, or as close to then/when an infant usually shows the developmental cues of readiness necessary to begin self-feeding. Such gross, oral, and fine motor skills usually present at around six months of age. If an infant is not six months of age nor shows the developmental cues required for BLW, the only safe feeding option is the conventional method of spoon-feeding purées. The following addresses some of the skills required and how they specifically related to the BLW feeding approach.

Developmental Cues Required for BLW

As any parent has witnessed, there are considerable differences in an infant’s development between four and six months of age. Advocates of BLW propose that an infant at six months of age is developmentally more advanced and therefore does not require purées nor to be spoon-fed by someone else. Instead, infants show the following gross, fine, and oral motor skills necessary for successful and safe self-feeding.

Gross Motor

A study published in the Journal of the American Dietetic Association (now known as Journal of the Academy of Nutrition and Dietetics) found that the gross motor skills required for self-feeding are postural stability (the ability to sit with little or no help) and to reach for and grasp objects. Self-sitting is considered necessary for successful BLW because the ability to sit with little or no support allows the infant to use their arms to reach for food, rather than for balance. Research also concludes that at the time self-sitting abilities emerge (around 5 months), infants also start to develop coordinated use of their hands in object manipulation and exploration.

Fine Motor

Due to the way foods are offered with BLW, adequate development of fine motor skills are key. Infants need to be able to grasp “finger-like” pieces of food and bring them to their mouth for self-feeding. There has been some concern that infants using a baby-led technique may not have adequate energy intake, or rather the physical stamina necessary to eat enough calories, when compared to those who are spoon-fed and parent-led. The infants considered at greatest risk of failure to thrive are thought to be those whose self-feeding skills are under-developed and thus, cannot accomplish an adequate intake with self-feeding. If an infant appears to lack the stamina to self-feed for adequate growth, parents should consider speaking with their health practitioner and/or a pediatric dietitian to rule out other issues and promote the skills required for self-feeding. Monitoring for nutritional adequacy and charting overall growth trends can help identify any issues early and prevent actual problems from presenting. This said, while the introduction of solids in infancy is important to a child’s nutritional and developmental status, breast milk or formula should continue to provide the main source of nutrition through at least the infant’s first year of life and promote appropriate growth as complementary foods are introduced.

Additionally, parents can help their infant develop fine motor skills for self-feeding with simple adaptations to the foods offered. Some ideas for modifications include cutting foods using tools that improve an infant’s ability to grasp it or to offer some skin on more slippery foods, such as bananas, pears, and peaches.

Oral Motor

As an infant is able to grasp food and coordinate the movements necessary to make it into their mouths, they also must be able to safely “chew” and swallow such foods. As it relates to choking, this is likely the greatest concern and complaint about BLW. To many parents surprise, even infants with no teeth are able to adequately gum through soft foods, such as those suggested with BLW. The motion is described by one source as, “a munching type of oral-motor activity, using up-and-down movements of the jaw to break up food.” In infants as young as six months, this motion is considered adequate to breakdown soft foods.

As an infant develops, their tongue develops the lateral mobility necessary to move food around in the mouth, take food to the back of their mouth, and swallow. As teeth emerge, infants are able to tolerate even more texture and firmness, further expanding their options for safe finger foods. With BLW, infants may develop the skills necessary for self-feeding better than those who are fed strictly purees. The reason is because BLW puts evolving oral motor skills to use with a variety of textures. Conversely, waiting too long to introduce infants to texture (considered after 9 months by most research) may increase the likelihood for feeding difficulties and fussy eating.

When Can You Start BLW

When many parents first reach out to me about if/when they can start BLW, they usually have tried a food or two and wonder if the way their child is responding is appropriate or indicative of the child not yet being ready. While both cases can be true, it is important for parents to go through the proper evaluation of such gross, fine, and oral motor skills prior to offering any foods. Then, as adequacy in these skills is seen, to begin safely introducing foods after around the six month mark.

For more ideas on what foods to offer and how to prepare such options, sign up for my newsletter so that you get information on this as the upcoming posts are published!