Doctors’ Notes


Baby-Led Weaning

“Baby-led weaning” is a term used to describe the process of introducing solid foods to an infant by allowing them to feed soft, appropriate foods to themselves.

Baby-led weaning can allow your baby to be an active partipant in their feeding, which for some families can make meal times more enjoyable. It can also help to develop an infant’s hand-eye coordination by allowing them to practice the skill of picking up food and placing food in their mouth. It can also help infants start to self-regulate their diet, which can carry on throughout their life and help with weight management, which can lead to overall health improvement.

Is Baby-Led Weaning Safe?

There are only a handful of studies to date evaluating the safety of baby-led weaning. One well-designed study published by the American Academy of Pediatrics in 2016 found that infants fed by baby-led weaning did not show any difference in choking events when compared to spoon-fed infants infants. (It’s important to note that for this study, “baby-led weaning” was a modified version which provided caregiver education on how to safely practice baby-led weaning before beginning the process.)

This study did report three additional outcomes which need to be addressed for infant feeding safety.

1. In both the baby-led weaning and spoon feeding groups, infants were offered foods that posed a choking risk.

2. In both groups, infants were not closely supervised while eating.

3. In both groups, infants had a small number of serious choking episodes

These results reinforce that infant feeding in general, either via baby-led weaning or spoon feeding, does a potential safety risk and should be done with close supervision and after appropriate education.

How Should Baby-Led Weaning be Conducted?

Wait until your baby is 6 months old before beginning to attempt baby-led weaning, and make sure they’re showing feeding readiness cues. For example, they should be able to hold themselves up while sitting, and they should be able to grab food and place it into their mouth.

Your baby must always be upright, and there must always an adult present during the entire feeding.

Foods should be tested by an adult before being offered to the child to ensure they’re either soft and mashable or fibrous and large enough that small pieces do not break off when sucked and chewed (as, for example, with strips of meat). Crumbly foods should not be offered.

Foods offered should be at least as long as the child’s fist, on at least one side of the food, until the child is equipped to manage small pieces of food.

The infant should be responsible for putting food in his or her mouth at his or her own pace and under his or her own control.

Caregivers should avoid foods that pose a high choking risk, such as:

• Foods that can’t be mashed well with the tongue and roof of the mouth

• Very small foods, like nuts, grapes, sweets, small fruits with stones (unless you have removed the stones)

• Raw vegetables

• Underripe or hard fruits (including raw apple, either whole or sliced)

• Citrus fruits (unless each segment has been peeled)

• Whole nuts (nut butters are fine)

• Popcorn

• Sausages, carrots, or other similar foods cut into round segments or “coins”

And remember: no honey before 12 months of age!

Is Baby-Led Weaning Better Than Spoon-Feeding?

There is currently no research to support that baby-lead weaning is superior to spoon feeding, or vice versa. Infants that begin learning to eat by spoon feeding often progress to self-feeding without any concern. While there are benefits to baby-led weaning as discussed above, we recommend following the feeding method with which you and your family are most comfortable, and then following safe feeding guidelines for that method.

One More Reminder

It’s important to remember that with any infant feeding, choking is always a risk, and safe feeding practices should ALWAYS be followed. Learning CPR can be helpful, so you know in advance how to help your child should he or she having a choking episode. For more questions about safe infant feeding,  give us a call in the office, or ask the provider at your child’s next well visit!

Rachel McCarrison, DNP, RN, CPNP-PC, has been a Kids Plus Provider since 2016.

Jesse Laughner spent a rotation at Kids Plus as a PA Student from Slippery Rock University.