BLISS – Baby Led Introduction To Solids – May Make Feeding Less Fussy Interview with:
Dr. Anne-Louise M. Heath and

Professor Rachael Taylor
Co-Principal Investigators for the BLISS study. What is the background for this study? What are the main findings?

Response: Conventional approaches to complementary feeding generally advise parents to spoon-feed their infant pureed foods, gradually progressing to greater variety and texture so that by the time the infant is one year of age, they are eating more or less what the family does.

Baby-led weaning (BLW) is an alternative approach where the infants feeds themselves right from the start of complementary feeding. Because children of this age cannot use utensils, this means hand-held foods are necessary. Advocates of BLW suggest that children have a lower risk of obesity because they remain in control of their own food intake, but research examining this issue directly is scarce. Health professionals have also expressed concern that BLW might put the infant at increased risk of iron deficiency (parents might avoid red meat for fear of the infant choking, and iron-fortified cereals are not easy for the infant to feed themselves), growth faltering (if only low energy foods are offered) and choking (from the infant feeding themselves ‘whole’ foods).

Our study therefore examined a version of BLW that had been modified to address these issues (called BLISS – a Baby-Led Introduction to SolidS). Two hundred families took part in our 2-year intervention, with half following traditional feeding practices and half receiving guidance and support to follow our BLISS approach. We found that BLISS children were not less likely to be overweight than those following traditional feeding practices, nor was growth faltering an issue. BLISS child ate about the same amount of food as control children, and their ability to eat to appetite was not different either.

However, it seems that children following a baby-led approach to complementary feeding are less fussy about food, and have a healthier attitude to food, which might make a difference to their health long term. What should clinicians and patients take away from your report?

Response: We found that a baby-led approach to complementary feeding could be an appropriate alternative to more conventional weaning practices in that it did not promote underweight or overweight at least until two years of age. The improvements in food fussiness might be of particular interest to parents, who can find this behaviour very stressful in their children. What recommendations do you have for future research as a result of this study?

Response: Our study was a carefully conducted randomised controlled trial, where participants did not get to choose whether they were followed a conventional or baby-led feeding approach. This means that we can confidently answer questions about the true effect of a baby-led approach – but it does not tell us what people in the community do without the guidance and support we provided. A large observational study is also required to determine the health status of children who are weaned following baby-led versus conventional approaches. 

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Taylor RW, Williams SM, Fangupo LJ, Wheeler BJ, Taylor BJ, Daniels L, Fleming EA, McArthur J, Morison B, Erickson LW, Davies RS, Bacchus S, Cameron SL, Heath AM. Effect of a Baby-Led Approach to Complementary Feeding on Infant Growth and OverweightA Randomized Clinical Trial. JAMA Pediatr. Published online July 10, 2017. doi:10.1001/jamapediatrics.2017.1284

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.




Last Updated on July 10, 2017 by Marie Benz MD FAAD