Infants are introduced to solid foods around six months, however, milk still remains the main source of nutrition for babies up until the age of one. This phase is called weaning or complementary feeding. While both terms are used, the World Health Organisation (WHO) tends to prefer the term complementary feeding as it indicates the continuation of the infant to drink milk. Two popular approaches to introducing food to infants is spoon-feeding or baby-led weaning (BLW). However, the questions of which approach to use as well as the quantity and which foods to introduce remain mostly inconclusive.

WHO recommends offering infants blended foods that are easy to digest from six months, and gradually introduce foods that increase in texture until the age of one. Finger foods are usually recommended around the eighth month. Traditionally, there was a preference for spoon-feeding as complementary feeding usually took place at four months of age.

At this stage, babies are unable to sit upright and bring food to their mouth, making it impossible for babies so young to eat by themselves. However, with baby-led weaning, babies are introduced to foods in their whole form allowing infants to choose what they would like to eat together with how much during mealtimes.

Food which is specifically prepared for babies has no added sodium and so family foods are usually unsuitable for infants due to their high level of sodium

While in theory, giving infants the opportunity to choose what and how much to eat gives babies a sense of control, those caring for their infants are concerned about issues such as whether or not they are having enough nutrients, and the risk of choking. Food which is specifically prepared for babies has no added sodium and so family foods are usually unsuitable for infants due to their high level of sodium, as well as being a choking hazard.

In order to appease infants’ carers’ concerns with respect to nutrition they need to be made aware to include and present the right high-iron rich foods to their infants. On the other hand, a longitudinal study showed no differences in weight at birth or six months between those who were spoon-fed and BLW. This was not the case with the 18-24 month age group, with the infants who were spoon-fed being significantly heavier than those following the BLW approach. However, weight gain was self-reported, which could lead to bias.

Whatever approach the parent or carer chooses needs to be infant-led as research about which approach is better for future eating habits is inconclusive at best. WHO recommends that what is important is that the food provided to infants is rich in energy and nutrients, clean and safe, if locally available and affordable.

Danielle Martine Farrugia is a PhD candidate, science communicator and lecturer.

Sound Bites

•        The global strategy for infant and young child feeding builds upon past initiatives in promoting, protecting and supporting appropriate infant and young child feeding. Past initiatives include the Innocenti Declaration and the Baby-friendly Hospital initiative to address the needs of all children especially those living in difficult circumstances such as infants whose mothers live with HIV, low birth weight infants and those born in emergency situations. This global strategy specifies responsibilities of governments, international organisations and non-governmental organisations.

•        Introducing children to a range of food textures depending on their age is important for developmental progress but may also play a factor in later dietary behaviours. Children tend to accept a range of food textures if they are introduced between the sixth and the 12th month.

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DID YOU KNOW?

•        At around the fourth or sixth month, the nerves and muscles in the baby’s mouth develop enough to allow for munching, biting and chewing.

•        The babies’ digestive system is mature enough to digest a range of foods at around four to six months.

•        If spoon-fed, babies should be given two teaspoons of food twice a day and gradually increase the amount and variety of food.

•        By nine months, a child should be eating a variety of family foods.

•        In many countries less than a fourth of infants between the ages of six and 23 months meet the recommended nutritionally adequate and safe complementary foods appropriate for their age.

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