5 May 2017 - The Conversation - Does spoon-feeding really make babies overweight?

Deciding when and how to introduce babies to solid foods can be overwhelming for parents. But aside from timing and amount, could how babies are introduced to solid foods also make a difference to their health?

Until the early 20th century, babies were simply given foods that the rest of the family ate, towards the end of their first year. This was before the dawn of the baby food industry led to the majority of babies in Western countries being weaned onto solid foods using specially prepared, pureed infant foods that are spoon-fed.

However, since government recommendations in 2003 changed to introduce solid foods at six months, increasing numbers of parents have been returning to letting their baby eat the same food as the rest of the family, by following baby-led weaning. Evidence suggests that delaying introduction of solids until six months may protect against babies becoming overweight. So spoons and purees are being forgone to let infants eat at their own pace – which they are typically developmentally able to do at six-months-old.

Research has found that parents are choosing baby-led weaning because they feel it makes for less stressful and easier (albeit messier) mealtimes. But growing numbers of parents also choose to follow the method because of suggestions that it may help their baby develop better eating habits and a healthier weight – but is this true?

The evidence so far

Limited research on baby-led weaning suggests that, to some extent, yes, it can help children develop better eating habits. Preschool children who followed baby-led weaning are less likely to be overweight than those who were spoon-fed. Similarly, toddlers who had followed the approach were less likely to be fussy eaters, less likely to overeat and were less likely to be overweight.

But is it really as simple as saying that spoons and purees are potentially putting babies at greater risk of being overweight and developing picky eating habits? In a nutshell, no.

A more balanced explanation is that baby-led weaning promotes a number of behaviours that positively shape an infant’s appetite and weight development. The baby-led approach naturally encourages parents to let their baby go at their own pace when eating. Research with older children shows that when parents are too controlling over what and how much their child eats, the child is more likely to go on to develop weight problems and be a fussy eater. Babies and young children are good at regulating their intake of food according to energy needs but parents encouraging them to finish all the food on their plate, or withdrawing certain foods so they crave them, can break this down.

The baby-led approach, on the other hand, allows infants to be in control, rather than parents. Although spoon-feeding parents may be responsive, the baby may accept more food than it would eat when self feeding.

We also know that adults who eat slowly are less likely to be overweight. The same could very well apply with infants: naturally, it takes more time for an infant to self-feed and chew whole foods than it does to be spoon-fed purees.

Potentially, the way food is presented to infants who are following baby-led weaning may promote a wider variety of intake too. Food in its whole form may not only be more appealing than puree, but self-feeding also allows infants to explore how foods feel. We know that this is an important part of how children learn: when older children are allowed to play with food they are more likely to eat it.

The importance of context

It could be that the healthy food attitudes gained through baby-led weaning are due to factors unrelated to the experience, however. Baby-led weaning has often been linked with breastfeeding as a natural follow on. Breastfeeding mothers are more used to their baby being in control of feeding – although bottle fed babies do follow baby-led weaning too. On average, breastfed babies are less likely to be overweight or fussy eaters and this might explain the difference, rather than weaning approach.

Healthy attitudes might also be developed because of the type of parent who chooses to baby-led wean. Babies who have a more difficult temperament are typically weaned earlier, before the recommend six months point, meaning they are likely to be spoon-fed. Mothers who are more anxious about their baby are also more likely to spoon feed too. This anxiety is linked to non-responsive feeding, which can increase the risk of the child being overweight.

Overall, it’s not a clear answer but current research does suggest that infants who follow a baby-led weaning approach may go on to be better eaters and have a healthier weight – but more studies are needed to confirm this.

However, this doesn’t mean that parents who choose to spoon-feed should worry. Babies’ food attitudes are unlikely to be anything specifically to do with spoons, but rather positive feeding interactions. Giving purees within a mixed diet is unlikely to have a negative impact; what is important is variation, chance to explore and, most importantly, a laid-back parenting approach.