Starting Solids With Baby: Purees vs Baby-Led Weaning

Babies…they don’t come with a manual…and nor should they, as they are all fascinating little beings with unique ideas and personalities; each growing and developing in their own marvellous way. One thing I’ve learned through motherhood and over my career is that no two kids are the same. A ‘one size fits all’ approach does not work with children.

My daughter Sydney was speaking in full sentences by 18-months and my son Thomas didn’t utter any single words until almost his second birthday. He loved baby-led weaning while she preferred purees and mashed foods. Sydney was always the star of the show; she loved people and would walk off with a stranger if I let her, while Thomas was painfully shy and would hide behind my legs if anyone looked at or spoke to him. Same parents. Same environment. Totally different kids.

Which leads me into this guide about starting solids...

Every week, parents ask me about the “best” or “right” way to start solids with their baby, and with the popularity of baby-led weaning and social media, they feel a lot of pressure to get it right. Many of them are scared.

Here’s the thing…there is no “right” or “wrong” way to introduce food to your baby. There are different ways to approach solids, and while baby-led weaning may work well for one child, it may not be the best for another. Some babies do better to progress gradually through food textures - moving from liquids to thin purees, to mashed foods, to chopped/minced textures, and then onto soft chewable table foods. Other babies prefer lots of independence and embrace baby-led weaning (BLW), jumping into self-feeding soft sticks of foods that they can explore and put into their own mouth.

What if a parent is scared and uncomfortable with the idea of baby-led weaning?

What if they have a severe fear of their baby choking?

What if watching their baby gag creates a great deal of stress and anxiety?

Feeding is a dance, between partners, preferably with baby in the lead. But with any dance, isn’t it best if everyone is enjoying themselves? Some parents have told me that mentally, they just can’t do it, and they have opted for someone else in the home to feed their baby because baby-led weaning makes them so anxious. Somehow, they have come to feel that it’s better to miss out on feeding their baby than to not do baby-led weaning. This makes me sad, as I know well the emotions parents go through when they are struggling with feeding their baby. Here are two blogs about parent mental health and feeding that might be helpful: "I Dread Mealtimes" and "Feeling Judged About Your Child's Feeding"

I frequently talk to parents about how social media is both a gift and a curse. Instagram, TikTok, and Facebook offer a wealth of parent resources about how to feed babies. I love following these accounts and connecting with and learning from my feeding colleagues. Many accounts feature reels/videos of babies starting solids using baby-led weaning, self-feeding, mapping-out their mouths, and working through gagging and spitting. While these videos can be a great resource for some parents, they can also create feelings of fear, disappointment, and doubt for others. I have always loved the quote, "Comparison is the thief of joy." - Theodore Roosevelt

A mom recently said to me,

“They never show any videos of the kids that did really poorly with baby-led weaning, and the stress and failure that the parent experienced when their baby couldn’t do it.”

Feeding Babies with Special Needs

Some of the babies I work with were born prematurely, have complex medical issues, developmental delay, or sensory processing difficulties that can make baby-led weaning extremely challenging/risky for them. 

Fear of Baby Choking

Some of the parents I work with have had a personal experience with choking and they are scared of baby-led weaning. The trauma of having choked themselves or seeing someone choke can lead to a very real fear for their baby. Another parent told me that they had lost several pregnancies and were terrified of losing their beautiful, healthy baby to choking. Some moms are dealing with postpartum anxiety and feel overwhelmed with expectations around how to “best” feed their baby.

A mom of an 8-month-old said to me this week,

“Nicola, I’m terrified at feeding times. I feel so bad that I might be doing something wrong. Am I creating a feeding delay? Is she going to have feeding aversion because I can’t bring myself to do baby-led weaning? I can’t even watch the videos on social media showing babies eating big pieces of food, it makes me so anxious. Why can’t I just do it the way my Mom used to feed me starting with pureed baby food?”

Is it ok to not do baby-led weaning? Yes, it's always ok to start solids the way that feels best for you and your baby. Feeding without shame is best.

Fed is Best is a wonderful foundation that provides education and resources related to infant bottle and breast feeding, that "strives to eliminate infant feeding shaming while prioritizing perinatal mental health." When parents are choosing whether to breast or formula feed their baby, we say fed is best. Just as breastfeeding is not for everyone, nor is baby-led weaning. Whether parents are deciding to start solids with purees or a baby-led weaning approach the same principle applies...fed is best. No shame. No judgement.

Happy baby + happy parent = happy feedings

Happy feedings = better growth and nutrition and a positive relationship with food

When to start solids/baby-led weaning: Is it better to start solids at 4 months or 6 months?

Some doctors still advise starting babies on rice cereal and solids around 4 months old, but as of 2021, the Canadian Pediatric Society (CPS), American Academy of Pediatrics, U.S. National Institutes for Health, and World Health Organization all recommend waiting until your baby is around 6 months old and showing signs of readiness to introduce solids. Canadian Pediatric Society offers guidelines for starting solids: Caring For Kids (CPS)

I love the term “baby-led feeding”…meaning regardless of whether parents decide to introduce purees, mashed foods, or hand-held foods to their baby, the key is that baby leads the dance. Babies can still participate in self-feeding with purees! Baby-led weaning can be adapted so that parents enjoy feeding their baby and use a more gradual approach toward finger foods. This baby-led approach can start on day one of starting solids. I always say, “The highchair tray should never be clean or empty.”  That means that right away you can let your baby get involved in the feeding process by looking, touching, smelling, squishing, and splashing in their food.

What you will need when starting solids with baby

• A highchair with a tray that offers supportive positioning including foot support
• Bibs (up to you! I always fed my kids in their diaper for easier clean-up)
• Plates and bowls with a rim that suctions to the tray (e.g., EZPZ Mini Mat)
• Spoons, prespoons (e.g., NumNum Prespoon GOOtensils)
• An open cup (e.g., EZPZ Tiny Cup)
• Washcloths

How to start solids using baby-led feeding with purees

• Create a calm, peaceful environment without too many distractions.
• Always provide supervision at feeding times.
• Eat alongside your baby! Model eating from a spoon at eye-level. Smiling and talking to your baby during mealtimes can help support early language development.
• Let your baby get messy! (Mealtime Mess Vs Manners)
• Place purees/mashed foods directly on baby’s tray for them to touch and explore with their hands. Touching foods helps baby's brain to learn what the food will feel like in their mouth and to prepare them for the sensory experience of eating.

• Preload baby utensils and hand them to baby to self-feed or place them on the tray for baby to pick-up and bring toward their mouth.
• Preload utensils and offer them to baby in a vertical position (food pointing toward the ceiling) so they can reach forward, grasp the spoon, and bring it to their mouth to self-feed.
• Dip baby’s favourite mouth toys/teethers in purees and hand them to baby or place them on the tray to allow self-feeding. There is no rule that babies must eat from a spoon! Try dipping a Baby Banana brush, Zoli teether, or favourite teething toy in blended foods!
• If you are occasionally using pouches, let baby hold the pouch to encourage self-feeding. If you are using a spoon, let your baby reach forward and pull it toward their mouth.

• As your baby becomes successful with purees, begin to gradually thicken the food and increase the texture. You can add dry infant cereal to purees to thicken or you can fork mash soft-cooked foods (e.g., avocado, banana, cooked sweet potato) into purees to gradually create a thicker, uniform consistency.

• Limit feedings to about 15 -20 minutes. End the meal when baby shows signs of being done. Always follow baby’s lead…avoid distracting, pushing, tricking, or coaxing your baby to eat.
• Here are some tips about gradually increasing baby’s food textures: Feeding Your Baby in the First Year

How to start solids using baby-led weaning (BLW)

• Create a calm, peaceful environment without too many distractions.
• Always provide supervision at feeding times.
• Let your baby get messy!
• Place soft pieces of foods directly on the tray, so baby can look, touch, smell, squish, and pick-up the foods.

• Offer foods that pass the “squish test” = the food breaks apart easily when squeezed between your thumb and fingers (e.g., think avocado, roasted sweet potato, hard-boiled egg).
• Offer foods that are about the size and shape of your 2 of your fingers. This will make grasping easier. As your baby develops a pincer grasp, you can start giving cubes of soft foods.

• Don’t worry if baby does not always bring the food toward their mouth. Touching and exploring is part of learning about food.
• Eat alongside your baby! You can provide slow, exaggerated models of chewing with your mouth open, so baby can see how your use your mouth to bite and chew. Smiling and talking to your baby during mealtimes can help support early language development.
• You can model breaking off pieces of soft table foods with your front teeth and using your tongue to push the food forward and spit-it out. This shows baby what to do when they have too much food in their mouth.
• Expect gagging when baby is learning to eat. Avoid overreacting to gagging and remain neutral. You can redirect baby by modelling what to do when they are gagging (e.g., chew or push the food forward with your tongue).
• Excessive gagging or frequent gagging and vomiting can lead to a negative association with early eating experiences, so it’s important to consult with a feeding therapist if your baby is gagging a lot when eating solids.
• Expect food to fall out of baby’s mouth. This is also part of learning to eat as baby learns to coordinate their mouth muscle movements.
• Limit feedings to about 15 -20 minutes. End the meal when baby shows signs of being done. Always follow baby’s lead…avoid pushing, tricking, or coaxing your baby to eat. Research shows that pressuring your child at mealtimes can reduce their willingness to eat.

First Foods for Baby-Led Weaning

• Avocado
• Roasted sweet potato
• Hard boiled egg
• Soft-cooked broccoli/carrot
• Banana
• Mango slices

What does the science say about baby-led weaning?

Are babies less likely to be a picker eater with baby-led weaning? The research says, not by much. Babies may be less picky about their food if they are fed using baby-led weaning compared to other types of feeding, it’s just not by that much.

Are babies more likely to choke with baby-led weaning? The research says no. Several studies have found that baby-led weaning did not cause more choking than traditional spoon-feeding.

Foods to avoid due to choking risk

• hard foods like nuts, hard candy, raw fruits and veggies, dried fruits
• round foods like grapes, berries, cherries, grape tomatoes, hot dogs
• large tough chunks of meat or cheese
• popcorn
• globs of peanut butter

Baby CPR/First Aid

I encourage parents to take a baby CPR course, as this can be educational and empowering and provide parents with confidence and tools to help their baby on their feeding journey. Here's a virtual CPR course with SickKids Hospital 

Know the difference between Gagging and Choking

Gagging is a perfectly normal part of learning to eat new foods but can be mistaken for choking. When a baby is gagging, they will be able to make noise, like coughing, while a choking baby may turn blue and will not be able to make noise or cough. 

Can I do both purees and baby-led weaning? Do you have to skip purees with baby-led weaning?

You can do liquids, purees, mashed foods, and finger foods all at once! Combo feeding is a great way to introduce your baby to new textures and tastes. Purees give your baby practice with swallowing food. Fork mashed and hand-held sticks of soft food can help develop your baby's mouth muscles. Adults eat purees and mashed foods as part of our diet (e.g., soups, yogurt, applesauce), so there's nothing wrong with offering a combination of foods and textures to your baby.

Can I help my baby eat? If baby wants you to...please do!

If your baby is leaning forward with an open mouth to indicate "yes" then it's ok. If your baby is closing their mouth or pushing the food away to indicate "no", then it's not ok to put food into their mouth. Some babies I see benefit from a bit of help with self-feeding, they need assistance to teach and encourage them to bring foods toward their mouth. As long as the feeding approach is responsive and directed by the child, then it's fine to help your little one while they learn to eat, just remember to always encourage self-feeding and independence along the way.

If I had but one wish for parents, it would be that they enjoy feeding their baby, that both partners relish the dance. That stress is low, smiles are abundant, and food is celebrated. If in order to achieve this, you prefer to start your baby with purees and gradually work forward with food textures, then that's always the "right way" to feed your baby.

References

Caring For Kids: Canadian Pediatric Society (CPS): Feeding Your Baby For the First Year

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Cameron SL, Taylor RW, Heath AL. Development and pilot testing of baby-led introduction to SolidS--a version of baby-led weaning modified to address concerns about iron deficiency, growth faltering and choking. BMC Pediatr. 2015;15:99. doi: 10.1186/s12887-015-0422-8. [PMC free article] [PubMed] [CrossRef] [Google Scholar]

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Centers for Disease Control and Prevention. (2020, December 11). Choking Hazards. Centers for Disease Control and Prevention. https://www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/choking-hazards.html. 

Fangupo LJ, Heath AL, Williams SM, Williams LW, Morison BJ, Fleming EA, Taylor BJ, Wheeler BJ, Taylor RW. A baby-led approach to eating solids and risk of choking. Pediatrics. 2016;19:e20160772.

Brown A, Lee M. Maternal control of child feeding during the weaning period: differences between mothers following a baby-led or standard weaning approach. Matern Child Health J. 2011;15(8):1265–71.

Daniels, L., Heath, AL.M., Williams, S.M. et al. Baby-Led Introduction to SolidS (BLISS) study: a randomised controlled trial of a baby-led approach to complementary feeding. BMC Pediatr 15, 179 (2015). https://doi.org/10.1186/s12887-015-0491-8: https://pubmed.ncbi.nlm.nih.gov/26563757/

Baby-led weaning or spoon feeding? The difference it makes to your child’s eating habits is actually very small: https://theconversation.com/baby-led-weaning-or-spoon-feeding-the-difference-it-makes-to-your-childs-eating-habits-is-actually-very-small-113219