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Impact of a modified version of baby-led weaning on iron intake and status: a randomised controlled trial
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  • Published on:
    Response to ‘Baby-led weaning and iron - looking good but not clear-cut’
    • Anne-Louise M Heath, Associate Professor University of Otago, New Zealand
    • Other Contributors:
      • Rachael W Taylor, Research Professor
      • Jillian J Haszard, Biostatistician
      • Lisa Daniels, Postdoctoral Fellow

    Gill Rapley makes some useful points about our recent paper (Daniels, L., Taylor, R.W., Williams, S.M., Gibson, R.S., Fleming, E.A., Wheeler, B.J., Taylor, B.J., Haszard, J.J. and Heath, A-L.M. (2018) Impact of a modified version of baby-led weaning on iron intake and status: a randomised controlled trial, BMJ Open, 8: e019036).

    In particular, she points out that:
    (a) While our Baby-Led Introduction to Solids (BLISS) intervention group was given specific advice on increasing iron intake, the Control group received only standard care.
    (b) It is not clear whether the infants in the BLISS group would have had equivalent iron status to that of the Controls even without the additional advice.
    (c) Infants following a traditional approach to infant feeding may also need advice to improve their iron intake, particularly now that complementary feeding should ideally be delayed to 6 months of age.

    There are many interesting questions that can be asked about baby-led approaches to complementary feeding, and their impact on infant nutrient status. Each of these questions would need a different study design. In our case, we were interested in answering the pragmatic question – Is it possible to follow a baby-led approach to infant feeding instead of traditional feeding without negatively impacting on iron status? This required that we have an intervention group (our BLISS group) and a group representing the status quo, i.e. what is happening in the commu...

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    Conflict of Interest:
    None declared.
  • Published on:
    Baby-led weaning and iron - looking good but not clear-cut

    It is reassuring to learn that a modified version of the approach to the introduction of solid foods for infants known as ‘baby-led weaning’ does not lead to an increased risk of iron deficiency (Daniels, L., Taylor, R.W., Williams, S.M., Gibson, R.S., Fleming, E.A., Wheeler, B.J., Taylor, B.J., Haszard, J.J. and Heath, A-L.M. (2018) Impact of a modified version of baby-led weaning on iron intake and status: a randomised controlled trial, BMJ Open, 8: e019036). However, before drawing firm conclusions it is important to note that two variables were at play in this trial: One group – the BLISS (‘modified BLW’) group – followed a self-feeding approach and received specific information concerning the method, which included an emphasis on the importance of offering iron-rich foods; the other (control) group spoon-fed their infants and received only standard care, with no extra information regarding iron.

    While it is indeed possible that iron levels in the BLW/BLISS group would have been lower, had the parents not been given additional dietary information – as implied by the authors’ cautious conclusion – it is equally possible that drawing their attention to the need for iron either had no effect, or had a negative impact that was offset by the infant being allowed to feed himself. Without a comparison between a self-feeding group and a spoon-feeding group, where both groups have the same information regarding iron, or between two BLW groups, only one of which is advise...

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    Conflict of Interest:
    None declared.