Baby-Led Weaning & Early Introduction of Top Allergens

By Malina Linkas Malkani, MS, RDN, CDN

The way we feed babies has changed dramatically over the past twenty years or so. While not a new approach to the introduction of solid foods, “baby-led weaning” (BLW) has become more mainstream and understood as a beneficial and viable option with evidence-based short- and long-term benefits. Scientific evidence supporting the early introduction of top allergenic foods during infancy for the prevention of food allergies has also grown. In fact, the new 2020-2025 Dietary Guidelines for Americans recommend offering top allergens (egg, peanut, tree nut, cow’s milk, fish, shellfish, soy, and wheat) early and often starting at about 6 months of age when babies are showing signs of readiness for complementary foods (in conversation with the pediatrician if babies are at high risk for food allergies).[vii]

The good news is that BLW is incredibly compatible with the early introduction of top allergens and can ease the process of offering these foods during infancy.

BLW is defined as the process of starting a baby on complementary foods using appropriately sized and textured finger-foods for self-feeding, starting at about 6 months of age with signs of readiness. It offers many advantages, however what makes it so unique is the “baby-led” aspect. As opposed to being passively spoon-fed, babies self-feed and decide whether and how much to eat, strengthening their own internal self-regulation systems, and boosting fine motor skills.[i] BLW promotes an earlier integration of babies into family meals, less picky eating in early childhood, healthier overall food preferences, and more adventurous eating.[ii],[iii],[iv],[v]  Easier in general for caregivers, it saves both money and time, as babies can eat the family meal with some minor adjustments (such as reserving a portion for baby before adding salt), reducing the need to purchase baby food and/or prepare separate meals.

A common misconception about BLW is that offering finger foods during infancy increases choking risk, however studies actually show that when parents are educated on food sizing and texture, BLW does not increase the likelihood of choking.[vi] Additionally, how we size finger foods for babies does not depend on the baby’s age or number of teeth, but rather which type of developmental grasp they use to pick up pieces of food. At about 6 months, most babies use a palmar grasp and stick-shaped foods the size of an adult pinky-finger or larger are best. Usually by about 9 months of age (although babies each develop on their own timeline) most start using a pincer grasp and small chickpea-sized bites work best. Regardless of food size, the texture of foods should be soft and easily smashible between the fingers. This makes foods more manageable in the baby’s mouth and reduces overall choking risk.

Another common misconception about BLW is that purees are not allowed. Purees are an important texture for babies to learn and can be served in a way that supports self-feeding by offering on a pre-loaded spoon. Further, there is no evidence that taking a combined approach and using both BLW and spoon-feeding is detrimental. In the end, it comes down to what works best for the caregivers and baby.

Practical ways to build top allergenic foods into a baby’s diet during BLW include offering:

  • Pieces of scrambled or hard-boiled egg and strips of frittata or quiche (eggs are an excellent, nutrient-dense first food for babies with a soft texture that lends itself to infant feeding)
  • Peanut or tree nut butters stirred into yogurt, thinned with breast milk or water, cooked into muffins or pancakes, or spread in a thin layer on a finger of toast (note that whole tree nuts, peanuts and globs of any type of nut butter are a choking hazard for babies)
  • Peanut powder - delicious in apple fritters (see recipe!) and peanut snacks such as Mission Mighty Me, Bamba and Puffworks
  • Full-fat yogurt and low-sodium softer cheeses such as ricotta, mascarpone and mozzarella which offer baby-friendly ways to introduce cow’s milk
  • Fish and/or shellfish cooked into fritters or shredded and served in a sauce for pasta
  • Tender-cooked, smashed edamame for babies using a pincer grasp, or tofu cut into strips
  • Wheat offered in soft fingers of pancake, toast or waffle, baked into muffins, or stirred into yogurt or applesauce in the form of wheat germ

Ultimately, how to feed a baby is a personal choice. The caregiver can rest in the knowledge that throughout baby’s first year, breast milk/formula will continue to be the main source of nutrients while self-feeding skills develop. If there is any concern about a food allergy, caregivers should always consult the pediatrician and/or allergist who will guide next steps.

Regardless of the feeding method used – traditional, BLW or a combination of both – caregivers can help set their babies on a long-term healthy path by recognizing, listening and responding to the baby’s cues for hunger and fullness, diversifying the baby’s diet and offering a wide variety of foods, reducing the baby’s risk of developing food allergies by building top allergenic foods into meals early and often, and finding the joy and connection in eating together.
Recipe: Peanut Apple Fritters

Soft, juicy and without added sugar or salt, these peanut apple fritters offer an easy and nutrient-dense way to serve peanuts to babies who are at least 6 months of age and showing signs of readiness for solid foods. Cut fritters into strips for babies using a palmar grasp (usually 6-9 months of age), or small chickpea-sized bites for babies using a pincer grasp (usually 9-12 months of age).

Servings: 9 (3-inch) fritters

Prep time: 10 minutes

Freeze time: 10 minutes

Ingredients

  • 1/2 cup peanut flour
  • 1/2 cup oat flour
  • 2 teaspoons baking powder
  • 2 teaspoons lemon juice
  • 2 large eggs at room temperature
  • ¼ cup whole milk
  • 2 large apples, peeled and diced
  • Peanut (or vegetable) oil for frying

Directions

1.    Wash, peel, core and dice apples, place in a medium bowl and toss with lemon juice to prevent browning.

2.    In a separate medium bowl, whisk together the flour and baking powder.

3.    Add eggs and milk to the flour mixture and whisk until combined.

4.    Fold in the diced apples.

5.    In a cast iron or other frying pan, add ¼ inch oil and heat over medium-high heat until oil reaches a temperature of about 375°F using an instant read thermometer.

6.    Drop about ¼ cup batter into oil and fry until golden brown, then flip and fry the other side until golden brown as well. (Test doneness by inserting a small knife into the center of a fritter. If it does not come out clean, fry a little longer.)

Note: Fritters last for up to 5 days in the refrigerator. Reheat for about 5 minutes in the toaster oven. They also freeze well and can last for up to 2 months in the freezer when wrapped tightly in plastic wrap and stored in an airtight freezer bag or container.

Recipe: Mascarpone Peanut Butter Melts

Love this easy way to offer babies flavor, teething relief, an interesting texture that melts in the mouth, an early exposure to two top allergenic foods (peanut and cow's milk)? and lots of nutrients babies need, like protein, fat, fiber, vitamins & minerals! These are best for babies who are at least 6 months of age and using a pincer grasp. (The pincer grasp usually emerges around 9 months but can show up before and/or after; babies are each on their own developmental timeline!) If still using a palmar grasp, they may get frustrated if they can't pick up the melt. Don’t skip the spices - the more flavors babies experience during infancy, the more likely they will be accepting of a wide range of flavors down the road.

Servings: 50 melts (dime-sized)

Prep time: 10 minutes

Freeze time: 2 hours

Ingredients

  • 1/2 cup mascarpone cheese
  • 1/2 banana
  • 1 pinch allspice
  • 1 pinch ground cloves
  • 1 pinch cinnamon
  • 1 tablespoon smooth peanut butter

Directions

1.    In a small bowl, mash the banana with a fork until it is liquified – a few lumps are ok

2.    Add the mascarpone cheese and spices and mix until well combined

3.    Add the peanut butter into the mixture and stir well so that the peanut butter is completely incorporated into the mixture

4.    Using a 1/2 teaspoon measuring spoon, drop dime-sized spoonfuls of the mixture on a parchment-paper lined sheet pan that will fit into your freezer and freeze for at least 2 hours

5.    Remove from freezer and serve immediately as a finger food for babies using a pincer grasp

References:

[i] Morison, Brittany, Rachael Taylor, Jillian J. Haszard, Claire J. Schramm, Liz Williams Erickson, Louise J. Fangupo, Elizabeth A. Fleming, et al. “How Different Are Baby-Led Weaning and Conventional Complementary Feeding? A Cross-Sectional Study of Infants Aged 6-8 Months.” BMJ Open 6, no. 5 (May 2016): e010665 doi.org/10/1136/bmjopen-2015-010665

[ii] Morison, Brittany, Rachael Taylor, Jillian J. Haszard, Claire J. Schramm, Liz Williams Erickson, Louise J. Fangupo, Elizabeth A. Fleming, et al. “How Different Are Baby-Led Weaning and Conventional Complementary Feeding? A Cross-Sectional Study of Infants Aged 6-8 Months.” BMJ Open 6, no. 5 (May 2016): e010665 doi.org/10/1136/bmjopen-2015-010665

[iii] Taylor, Rachael W., Sheila Williams, Louise J. Fangupo, Benjamin John Wheeler, Barry J. Taylor, Lisa Daniels, Elizabeth A. Fleming, et al. “Effect of a Baby-Led Approach to Complementary Feeding on Infant Growth and Overweight: A Randomized Clinical Trial.” JAMA Pediatrics 171, no.9 (September 2017): 838-46. Doi.org/10.1001/jamapediatrics.2017.1284.

[iv] Van der Horst, Klazine, and Ester F. C. Sleddens. “Parenting Styles, Feeding Styles and Food-Related Parenting Practices in Relation to Toddlers’ Eating Styles: A Cluster-Analytic Approach.” PLOS ONE 12, no. 5 (May 2017): e0178149. Doi.org/10.1371/journal.pone.0178149.

[v] Townsend Ellen, Nicola Pitchford. “Baby Knows Best? The Impact of Weaning Style on Food Preferences and Body Mass Index in Early Childhood in a Case–Controlled Sample.” BMJ Open 2, no. 1 (January 2012): e000298. doi.org/10.1136/bmjopen-2011-000298.

[vi] Brown, Amy E. “No Difference in Self-Reported Frequency of Choking Between Infants Introduced to Solid Foods Using a Baby-Led Weaning or Traditional Spoon-Feeding Approach.” Journal of Human Nutrition and Dietetics 31, no. 4 (December 2017): 496-504. Doi.org/10.1111/jhn.12528.

[vii] https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdf

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