Introducing solid foods using baby-led weaning vs. spoon-feeding: a focus on oral development, nutrient intake and quality of research to bring balance to the debate

The World Health Organization recommends that infants be introduced to first solid foods from 6 months of age to complement milk feeds. The introduction of complementary foods is required to help infants meet their changing nutritional requirements. In recent years, baby-led weaning and spoon-feeding have been discussed as mutually exclusive approaches to introducing first solids. Baby-led weaning advocates that babies direct and control the process of weaning, deciding what they will eat, how much and how quickly. There is an emphasis on parents providing chunks of soft food that babies can pick up and chew. A traditional spoon-feeding approach involves introducing smooth runny purees as the texture for first foods and progressing to chewable solids as oral motor skills develop. Spoon-feeding provides an opportunity for infants to develop oral skills necessary for safe management of solids and may facilitate intake of iron-rich foods at weaning, whilst baby-led weaning promotes greater participation in family meals and exposure to family foods. The need to supervise infants whilst eating to avoid risk of choking on food is required for both approaches. The review highlights the need for quality, well-designed research on different approaches to the introduction of first solid foods and suggests that a combined approach to baby-led weaning should be considered

Rheological characterisation of thickened milk components (protein, lactose and minerals)

Thickened fluids are commonly used in the medical management of individuals who suffer swallowing difficulties (known as dysphagia). However, it is not always easy to obtain the correct consistency of thickened fluids. Variabilities can be due to thickening agents, solids content, and differences in dispersing medium. Thickened milk is a fluid that is commonly served for patients, but is one of the most complex fluids. This study examined the rheological characterisation of individual thickened milk components (protein, lactose and minerals) thickened with a commercial xanthan gum based thickener and investigated the effect of these components on the rheological behaviour of complete thickened milk. It was found that protein increased the final viscosity of the fluid but did not affect the dynamics of the thickening process. Conversely, mineral content significantly slowed down the thickening process, but only slightly increased the viscosity of the fluid. Lactose had no effect on either the dynamics of the thickening or on the final viscosity. This study confirms and explores the interactions between thickener and milk components in milk used for the medical and nutritional management of swallowing difficulties