Amy Brown (0s):

To me, the main core bit is not necessarily around the spins or the purees. It's about the baby being in charge and the baby being fed responsibly. however they are being fed.

Katie Ferraro (16s):

Hey, there I'm Katie Ferraro, registered dietitian, college nutrition professor, and mom of seven specializing in baby led weaning. Here on the baby led weaning made easy podcast, I help you strip out all the noise and nonsense about feeding leading you with the competence and knowledge you need to give your baby a safe start to solid foods using baby led weaning. Hey guys, welcome back. So I know you're here because you're interested in baby led weaning. This alternative to traditional spoon-feeding stuff sounds plausible. Sounds feasible. Looks cool when babies are feeding themselves, sounds nice not to have to short order cook for my baby or force feed them purees, but does it actually work like, is there any real research or evidence behind baby led weaning?

Katie Ferraro (1m 8s):

Well, in today's episode, I am bringing you Dr. Amy Brown. She was one of the most prolific researchers. She's published numerous articles, tons of research about baby led weaning. And she is here to tell you all about the evidence behind baby led weaning. So this episode is for those of you who maybe you're dealing with a skeptical pediatrician, or maybe you've got a partner who's really heavy into research, or you yourself just want to know more about the research and the evidence base that supports a baby led approach to feeding.

2 (1m 38s):

Well, Dr. Brown is your gal. She is a psychologist by training, interestingly enough, but she has a wide array of experience in parenthood. So baby feeding, baby behavior, infant feeding mental health, but she's published widely across all of those areas with a big focus in baby led weaning. And so that's what we're going to talk about today. The research and the evidence that is behind this alternative to traditional spoon-feeding. Dr. Brown is also the author of a book called Why Starting Solids Matters. She's got a number of different publications exploring the safety and the efficacy of this baby led approach to feeding. I'm going to link to everything she talked about in today's episode, because it's one of those ones where like, if you're in your car, you're on a walker, you're feeding your baby, you're going to be like, wait a minute.

2 (2m 23s):

I want to read that article. I want to read that article. My pediatrician needs to see that one. Whoa, I want to follow up on that study. It's all going to be linked in the show notes for today's episode. I'm also going to link out to Dr. Brown's new website, where she's got all of her research organized. So all you research nerds out there, or if you're just interested in learning more about the research, whether or not you consider yourself a nerd, I think you're going to absolutely love this interview with Dr. Amy Brown. So with no further ado, let's get started talking about the evidence behind baby led weaning with Amy Brown. All right. Well, hello, Amy. Thank you so much for joining us on the podcast today. I am so excited to talk to you about research behind baby led weaning.

Amy Brown (3m 5s):

Thank you for having me now.

Katie Ferraro (3m 6s):

Could you tell us just a little bit about your background? I'm very familiar with your work as someone who works exclusively in baby led weaning, but for other parents and caregivers who might not know about your work yet, tell us how you came to be interested in pursuing all the different areas of parenting that you conduct research in, but especially baby led weaning.

Amy Brown (3m 24s):

So I'm actually a psychologist by background. I wanted to do a PhD, always been interested in eating behavior. So stuff around why we end up eating in the way that we do, or the kind of different social and cultural influences. I wanted to do something with older children and was interested in adult eating behavior, particularly disordered eating, but then I had my own babies and had all these different experiences you have with them. So, you know, breastfeeding them or giving them formula and introducing them to solids. And when I had my first baby, I started coming across this idea of baby led weaning.

Amy Brown (4m 4s):

So the concept as something different was actually quite new back then. This would have been, oh, late 2006, early 2007. And I got really interested, lots of different forums you could go on at the time. The baby led weaning book didn't come out until a little bit after that. But as a researcher, I was just really interested in trying to look at what the evidence behind this was because there were so many parents now following it. And I went to the literature and went, oh, there is actually nothing here. Let's fix that. So we started at the beginning completely at the beginning, just kind of documenting what parents were doing and why they were doing it.

Amy Brown (4m 47s):

And since then we've been looking at followup data and all sorts of things around the experience and what it might lead to and why parents choose it and the problems they have.

Katie Ferraro (4m 60s):

So a lot of times, at least in my experience, parents worry that baby led weaning when they first hear about is, oh, it sounds interesting, but that's just, that's a fad or that's a trend and some, you know, woo woo parenting technique. And I always try to counteract that by pointing out that there is this research coming out, a lot of it done by you and your group and a number of studies have been published in the past that do support an infant's ability and desire to safely self feed. So i'm curious, do you have tips for parents and our listeners who are worried that maybe baby led weaning is just a passing trend or a fad?

Amy Brown (5m 33s):

I mean, I think I'd say two things to that. And that's a really common thing that people say to me. I think we just kind of have to go back a little bit in history when we were kind of evolving the baby food industry didn't evolve alongside us. We didn't have a baby food industry of pureed specialized things until about 1930, kind of a look into the history of that. I think it was sort of the UK and the US kind of similar points in the 1930s. They developed the ability to be able to churn and store food for longer life. And they were doing that with vegetables or adults. So they, you know, they were. Some kind of bright people have this idea that if you could do that in kind of big jars, then why couldn't you do it in smaller jars and has specific foods for babies?

Amy Brown (6m 24s):

I mean, it was a bit more complicated than that, but that's the kind of history of that. And it was the idea that from then on, you then have this idea of special babies. They're just that you give to babies. And of course there's a big market in an industry behind it. And as soon as you start making money out of something, it becomes more and more and more. If you go back to even 10, 20 years before that, this concept of specialized baby food, it was just non-existent. If you kind of look at winning records, most babies would probably just give them family foods when they were around nine, 10 months of age. I mean, some of it might've been mushed down a bit, but this concept of a special pureed food that you have for your baby, was non-existent until we learned how to make money out of the idea.

Amy Brown (7m 10s):

So I think a lot of people, you know, if you say to them that this is a new idea of baby led weaning, and they look at you, like you've, you've gone crazy because it's just what we did for generations before. And I'm sure most people, when they have, you know, by the time you get to about your third baby, this idea of wheeling routines and special foods and schedules and things like that, goes out the window and they just get what they're lucky to have, essentially, you know, the guests throws a little bit of food, say it's not some new thing. The other kind of other side of that is that there is no evidence base to show that spoon-feeding and puree to special baby foods safe or a good thing.

Amy Brown (7m 52s):

They literally came about when industry back in the bursaries created them. Nobody did or demanded research or demanded evidence that this was a good thing. Yet we come kind of full circle and they get giving our babies family foods again. And we're suddenly told, oh, well, you need to provide evidence for that. And you need to prove that safe. And you need to prove that babies eat enough, even though the spoon and baby food industry never had to do the same thing. So it's one of the reasons we ended up doing the research is because every time we talked to her, like say the department of health here in the UK and said, okay, we need some recommendations around baby led weaning.

Amy Brown (8m 32s):

They come back and say, well, what's the evidence?

3 (8m 34s):

Was the evidence beneficial? So it's kind of that we've kind of got stuck in the way, but I think we need to think back and actually think about where these ideas are kind of coming from that it might not be safe, or it might not be beneficial because if parents

Amy Brown (8m 49s):

Start moving towards just giving their baby family foods and not paying money, the market around baby food wouldn't do so well. So that I think we kind of need to think about where the idea comes from. And it's certainly not, but it's not safe or good for babies. It's just what we always used to do for generations.

Katie Ferraro (9m 7s):

I love that approach. When someone says baby led weaning is a fad or a trend we might respond with, actually commercial baby food is a fad or a trend and has been around for significantly less period of time than feeding your child modified versions of the same foods the rest of the family eats it. That's a good marketing technique. You got to sometimes fight fire with fire when it comes to marketing. So I know in the United States, at least we have a lot of pediatricians in our audience and many pediatricians who are educating themselves about baby led weaning and looking into the research years included. But the reality is as a professor of nutrition myself here in the US, more than 90% of physicians in our country have never taken a dedicated nutrition course. So parents will sometimes say things to me like, oh, my pediatrician doesn't believe in baby led weaning.

Katie Ferraro (9m 52s):

And I always then recommend your review article. It's called Baby Led Weaning The Evidence To Date. And I say to parents who maybe aren't familiar with this publication, take this, find this here's the link, go to your doctor and talk about this. So I was curious for those of us who maybe haven't read the whole review article, could you briefly summarize where we're at, regarding the evidence behind baby led weaning here in 2020?

Amy Brown (10m 16s):

Oh yeah. So there's new stuff coming out every day. And I mean, I think we wrote that article. I think it's 2017, and we've done quite a bit since say sort of the main kind of areas that have been backed up by research. And obviously we need further research. A big one is around the choking risk that often comes up, oh, you can't give babies whole foods, they'll choke. Looking at kind of evidence from across a number of studies. Now that's basically been shown not to be true. There is no increased risk of giving a baby finger foods to eat compared to giving them a puree, as long as the foods are appropriate. So they're not kind of nuts or things you shouldn't really give a baby anyway, or things like very hard uncooked, carrot sticks or hard uncooked, apple slices, things that can break off in the baby's mouth, maybe the scale to be able to eat.

Amy Brown (11m 11s):

If we're looking at introducing solids after around six months, then babies have the physiological skills be able to pick things up and achieve them. So obviously you can't do any kind of randomized trial around choking. You can't try and get babies to choke and see what happens. So it has to come from sort of observational data from the research that is happening, but there's probably about four or five papers that show that it's just not an additional choking risk. And there's, there's no reason why it would be any more than it is an adult choking. So that's the, the choking side of things. In terms of weight, there's been a few studies now looking at the impact of baby led weaning versus spoon feeding on baby's weight.

Amy Brown (11m 56s):

And some of them show that when babies are baby led wind, they're more likely to be a healthy weight. So there are two studies main studies I can think of that, that show that on average, the baby who's feeds themselves is less likely to be overweight and just being fat baby. And it makes a lot of sense, cause it's all to do with responsive feeding. And it's all about those babies stopping when they're full. So if they're feeding themselves when they're full, they can just stop eating, whereas if you're spoonfeeding a baby, the baby might, you know, they might take a few extra bites if you keep kind of encouraging them to eat a little bit more and that over time could lead to additional weight. The other thing I think with the weight is the, when a baby is, self-feeding sort of what I call real foods rather than pureed special baby feeds, it's going to be a slower process.

Amy Brown (12m 47s):

So by the time they pick it up and they put it in their mouth and they chew it, they've given that body time to respond. So we know with adults don't make, if the adults who eat more slowly are more likely to be a healthy weight compared to those who rush their meals, because they don't get that signal that they're full so quickly say those studies there, but the two, the two studies I'm thinking about are observational, they're about, parents who have chosen to either spend feed or baby led weaning. There has been a trial going on in New Zealand for quite a few years looking at parents who are randomized to follow a traditional winning approach versus a baby led weaning approach.

Amy Brown (13m 28s):

They didn't find any differences in weight between the two groups at 12 months or 24 months. It just didn't have any impact on weight. My main thoughts about that study and people will probably hear me talk about this quite a lot is actually how suitable randomized control trials are when it comes to feeding babies things, because it's such a complex subject. And we know from a kind of medical perspective, we like a trial. We say, it's the gold standard of data. And perhaps if you've got a medication and you want to randomize, whether someone has one dose or another dose, then that's a fairly straightforward behavior. Or you have to do is get people to take their dose. We know that that can be problematic in itself, but when it comes to randomizing stuff like breastfeeding or randomizing how a baby is introduced to solid foods, you start hitting all sorts of problems because families aren't that simple.

Amy Brown (14m 22s):

They aren't that straightforward. They're affected by lots of different things. So as with many of the trials that try to look at early infant feeding, though that study in New Zealand didn't have a situation where everybody in the baby led weaning group, did baby led weaning, and everybody in the traditional group ended up doing traditional weaning. You had crossover. So my question is always, well, what exactly are we measuring there? And it's, you know, it's, it's a limitation to me, well-designed study, but as always people are people, so that can affect the results. Just one more study on that is actually a recent publication from one of my PhD students, Sarah Jones.

Amy Brown (15m 3s):

What she looked at is she weighed and measured a lot of babies for her PhD. And then she looked at that their weight outcomes at around 12 months. And she didn't just look at whether they were spoon fed or baby led weaned. She also looked at the interaction with how they were given their milk feeds. So she looked at whether they were breastfed or whether they are formula fed. And because in the UK, we don't have many babies who are exclusively bottle fed, express milk. We tend to have two main groups that breastfed directly, or that bottle fed most of the time. And what she found that is that when babies were baby led weaned, how they were milk fed didn't seem to impact upon their weight.

Amy Brown (15m 51s):

So the babies who are baby led weaned and formula fed, are a similar weight to the babies who were baby led weaned and breastfed, but when babies were spoon fed, if they were also bottle fed, they were more likely to be a heavier weight than all the other three groups. And one of the reasons we think this is happening is that because when you're spoon fed and you're bottle fed, you have very little opportunity to be fully in control of how much milk and feed you're taking in. So it all comes back to this idea or as responsive feeding again. So it's maybe something we want to pick up on, on another question. But it's, it's just kind of thinking about how baby led weaning can really encourage responsive feeding and put babies in control of that own appetite.

Katie Ferraro (16m 37s):

And that's so important because we're taught, especially when you're learning, how to breastfeed is that obviously beyond the nutrition, benefits, bonding, etc, your baby is engaged in responsive feeding. And I always think it's so ironic when at six months of age, we just flip a switch with traditional spoon feeding and throw that right out the window where now the baby is no longer in control. Me, the parent or caregiver, I will arbitrarily choose this amount of spoon fed puree that I will then essentially force feed the baby. And I love that the concept of responsive feeding is becoming so much more in the forefront. Like it's a term that yes, researchers have used for so long, but parents are starting to learn about. And even here in the US I was just helping to edit a very well-established introduction to nutrition textbook it's in its 16th edition.

Katie Ferraro (17m 20s):

We all use it. And it finally is the first edition where they use the term responsive feeding when they're mentioning feeding babies, even though it's all over the breastfeeding stuff, we sometimes forget about it in that second six months of life. And as you point out, it really is so important. So what I actually wanted to ask too, is I know so much of the data is evolving and it's dynamic, and it's oftentimes based on self-reported intake and there are challenges to designing those studies. But I think it's important for parents to hear as well that there are no definitive studies that show that baby led weaning increases choking risk or leads to growth faltering or babies can't meet their nutrients. Like, would you say that that statement is fair for the parents who say, oh, my doctor says I can't do it because the baby will choke.

Katie Ferraro (18m 2s):

They won't get enough iron. And then they also won't get enough nutrition. There's no data to support those statements. Am I correct?

Amy Brown (18m 9s):

Well that there is no data to support that. Another one of my PhD students has a paper under review at the moment. So her PhD has actually been looking at nutrient intake amongst spoon fed and baby led babies. She has looked at various different types of ways of measuring that. So food frequency, questionnaires, you know, how often does your baby have this, which we know is really more of a measure of exposure rather than intake. So there's studies that accurately measure how much the baby is actually eaten, just whether they be offered it. She does another study looking at 24 hour diet diary. And again, that we just kind of look at exposure really, rather than the, how much the baby is having, but certainly the babies in her study, the ones who were baby led weaned were being exposed to more things like different sources of protein and different vegetables at a much higher exposure right there.

Amy Brown (19m 3s):

And there were no difference in exposure rates, but it's things like iron. In her paper she has, it's a fairly small sample, but that's quite usual with this type of research. She had asked parents to complete a three day weighted food diary. So what that meant is that parents actually kept a diary of everything that baby actually ate. So involve taking a pair of small kitchen scales around with them and literally weighing everything before they gave it to their baby. And then trying to work out how much know the baby had actually eaten a little bit. So we had this poor parents, you know, scraping food off the bib and picking up food off the floor. So she has a really accurate idea of intake.

Amy Brown (19m 44s):

And again, we're pretty much finding the babies are eating very similar amounts, depending on whether they're spoon fed or baby led weaned. We find that your average baby lead weaned baby is eating less than your average spoon fed baby, but that's actually a good thing because babies aren't meant to be eating huge amounts of food. I mean, I think how much your baby eats is a really big concern for new parents, but the idea that they should be eating loads is completely incorrect. I mean, the world health organization recommends around 200 calories a day from solid foods for babies, you know, six to eight months old. It's a tiny amount.

Amy Brown (20m 24s):

If you split it over three meals or, you know, several small bits over the day. So she has found the baby who are baby led weaning are eating closer to that amount. Whereas babies who are spoon fed eating much more than that on average. I mean, there's obviously variation between babies

Katie Ferraro (20m 38s):

And it's so important that to point that out to parents, because especially I'm a dietitian and I have a lot of dietitians in my community and they get so hung up on the quantity or the portion or the, or the milligrams. And the point is your baby is learning how to eat. And so we want to focus on giving the baby the opportunity to learn how to eat instead of focusing on how much the baby is eating. And so I understand the importance of doing the research to measure the milligrams, but the idea of like scraping the food out of the baby's hair to measure it, to prove that they're eating enough, it is during a period when they should be given the grace to learn how to eat, knowing that breast milk and or formula still provides most of their nutrition. Would you agree?

Amy Brown (21m 20s):

It's a learning experience. It's about moving from that process of milk foods to family's foods when they're older, it's about tastes and textures and playing with it and all of that. And we've really lost sight of that. I think under the kind of pressure to get food into your baby. And I think a lot of that comes from industry and pushing anxiety and products on the parents. And of course, baby led weaning is really against that. So it's always going to be kind of fighting an uphill battle. And again, this idea that we even need to prove that these babies are getting enough when nobody has come along and said, right, we need to check that spoon fed babies are having the right nutrients. There isn't that data, this little data on what babies are actually eating and the idea we have to prove it is it's quite crazy.

Amy Brown (22m 7s):

I mean her data, again, in terms of nutrient intake, she didn't find very many differences between baby led and spoon fed babies or tall for macro or micronutrients. One of the things she did find is that most babies were quite low on iron intake. Again, suggesting that the idea that a baby should perhaps be having the backup vitamin drops, The baby led when babies were eating too little iron and it was that most babies weren't perhaps getting the nutrients that they may be should. So it should be a focus on nutrient rich food for all babies, but I can really see how under the kind of wrong kind of person wanting to be against baby led weaning.

Amy Brown (22m 50s):

You could take that finding in isolation and go, oh, baby led weaned babies aren't having enough iron when actually it's something that modern parents struggle with quite a bit I think in terms of that transition.

Katie Ferraro (23m 1s):

Critics do the same when it comes to weight. Oh, well, you don't have any studies that show that baby led weaning prevents obesity. However, we do have lots of studies that show that babies who start with a baby led approach are not necessarily going to have growth faltering. Like they have the capability to feed themselves adequate amounts of food that in conjunction with formula and her breast milk would allow them to thrive and grow and have those experiences where they continue to learn how to eat. So they can then get more of their nutrition from the food. So I love the research that you do, but I do respect what you're saying, which is it's ridiculous that we even have to do this in the first place, because for generations, babies have learned how to eat without the input associated with the entire world of commercial baby food.

Katie Ferraro (23m 44s):

But for the parents don't have the time or the effort, or perhaps even the desire to read all of the peer review published articles and the review articles and the world that you work in. I know that you've also written a fabulous book. One of my favorite books called Why Starting Solids Matters. And I was curious if you could just tell us a little bit about the book, but what was your impetus for writing it and then also where we can get it because it is on my most recommended reading list for parents who want to learn about starting solids safely with baby led weaning.

Amy Brown (24m 15s):

It's not a how to introduce solid foods book. You won't find a single recipe or portion size suggestion.

Katie Ferraro (24m 22s):

Thank you. Thank you. Thank you for that. There's plenty of that out there. We need to know why this even matters.

Amy Brown (24m 28s):

It's more about the evidence behind why we do what we do when it comes to introducing solids and what really matters. So it talks a bit about what I've already said around the history of how we've got to where we are with, you know, supermarkets with a huge array of, you know, so many products that they're, they're pushing on parents, all the anxieties parents have and all the tricks. I mean, people seem to know a lot more about perhaps the tricks of the baby milk industry of how they tried to sell products, but there's a lot of trickery that's going on around baby foods as well, and trying to get parents to buy different things.

Amy Brown (25m 9s):

So it looks a lot at that around advertising and labeling of baby foods. I mean, your laws might be very slightly different in the US, but here certainly the way foods are labeled in terms of the title can be very misleading in terms of their content. So you actually only have to have quite a low, really low percentage of a food in your baby food to be able to have that name in the title. So, you know, you can call it a chicken dinner and it's actually got a very low proportion of chicken in it, but parents are misled by it.

Katie Ferraro (25m 47s):

It is certainly same here. You have to have like almost an advanced degree in order to truly decipher a food label. And it's, it's mostly marketing into commercial on the front of the package. And I think a lot of parents don't recognize that.

Amy Brown (25m 58s):

And A lot of, kind of the new kind of tendency for super foods and things like that. So we have things like baby foods are labeled as kale

Katie Ferraro (26m 6s):

But it's really just green apple sauce.

Amy Brown (26m 10s):

With a tiny little bit of pain in it. And there is a, I can't remember what brand of baby food that is not probably best not to mention that. They have the same food that they sell in the UK and in the US so it's exactly the same product, but it's called a different thing in the US compared to the UK in terms of the order of the name, because they did market research and found that parents in the US like this food best and parents in the UK like this food best.

Katie Ferraro (26m 39s):

Can I ask you if you have, do you guys have the shelf stable yogurt products for which always just knocks my socks off? Like, if it were actually yogurt, it would require refrigeration. And yet here it is sitting on the shelves for months on end, and you think it's yogurt. Like it's almost laughable sometimes how far removed from food, all of the baby food is. And I tell parents, you can totally avoid that entire aisle at the store and your baby will be perfectly fine. And I think sometimes they actually like that. It's almost a relief and you kind of see them just, oh, wow. So I don't have to spend all my time and money trying to figure this stuff out. Nope. You could bypass that entire aisle because your baby can learn to eat real food.

Amy Brown (27m 18s):

We've got a big push on baby healthy snacks, supposedly at the moment that are supposedly vegetable stick crisps and you know, their vegetables and their high-end fiber. And you look at them and you go, no, they're crisps.

Katie Ferraro (27m 31s):

It's potato starch and salt. And all it will do is prevent your baby from eating food at the actual meal. So snacks are great if you'd like to sabotage their intake one hour later when you're trying to get them to eat dinner.

Amy Brown (27m 42s):

So it looks, it looks at things like that about whether you need to buy, you know, these specific foods. It looks at the idea of why we, the evidence suggests introducing solids at around six months and not earlier, it looks at recommendations around amount. It looks at, you know, stuff behind fussy eating and how to try and what we know about that and how we can try and reduce that. It looks at all the myths as well. You know, the, you know, if you give your baby solids, they'll sleep longer, oh, your baby's looking at your food. They want it. No, no, none of this is true.

Katie Ferraro (28m 17s):

And you have a very eloquent way of undoing some of those myths, because I just, the one about the one teaspoon of baby cereal and your baby's bottle is going to make them sleep through the night. It's like, do you know how many calories are in an actual teaspoon of babies here, or even the same with pouches all the times we encounter parents who say, we didn't eat very much at the meal. So I'm going to finish the meal off with a pouch, just so I know he gets something. I said, turn that pouch over. There's 32 calories in that pouch in on what planet do you think that's going to keep your baby full? That's not the point here. We need our babies to have again, the opportunity to learn how to eat. I honestly think Amy, your next book, at least for us, parents should be, you know, you have what, Why Starting Solids Matters, but it's why the drinks you offer your baby matters because we have a whole situation.

Katie Ferraro (28m 58s):

And I'm assuming it's similar in the UK, but with toddler milks and the very aggressive marketing of toddler milks, and then these transition formulas that start at nine months. Well, I mean, we should be focusing on transitioning our baby to cow's milk at 12 months, not a whole other subset of formulas. That can be very, very confusing to parents. Do you guys have the same issue with toddler milks or transition formulas? They're in the UK?

Amy Brown (29m 20s):

Yeah, they're called follow on formulas here. So they're from six months. So we have obviously different advertising laws here around advertising infant milk at all. So by law, we are not allowed to advertise first stage infant formula that is suitable for babies from not 12 months, because you're not allowed to advertise any product that is aimed at replacing breast milk for babies under six months old. So for us, our kind of follow on milks that are supposedly suitable from six to 12 months of basically a way to pass and get around that law because you are allowed to advertise follow on milks, and then you can pick up that market from six months.

Amy Brown (30m 7s):

So even though parents are told that first stage infant formula is all your baby needs up to 12 months old, and then you can move on to cow's milk, the advertising messages and regulations, the messages that the interesting news start creeping in from six months in of course, parents and switched to it because they use all these different slogans, this one to make your baby sleep. You know, this one has got added made up ingredient in it that has no evidence behind it and all of that.

Katie Ferraro (30m 35s):

And all of the immunity messaging now on top of everything is further confusing to parents.

Amy Brown (30m 41s):

That brand recognition then means that basically serves as an outlet for that first station, because even though their packaging should be different, it very rarely is that different. So we've just been doing research, showing that a lot of parents misinterpret the follow on milk adverts for actually first stage baby milk. I think it's being advertised anyway. And also they are believing the statements from the follow on advertising. So quite interestingly, when, when we say to them, you know, oh, you affected by advertising. They all go, oh no, absolutely not affected. And we say, well, someone must be, or they wouldn't be doing it.

Katie Ferraro (31m 17s):

They wouldn't be the fastest growing segment of the formula industry.

Amy Brown (31m 22s):

Then they say, oh, well, yeah, I give this one to my baby because it's the most scientific, it's the one that's got the most research behind it, or this is the one that helps my baby's sleep. Or this is the one that my baby needs because they're particularly hungry. So the messaging is getting through and it's just, you know, industry should not be anywhere near infant diarrhea. It's too important to be misinterpreted or downright lies around the impact of different milks on babies when it's not, evidence-based. That's nothing against the actual formula if parents need or choose to use it. But it's around the tactics of the industry that are trying to sell it to them. And I don't know if you have this issue, we have an entire range of first agent from formulas that vary hugely in price.

Amy Brown (32m 7s):

So you can get a supermarket own brand one, which is around four pound for roughly 800 grams. Or you can go to the more expensive ones that are closer to 16 pounds. So there's a, there's a huge different in cost for something that will last a baby, maybe a week when actually the content has been shown to be pretty much identical. If there were any added ingredients found by research to have a real impact on babies, then by law here, they'd have to be added to every first stage infant formula. So they're not different, but they're hugely different in price. And that's the advertising, It's parents will buy the one that has been shown to be appealing to them based on whether they want the scientific one or the one with the happy baby on the front.

Katie Ferraro (32m 51s):

And at the end of the day, it's nonfat milk powder with some corn syrup in it with added sugars that children should be minimizing. Anyway, I think parents don't even recognize all the different, at least in the United States. There's so many different ingredients that can potentially represent added sugars. I mean the last place we want to be getting it from is milk. So I was curious too, just regarding the sentiment in the UK versus the US like in the United States, I do a fair amount of work. I'm in California with the California WIC association. So that's the special supplemental nutrition program for women, infants and children. And they've always espoused a traditional spoon feeding approach. But in the last few years, they speak at our annual convention and we're slowly talking about, we call it a baby led approach to feeding.

Katie Ferraro (33m 30s):

They don't love the term baby led weaning. That's fine. We can turn it around, but increasingly even our bigger government agencies are starting to adopt this as wait a minute, this is certainly something that's a follow on to all of the responsive feeding techniques that we teach for breastfeeding. And they are becoming more open to talking about it, incorporating it. I just, you helped me, which was fabulous on a presentation I just did for all of our health care professionals in California. That was all about the evidence behind it, because of course it does need to be evidence-based, but we also need to acknowledge that babies do have the ability and the desire to feed themselves starting at around six months of age. So I was curious in the UK, is there, what is the sentiment about baby led weaning or a baby led approach to feeding or responsive feeding, whatever you may call it as, as far as you're concerned?

Amy Brown (34m 17s):

I think, again, we're kind of stuck because they don't deem it to have enough evidence to be able to actively promote it to parents. In terms of baby led feeding, they see that as being baby led weaning, we end up in a situation where, because there is no official guidance that health professionals don't give consistent messaging, or they might tell parents do it, which we know doesn't work for anything. Does it, I mean, we've, we finally kind of recognize around safe sleep guidance that parents need advice around how to, you know, safely batch now with their baby. If that's what they're going to do, telling them to do it, doesn't stop them from doing it. It's better to be safe. And the same happens with introducing solids.

Amy Brown (34m 59s):

If you don't give parents good advice on what they want to do, they'll do it without that advice or they'll hide it from you. So it seems a sort of backwards way of thinking to me. We do have a big emphasis on responsive feeding, but the only official evidence is really around spoon feeding. It is kind of weaning and things like that are kind of creeping in. There's more kind of mention Of them. I would say, compared to 10 years ago, in terms of actual guidelines about how to do baby led weaning then no, but saying that our official guidelines are to start giving your baby solid foods around six months and to do a mixture of finger foods and pureed or mashed foods.

Amy Brown (35m 44s):

So one of the questions we have is, you know, at what point is baby led weaning, baby led weaning? Can you only do baby led weaning if you never spoon feed your baby? What is baby led weaning actually about? Is it actually to do with the spoons and the purees, or is it to do with the responsive feeding and the baby being in control? Say to me, the main core bit is not necessarily around the spoons or the purees. It's about the baby being in charge and the baby being fed responsively however, they are being fed. And also the other kind of stuff around it. So the things like them, having finger foods to play with and touch and learn about, and it being gradual and things about them sitting round the family meal table and having a bit of what everybody else is eating and joining in that social learning experience.

Amy Brown (36m 38s):

To me, it's those things that are really the most important things. Not whether a baby occasionally has a puree or it's been fed because, you know, you've just cleaned them all year round. The grandmother's house has got white carpets and white sofas and you don't want food everywhere, you know, or you want to give them some yogurt and you don't want it all over your walls. To me, it's, it's about the way of thinking the mindset behind your baby being in charge and trusting your baby and letting them being in control of things. And it being a learning social experience rather than necessarily the spoons and the purees.

Katie Ferraro (37m 16s):

That's so wonderfully put, like as a researcher, you have to focus on the milligrams and the micrograms and the ounces and the portions, but in real life, we all want our babies to learn how to be in control of, and to listen, to, and respond to their own hunger and fullness cues. And in reality, baby led weaning does allow them to do that. So thank you again for sharing all of the research that you and your PhD students in your group is doing. For our audience, who would like to learn more about your work, Amy, where can they go to learn more?

Amy Brown (37m 44s):

I've actually got a brand new website that has got all of my research on it and started adding all of my research papers one at a time, and then realized like published over a hundred. And this might take some time. So it's a work in progress, but there's everything on there. So it's professoramybrown.co.uk. Nice and simple.

Katie Ferraro (38m 2s):

All right, professoramybrown.co.uk. And you guys, I will go ahead and link up all of the papers that Dr. Brown has published with regards to baby led weaning. Cause we are huge fans of your work and have like all of them, because we're citing them regularly to talk to parents, especially when we're talking to healthcare professionals that, yes, this is a real, and there is a real emerging body of evidence to support this alternative to traditional spoon-feeding. All of the resources that Amy mentioned will be in the show notes for this podcast episode. And you guys can find that blwpodcast.com and I'll link to Dr. Brown's site as where you can go to learn more about her research. So Amy, thank you again for being here. This was such a fabulous conversation and so useful for our audience to hear.

Amy Brown (38m 43s):

Thank you.

2 (38m 45s):

Okay. Wow. That was amazing. So much valuable information, right from the researcher's mouth. It was it think it's so amazing when you actually, through the beauty of the internet, get to talk to the people who are doing the research in the field for the people that are like out there every day, feeding those babies. So you guys are listening directly to Dr. Brown through this podcast. So cool. I'm a huge fan of her work. Not only her research, I loved how she basically said it's kind of ridiculous that we even have to be doing this research. And I feel her, like we don't talk about milligrams and micrograms, and I don't want you guys to stress about exactly how much your baby's eating, but like the part where her research team is literally scraping food off of baby's bibs to weight and measure it.

Katie Ferraro (39m 25s):

They're doing that for you. Okay. They're doing that for your pediatricians, who might be doubtful about a baby's ability to self feed. It is important research to be doing, but I hope you also got that underlying message from Dr. Brown, which was the way our babies learn how to eat is so important. So yes, we need to have the research to address the fact that this is a safe approach that this will meet baby's needs. But remember what she was saying that the whole entire commercial baby food industry is less than a century old. If you think about it and that the majority of the things in the baby food aisle, actually, all of them you could do without, okay, your baby can learn to get a safe start to solid foods using baby led weaning. And there is that real, incredible body of research behind it to back it up.

Amy Brown (40m 5s):

So I hope you enjoyed this episode with Dr. Amy Brown, all about the evidence behind baby led weaning. If you want to grab any of the links to the research articles, the references, her book, her website, I'm going to link it all up on the show notes for this page, which is at blwpodcast.com. Thanks for listening. Bye-bye.