Baby-Led Weaning: What Role Does It Play in Obesity Risk during the First Years? A Systematic Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Literature Search
2.2. Inclusion and Exclusion Criteria
2.3. Intervention
2.4. Outcome Measures
2.5. Study Selection
2.6. Data Extraction
2.7. Assessment of Risk of Bias
3. Results
3.1. Study Characteristics
3.2. Method of Weaning
3.3. Weight and Body Mass Index
3.4. Risk-of-Bias Assessment
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameter | Inclusion Criteria |
---|---|
Population | Infants and children (no limitation for age) |
Intervention | Baby-led weaning approach |
Comparison | Standard or spoon-fed weaning approach |
Outcome | Weight, body mass index and prevalence of overweight |
Study type | Controlled trial and observational studies |
Reference | Location | Type of Study | N (Number of Subjects) Recruitment (Dates) | Age of Infants (Months) | Outcome Measures | Definition of BLW | Intervention | Results and Conclusions (Regarding Weight or Body Mass Index) |
---|---|---|---|---|---|---|---|---|
Kahraman et al. (2020) [24] | Turkey | Observational (cross-sectional) | 485 mothers (137 BLW, 246 partial BLW, 102 TSF) October 2017–February 2018. | 6–24 | Self-reported infant weight and length. Calculation of WAZ, LAZ and BMIZ (Turkish children reference data). | (No definition in the text) | None | Less overweight in BLW (BMIZ > 2SD: 5.1% BLW vs. 14.7% TSF; p = 0.000). |
Jones et al. (2019) [25] | United Kingdom | Observational (comparative cross-sectional and longitudinal) | Cross-sectional study: 269 infants (109 BLW, 160 TSF). Longitudinal study: 101 infants (30 BLW, 71 TSF). February 2016–November 2017. | 3–12 | Infant weight and length at one time point (cross sectional data set) and ≥16 weeks later (longitudinal data set). Calculation of WAZ, LAZ, BMIZ and WAZV (WHO reference data). | Predominantly self-fed (self-fed always and often). | None | No significant differences in WAZ among BLW regardless of the type of breastfeeding (WAZ, mean (SD): =−0.07 (1.35) BLW and formula vs. 0.06 (1.00) BLW and any breastfeeding; p = 0.84) TSF and fully formula fed (both simultaneously) significantly heavier than those who had received any breasfeeding (WAZ, mean (SD): 0.38 (0.81) TSF and formula vs. 0.17 (0.98) TSF and any breastfeeding; p = 0.04) Lower increases in WAZ and BMIZ in BLW, but not statistically significant (WAZ change: +0.13 BLW vs. +0.29 TSF, p = 0.86; BMIZ change: +0.17 BLW vs. +0.42 TSF, p = 0.07) |
Dogan et al. (2018) [26] | Turkey | RCT | 280 breast-fed infants (142 BLW, 138 Control (TSF). January 2014–April 2016. | 5/6–12 | Infant weight, length and head circumference (at 6 and 12 months). Calculation of weight for length percentiles (at 12 months; WHO reference data). | BLISS | Control (TSF): standard well childcare. BLW group: 4 additional group training meetings and 6 home visits for support and education in BLISS until 11 months of age. | Control (TSF) significantly heavier at 12 months (11.1 ± 0.5 kg Control (TSF) vs. 10.4 ± 0.9 kg BLW; p < 0.001). No overweight in BLW at 12 months (BMIZ > 2SD: 17% in Control (TSF) vs. 0% in BLW). No underweight in Control (TSF) at 12 months (BMIZ ≤ 2SD: 0% in Control (TSF) vs. 2% in BLW). |
Fu et al. (2018) [27] | New Zaeland | Observational (cross-sectional) | 876 parents (155 BLW, 93 partial BLW, 628 TSF) June 2017. | 6–36 | Infant weight at 6–7 months as recorded by a health professional. Calculation of WAZ. | Mostly self-fed or self-fed | None | No differences in WAZ between full BLW and TSF at 6–8 months. (WAZ, mean (SD): −0.3 (0.9) BLW vs. −0.4 (1.3) TSF; p = 0.874). |
Taylor et al. (2017) [28] | New Zealand | RCT | 206 women in late pregnancy (105 BLW, 101 Control (TSF)). 166 infants at 24 months (88 BLW, 78 Control (TSF)). December 2012–March 2014. | 0–24 | Infant weight (at 6, 7, 8, 9, 12, and 24 months) and length (6, 12 and 24 months). Calculation of BMI and BMIZ (at 12 and 24 months; WHO reference data). | BLISS | Control (TSF): government-funded routine midwifery and well-childcare. BLW group: 8 additional contacts (6 face-to-face, 2 telephone) for lactation and BLISS support from birth to 9 months of age. | No significant differences in BMIZ between BLW and Control (TSF) at 12 months (adjusted difference, 0.23; 95% CI, −0.06 to 0.52) and at 24 months (adjusted difference, 0.15; 95% CI, −0.12 to 0.45). Higher risk (no statistically significant) of overweight in BLW at 12 months (RR 2.5; 95% CI, 0.9 to 6.9) and at 24 months (RR 1.8; 95% CI, 0.6 to 5.7). |
Brown and Lee (2015) [29] | United Kingdom | Observational (longitudinal) | 298 children from a previous study [31] (163 BLW, 135 TSF). | 18–24 | Self-reported infant weight and length at the time of the recruitment. Calculation of WAZ (WHO reference data). | ≤10% spoon-feeding and purees. | None | TSF significantly heavier at 18–24 months. (Weight, kg (SD): 12.86 kg (3.73) in TSF vs. 11.79 kg (3.53) in BLW; p = 0.005). Less overweight in BLW at 18–24 months (8.1% BLW vs. 19.2% TSF). More underweight in BLW at 18–24 months (5.4% BLW vs. 2.5% TSF). |
Townsend and Pitchford (2012) [30] | United Kingdom | Observational (case-control) | 155 parents (92 BLW, 63 TSF). June 2006–January 2009. | 20–78 | Self-reported infant weight and length. Calculation of BMI, BMIZ (WHO reference data) and BMI percentile rank (CDC, NHS). | Self-reported as BLW (and checked by specific questions about their weaning practices). | None | Lower BMI in BLW (CDC percentile rank: 48.46 BLW vs. 61.44 TSF; p = 0.009). Less obesity in BLW (BMIZ > 2: 1.6% BLW vs. 12.7% TSF). More underweight in BLW (BMIZ ≤ 2: 4.8% BLW vs. 0% TSF). |
Brown and Lee (2011) [31] | United Kingdom | Observational (cross-sectional) | 604 mothers (351 BLW, 253 TSF). | 6–12 | Self-reported estimates of the infant weight (at 6 months and at the time of recruitment). Self-reported perception of infants’ growth (at 6 months). | ≤10% spoon-feeding and purees. | None | No significant differences for estimated weight at 6 months or estimated current weight (statistics not available). |
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Martinón-Torres, N.; Carreira, N.; Picáns-Leis, R.; Pérez-Ferreirós, A.; Kalén, A.; Leis, R. Baby-Led Weaning: What Role Does It Play in Obesity Risk during the First Years? A Systematic Review. Nutrients 2021, 13, 1009. https://doi.org/10.3390/nu13031009
Martinón-Torres N, Carreira N, Picáns-Leis R, Pérez-Ferreirós A, Kalén A, Leis R. Baby-Led Weaning: What Role Does It Play in Obesity Risk during the First Years? A Systematic Review. Nutrients. 2021; 13(3):1009. https://doi.org/10.3390/nu13031009
Chicago/Turabian StyleMartinón-Torres, Nazareth, Nathalie Carreira, Rosaura Picáns-Leis, Alexandra Pérez-Ferreirós, Anton Kalén, and Rosaura Leis. 2021. "Baby-Led Weaning: What Role Does It Play in Obesity Risk during the First Years? A Systematic Review" Nutrients 13, no. 3: 1009. https://doi.org/10.3390/nu13031009
APA StyleMartinón-Torres, N., Carreira, N., Picáns-Leis, R., Pérez-Ferreirós, A., Kalén, A., & Leis, R. (2021). Baby-Led Weaning: What Role Does It Play in Obesity Risk during the First Years? A Systematic Review. Nutrients, 13(3), 1009. https://doi.org/10.3390/nu13031009