Parent-led or baby-led? Associations between complementary feeding practices and health-related behaviours in a survey of New Zealand families

Objective: To determine feeding practices and selected health-related behaviours in New Zealand families following a 'baby-led' or more traditional 'parent-led' method for introducing complementary foods. Design, setting and participants: 199 mothers completed an online survey about introducing complementary foods to their infant. Participants were classified into one of four groups: 'adherent baby-led weaning (BLW)', the infant mostly or entirely fed themselves at 6-7 months; 'self-identified BLW', mothers reported following BLWat 6-7 months but were using spoon-feeding at least half the time; 'parentled feeding', the mother reported not having tried BLW; and 'unclassified method', the mother reported they were not following BLWat 6-7 months but reported the infant mostly or entirely fed themselves at 6-7 months. Results: 8% were following 'adherent BLW', 21% 'self-identified BLW' and 0% were following the 'unclassified method'. Compared with 'self-identified BLW' and 'parent-led feeding', a higher proportion of the 'adherent BLW' met the WHO recommendations to exclusively breastfeed for 6 months and to introduce complementary foods at 6 months. The 'adherent BLW' group was more likely to have family foods (p=0.018), and less likely (p=0.002) to have commercially prepared baby food. Both BLW groups were more likely to share meals with the family compared with 'parent-led feeding'. In contrast to 'self-identified BLW' and 'parent-led feeding', the 'adherent BLW' group did not offer iron-fortified cereal as a first food. Conclusions: This study suggests that although many parents consider they follow BLW, a very few are following it strictly. The extent to which BLW was followed was associated with potential benefits (eg, sharing family meals) and risks (eg, low iron first foods) highlighting the importance for health professionals and researchers of accurately determining the extent of adherence to BLW.