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Baby-Led Weaning First Foods & Iron

More and more babies use baby led weaning. First foods, especially those containing iron, become a critical part of the diet. Learn why iron rich foods are important for baby, especially with a baby led feeding approach.

Baby eating broccolini in baby led weaning first foods and iron

What is Baby Led Weaning?

Baby led weaning (BLW) originated in the UK by Gill Rapley, and is popular worldwide, including in the United States.

It’s a feeding method based in using whole foods, instead of spoon-feeding. Babies are offered table food in graspable shapes and dissolvable forms (sticks of soft-cooked veggies, ripe fruit or soft bread) that she can manage to eat on her own.

Research on BLW has been afoot. Mostly to look at choking incidences, nutrient adequacy, weight differences, pickiness and overall health.

In the earlier studies, the research focused on a baby’s ability to self-feed and self-regulate his intake. More recently, studies are looking at choking risk and nutrient adequacy. Particularly, iron adequacy in the diet and calorie content, which makes me happy to see.

Feeding My Babies

As you probably know already, I have four kids. They were all breastfed. Each one started solids with a spoon, at around 4-5 months of age (back then we started at 4 months; current recommendations are to begin at 6 months).

They transitioned quickly over to chopped and finger foods at about 7 or 8 months.

I distinctly remember offering my first born a soft, buttery cracker to gnaw on when she was around 6 months of age. (What I remember most was the fear that she would choke.)

She didn’t have any teeth, so she gummed that cracker until it was a mess.

Looking back, I consider that falling within the guidelines of BLW, with the exception of eating off the spoon as well.

Personally, I’ve always been a responsive feeder, probably because I was trained in the ’80s on Ellyn Satter’s Division of Responsibility.

From my professional vantage, one of the best things I see with BLW is the encouragement of babies to regulate their own eating.

In other words, they’re encouraged to start and stop their eating according to their appetite.

However, I’ve always wondered if BLW would be adequate in nutrition, particularly for the breastfed baby.

And, especially with regard to iron.

Iron-Rich Foods for Baby Led Weaning

The question of iron adequacy is one that keeps coming up for me. The present research doesn’t completely quiet my concerns, however, the word is getting out and I believe more and more parents are feeding with consideration to iron and other nutrients.

I’m hoping for more studies, and will continue to support families who want to take a BLW approach with the nutrition information they need to optimize both brain and body growth and development.

[Similarly, I had my reservations about early introduction of peanuts before there was enough substantiated (and well-conducted) research on the topic.]

A Tour of the Research on Baby Led Weaning and Iron

Let’s take a look at what we know.

One pilot study out of New Zealand shed some light on how much iron babies who are fed using the BLW approach are getting.

In their study of 23 families, babies were divided into two groups.

One group (the BLISS group — these are parents participating in a modified-BLW weaning approach including education on iron and energy requirements and guidelines for feeding) received education about high iron foods, energy dense foods, and foods that may cause choking prior to starting solids using BLW, while the other group proceeded with BLW without any specific nutrition or choking education.

Even though the study was small, the researchers found some interesting things.

For one, parents who were educated about iron, calorie density of foods, and choking hazards offered their babies more high iron foods which resulted in more iron consumed, though this was not statistically significant.

They also gave their babies more high calorie foods and steered clear (mostly) of choking hazards.

{Read more about choking and BLW here: Baby-Led Weaning: A Developmental Perspective}

Babies of BLW-educated parents also introduced more food variety to their babies than those who approached BLW without special instruction.

In both groups, however, iron intake fell short of the nutrient requirement as outlined by the Institute of Medicine (IOM).

Although the researchers did not specify how much iron each group consumed during the study, they did note that babies of BLW pre-educated parents were served 20.1 grams of red meat per day (2.4 servings) compared to the babies of non-educated parents who received only 3.2 grams of red meat (0.8 servings) per day.

What is missing is evidence that the iron that was consumed in babies from BLW pre-educated parents was enough. Specifically, that there were adequate blood levels of iron in BLW babies.

Moving on…

Another 2016 study looked at 51 babies aged 6 to 8 months who were either spoon fed or fed with the baby led weaning approach. The researchers evaluated the baby’s caloric and nutrient intakes.

They found that calorie intakes were similar between BLW babies and traditionally spoon-fed babies, however intakes of total and saturated fats were higher in BLW infants, and intakes of iron, zinc and vitamin B12 were lower amongst BLW babies.

In a 2017 review study which looked at all research to date, the authors concluded that the evidence to date indicating BLW promoted healthy eating and healthy weight gain was weak, although promising.

In a more recent study (2018), researchers looked at the issue of iron status and other nutrients in BLW babies to address these shortfalls in the literature. They recruited about 100 participants each to a control and test group (200+ participants in total).

In the test group, parents were provided 8 weeks of education and support on BLW, using a modified approach to BLW including iron and energy intake education. Iron intake was measured and iron status was also evaluated. The results: iron intake and status was found to be adequate in BLW babies.

Additionally, however, sodium, fat and added sugar intake was found to be higher in BLW infants than control subjects. Overall, using the modified BLW which outlines daily iron and energy intake (1 serving of iron-rich food and 1 serving of energy-dense food at each meal) seemed to meet baby’s needs for iron and energy, but parents can give more attention to salt and sugar sources in their baby’s diets.

iron baby led weaning

BLW Iron Rich Foods are Critical

At birth, babies are theoretically “loaded” with sufficient iron to get them through the first 6 to 8 months of life. This depends, however, on a few things: mom’s iron stores and iron status during pregnancy, whether baby was born prematurely, and the timing of the umbilical cord clamping (early clamping reduces blood volume delivery to baby while delayed clamping (2-3 minutes after birth), which allows baby to receive about 30-50% of total blood volume from the placenta).

The truth is, we don’t know the iron endowment status of most babies at birth. If you have listened to my TEDx talk, you know my first-born was anemic at 18 months.

This, I believe, was due partly to my own iron-deficient status during my pregnancy with her. In other words, I believe she wasn’t “endowed” with a strong iron status because I was struggling to achieve a normal iron status myself (more on that later).

From the fourth month and on, your baby’s iron stores are used rapidly because he is experiencing tremendous growth, and as such, expanding his blood volume quickly, while developing his own iron stores in his body.

Experts note that iron deficiency may be difficult to assess in this period due to these rapid changes in body composition.

In children under age 4 who live in industrialized countries (hello, USA), it’s estimated that about 20% are iron deficient. More than 9% of the US population is iron deficient.

Iron Deficient Mom = Low Iron Endowment in Baby

When I had my first child, I was 30 years old. I had been an active adult, mostly participating in running for exercise. When I was pregnant, I became iron deficient.

I started on iron supplements around 4 months into my pregnancy, and continued with increasing doses of iron to normalize my blood levels. By the end of the pregnancy, I was taking large doses of iron and eating an iron-rich diet (hello, steak! One of my favorite meals!!).

Despite this, I struggled with anemia throughout my whole pregnancy.

My daughter was breastfed for the first 6 months before I returned to work. Twenty years ago, no one told me to give my daughter iron supplements at 4 months…so I didn’t.

(Now, the advice is to provide 1 mg iron/day starting at 4 months to all breastfed babies.).

My daughter started solids around 5-6 months of age using iron-fortified rice cereal fed with a spoon. She wasn’t the easiest baby to feed, and we struggled a bit.

At her one year checkup, she was flirting with the 5%ile for weight (read: she was underweight).

At her 18 months checkup, she was anemic.

Looking back and knowing what I do now, I believe she wasn’t “endowed” with strong iron stores at birth because I was anemic throughout my pregnancy.

She didn’t receive an iron supplement at 4 months, and even though she ate iron-fortified cereal and meats, it wasn’t enough to keep her blood iron-rich.

My early experience with iron and anemia — for myself and my daughter– has given me a clearer perspective on feeding babies. We all need to pay particular attention to nutrition and food sources of nutrients for our children.

Poor Iron Intake is No Good for Any Baby

When a young child is iron deficient or has iron deficiency anemia, a negative impact on their health may occur, including changes in immune status, delayed mental development, and below average school achievements.

This happens partly because there is a preferential use of iron in the body to make hemoglobin (a protein found in red blood cells which carries oxygen to cells and organs in the body), which may shunt iron away from the brain when iron intake is low in the diet.

The American Academy of Pediatrics (AAP) now screens for iron-deficiency anemia at 12 months, stating,

“There is growing evidence that iron deficiency and iron deficiency anemia have long-term effects on behavioral and neuro-developmental issues that can appear one to two decades after the anemia is treated.”

American Academy of Pediatrics

{Read: AAP’s stance on the importance of iron}

Iron for Babies: Where Do They Get It?

While breastfed babies get iron from breast milk, at 6 months, the contribution of iron isn’t enough when considering the dramatic rise in baby’s iron requirements.

Formula-fed babies get iron from drinking iron-fortified formula.

At 7 months, your baby’s iron requirements jump from 0.27 mg per day (Adequate Intake) to 11 mg/day (RDA).

Complementary foods, otherwise known as first foods or solids, should begin around 6 months.

Traditionally, iron-fortified cereals have been the first food for baby, delivered by spoon. But modern day feeding, including BLW, is steering parents away from this approach.

Professionally, I believe starting with beef or other meats is the way to go. And the current 2020 Dietary Guidelines for Americans is recommending the same.

I am not convinced it’s entirely possible for babies to get enough iron and other nutrients such as zinc and B12, using a traditional BLW approach without a sound nutrition education plan, such as outlined in the BLISS studies.

Alternatively, you can connect with a nutrition professional or read my book, The Smart Mom’s Guide to Starting Solids for a good resource on meeting your baby’s nutritional and feeding needs.

I believe thinking about, and planning for iron-rich foods in your baby’s diet is necessary to offer the best chance at optimal development and growth. And when it comes to BLW, using the modified-BLW approach, at a minimum, is the way to go.

Iron rich foods for baby

Add Iron Foods for Baby Led Feeding

Young babies who are transitioning to solids and who are breastfed are at risk for low iron intake.

If you are following BLW, you’ll want to keep your eye on iron and offer iron-rich foods.

In our book Fearless Feeding, my co-author and I suggest offering two servings of iron-rich foods each day for the baby transitioning to solids if spoon-feeding.

If using the modified-BLW approach, offer one serving of iron rich food and one serving of energy rich food at each meal.

This is the best approach we know to date, but it may not prevent your child from an iron deficit, especially if low endowment or skipping iron supplements with breastfeeding happens.

Here’s an example of iron-rich meals:

  • 4 tablespoons of iron-fortified oatmeal with an egg yolk (7 mg iron)
  • Meat puree with green beans (3 mg)

The key challenge with baby led weaning is that even though high iron foods are offered, babies may not eat enough to meet their iron needs.

Their tummies are tiny and they are just learning to chew, making the actual ingestion of iron (and zinc and B12) a big question.

The good news?

More research is helping us understand that when there is attention on iron and other nutrient-rich foods, babies have a better chance at meeting this important requirement.

Getting Enough Iron with Baby Led Weaning

High Iron Baby Food to Choose Everyday

Below I have listed the iron content of common high iron foods (from the USDA Nutrient Database), but you can see that portions are much bigger than a young baby (or even older baby in some cases) would likely eat.

The animal food sources of iron will be better absorbed and utilized than the plant-based options. They will need a source of vitamin C to go alongside to assist in better absorption.

  • Beef (1 ounce): 1 mg
  • Chicken, dark meat (1 drumstick): 1 mg
  • Lamb: (1 ounce): 0.5 mg
  • Egg (1 large): 0.6 mg
  • Black or pinto beans (1/2 cup): 1.8 mg
  • Raisins (1 small box): 0.8 mg
  • Cheerios (1 cup): 9.3 mg
  • Spinach (1 cup): 0.81 mg
  • Tofu (1 cup): 2.7 mg
  • Lentils (1 cup): 6.6 mg

Combined Feeding: The Best of Baby-Led Weaning & Spoon Feeding

If you’re feeling that you might be missing the mark with baby led weaning first foods rich in iron, you can always do a blend of baby led weaning and spoon-feeding, making sure that what is on the spoon is an iron-rich food.

(You can even pre-load the spoon and hand it over to your baby to self-feed, eliminating the temptation to overfeed.)

Pureed meat, including beef, chicken and turkey (dark meat especially) can provide iron, as well as zinc and vitamin B12.

As we see more studies about the adequacy of nutrient ingestion with BLW emerge, I favor a combined approach that includes spoon-feeding and hand-held solids using baby led weaning.

If you are intent on BLW, I advise a modified approach, focusing on iron and energy-rich foods. Another book I respect (with recipes), is Jennifer House’s book, The Parent’s Guide to Baby-Led Weaning.

A combination spoon-BLW feeding approach will help optimize self-feeding and self-regulation, while also ensuring adequate nutrition, especially for iron.

I think this promotes the best of both (worlds) approaches!

How do you make sure your baby gets enough iron?

The Smart Mom's Guide to Starting Solids

Need More Help with Baby Led Weaning First Foods?

Be sure to check out my book, The Smart Mom’s Guide to Starting Solids, which outlines all your feeding and food options for baby led weaning and spoon feeding.

This post was updated from its original in October 2020.

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