Complementary Feeding Methods: Answers to Top Questions

• Encourage parents to pay attention to developmental signs of readiness for their baby to begin their transition to solid foods.
• Parents should not feel pressured to feed in a certain way, and to do what’s best for them (Kimninou 2019).
• Suggest that parents offer baby a preloaded spoon with baby cereals or purees, or very soft-cooked foods that are about the length of a finger.
• Let parents know that it is common for food to miss the mouth in the beginning. Remind them that baby is learning not only how to self-feed, but how to use their hands to bring specific things into their mouth. It can be hard to tell exactly how much has been eaten, which makes relying on responsive feeding even more important.
• Let baby tell you when they are done eating (Leong 2018).
• Inform parents about the lack of evidence and clinical guidelines to support one feeding method over another. If parents prefer a baby-led method of introducing solids, points of information regarding the introduction of solids can be provided (adapted from Anderson 2020):
  1. Ensure that your baby is ≥ 6 months of age (correct for prematurity) and developmentally ready to self-feed
  2. Never leave your baby alone with food and always supervise them when they are eating
  3. Make sure your baby is sitting upright when eating
  4. Allow your baby to eat at his/her own pace
  5. Introduce foods that your baby can mash on the roof of their mouth with their tongue (e.g., soft, cooked vegetables)
  6. Avoid high-choking risk foods (e.g., nuts, grapes, crackers, raw apples, raw vegetables, sausages or other foods cut in to rounds or 'coins')
  7. Offer iron rich foods at each meal (e.g., meats [red meat, poultry, fish] and alternatives [beans, lentils and eggs])
  8. Offer a wide variety of foods and at least one high-energy food at each meal (e.g., avocado, full fat cheese, plain yogurt, nut butters, meat and alternatives)
  9. Avoid food with added salt and/or sugar
  10. Pay attention to hunger and satiety cues

Adapted from the BLISS trial (2) and systematic review by D'Auria et al. (5).

• Choking is a risk regardless of the feeding method practiced. If concerned about choking, visit Health Canada's website to learn more.
• Remind parents and caregivers that no matter what feeding methods are employed, young children must always be seated and supervised when eating.

• Appropriate finger foods for infants include soft, easily chewable options that are cut into small, bite-sized pieces. Baton shaped foods are also acceptable.
• Some examples include small pieces of ripe fruits like banana or avocado, cooked/diced vegetables like sweet potato or carrot, soft-cooked pasta or rice, small pieces of well-cooked and shredded chicken or fish, and small cubes of cheese. It's important to choose foods that are age-appropriate and easy for the infant to pick up and eat independently.
• Gerber offers many choices that are developmentally appropriate such as Puffs (8m+), Yogurt Melts® (8m+), and Lil’ Crunchies® (8m+). These foods can help give parents peace of mind that their child will meet nutrition needs while exploring self-feeding.

• Iron: Iron is critical for neurological development and immune function. All babies need to consume iron containing foods during complementary feeding. 

• There is no long-term research that finds BLW and/or baby-led feeding will reduce picky eating.
• Some studies show that BLW reduces parents’ perception of picky eating in the beginning of starting solids (Finnane 2017, Utami 2020).
• Continuing to expose baby to a wide variety of flavors, textures, and colors throughout complementary feeding is one way to encourage food acceptance.

• Parents have reported that their babies are more likely to be exposed to a higher variety of fruits and vegetables during BLW, however, they may not necessarily be consuming the fruits and vegetables (Białek-Dratwa 2022).
• Recent research suggests that babies following traditional spoon-feeding have fecal microbiota with a more complex composition at 12 months than babies following BLW due to higher intakes of fruits, vegetables, and dietary fiber which is partially responsible for higher diversity of the fecal microbiota (Leong 2018).

• All of GERBER® baby cereals are iron fortified to help with baby’s nutrition and growth. Additionally, GERBER® baby cereals come in different grain types and flavors.
• Combine purees and cereal with table foods as baby grows:
  • Offer foods that are soft-cooked. There may be a limited number of foods at the family table that meet these requirements. You can encourage patients to offer those choices alongside a puree such as GERBER® mealtime purees.
  • At breakfast, combine iron fortified baby oatmeal with soft, fresh fruits, such as thin slices of banana or avocado.
  • Provide baby cereal or puree in a hand-held way e.g., spread on toast.