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O Baby-Led Weaning (BLW) é um método de diversificação alimentar alternativo ao método de diversificação convencional e distingue-se deste por se iniciar com alimentos inteiros cortados em formatos e com texturas apropriados, em vez das tradicionais papas e purés. Trata-se de uma metodologia que apenas pode ser iniciada aos 6 meses de idade e é recomendado como primeira abordagem apenas em crianças com normal desenvolvimento para a idade. No BLW é a própria criança que se alimenta, controla o que ingere, a quantidade e o ritmo de ingestão, cabendo aos pais o papel de apresentar uma seleção de alimentos adequada e variada e o de supervisão da refeição. Os alimentos selecionados são os mesmos que são apresentados à restante família e por isso a integração da criança nas refeições da família inicia-se a partir do começo da sua diversificação. Este método é escolhido pelos pais que acreditam que ele é mais simples e prático de aplicar, que traz vantagens a nível do desenvolvimento, que permite a aquisição de hábitos alimentares saudáveis, uma melhor regulação do mecanismo da fome e saciedade e que isso se irá traduzir em ganhos para a saúde que se vão prolongar ao longo da vida da criança. Para os pais, o método apresenta poucos inconvenientes. Já para os profissionais de saúde, apesar de reconhecerem que o método possa ter benefícios, existem riscos que os tornam algo céticos na altura de o recomendar. Exemplos desses riscos são o défice energético e de nutrientes como por exemplo ferro, excesso de gordura, particularmente gordura saturada, contacto precoce com açúcar, sal e alimentos processados e risco engasgamento. Dos estudos conduzidos até ao momento, tem sido possível constatar que os pais que optam pelo BLW têm características diferentes dos que optam pelo método convencional: têm mais habilitações, um nível socioeconómico mais elevado e personalidades menos ansiosas e controladoras, o que também pode contribuir para os benefícios atribuídos ao método. Também é prática comum entre quem o aplica o de respeitar as recomendações da Organização Mundial de Saúde (OMS) quando ao tempo de amamentação em exclusivo, ou seja, os 6 meses. A investigação sobre BLW é ainda incipiente e baseada essencialmente em estudos observacionais, sendo necessários estudos de desenho experimental e com mais longos períodos de seguimento, para se avaliar com justiça os seus potenciais benefícios ou riscos. Recentemente têm sido publicados resultados de um importante estudo randomizado que pretende avaliar as vantagens deste método e, contrariamente ao que os estudos observacionais pareciam sugerir, o BLW não parece estar associado a menor índice de massa corporal. Por outro lado, também não parece associar-se a maior risco de vómito e engasgamento, desvantagens que são frequentemente apontadas a este método. Assim sendo, há necessidade de se investigar mais esta forma de diversificação, com estudos randomizados, maiores tamanhos amostrais e tempos de seguimento destas crianças mais longos, que permitam melhor avaliar os riscos e os benefícios.
Baby-Led Weaning (BLW) is an alternative method to introduce complementary feeding that differs from the traditional weaning style by beginning the process with whole foods, cut into appropriate shapes and textures instead of traditional puréed or mashed foods. It is a method that can only be started at 6 months of age and it is recommended as a first approach only in children with normal development for their age. With the BLW method it is the child who self feeds, controls what he or she eats, the quantity and pace of ingestion, and the role of the parents is to present an adequate and varied selection of foods and supervising the meal. The selected foods are the same ones that are presented to the other family’s members and therefore the integration of the child into family meals starts from the beginning of their weaning. This method is chosen by parents who believe that it is simpler and more practical to apply, that it brings development advantages, allows the learning of healthy eating habits, a better hunger and satiety mechanisms’ regulation and that this will translate into health gains that will extend through the child's life. For parents, the method has few drawbacks. For health professionals, although they recognize that the method may have its advantages, there are risks that make them skeptical when it´s time to recommend it as a weaning method. Such risks are dietary disadvantages: energy and nutrient deficits (iron especially), excess fat, and saturated fat in particular, early contact with sugar, salt and processed foods and increased risk of choking. Research conducted so far showed that parents who choose BLW have different backgrounds from those who opt for the traditional weaning method: they have a higher level of education and socioeconomic status and have a less anxious and controlling personalities, which can also influence the favorable outcomes attributed to the method. It is also common practice among those who apply it to respect the six month World Health Organization (WHO) recommendations on exclusive breastfeeding period. Research and data on BLW are still incipient and are based essentially on observational studies, with small samples. More experimental studies with longer follow-up periods are necessary to properly assess its potential benefits or risks. Recently, the results of an important randomized trial that intends to evaluate the advantages of this method have been released and, in opposite to what observational studies seemed to suggest, BLW does not seem to be associated with lower body mass index. On the other hand, it also does not seem to be associated with a greater risk of vomiting and choking, therefore, there is a need to further investigate this form of weaning, with randomized studies, larger sample sizes and longer follow-up times of to better assess its risks and benefits.
Baby-Led Weaning (BLW) is an alternative method to introduce complementary feeding that differs from the traditional weaning style by beginning the process with whole foods, cut into appropriate shapes and textures instead of traditional puréed or mashed foods. It is a method that can only be started at 6 months of age and it is recommended as a first approach only in children with normal development for their age. With the BLW method it is the child who self feeds, controls what he or she eats, the quantity and pace of ingestion, and the role of the parents is to present an adequate and varied selection of foods and supervising the meal. The selected foods are the same ones that are presented to the other family’s members and therefore the integration of the child into family meals starts from the beginning of their weaning. This method is chosen by parents who believe that it is simpler and more practical to apply, that it brings development advantages, allows the learning of healthy eating habits, a better hunger and satiety mechanisms’ regulation and that this will translate into health gains that will extend through the child's life. For parents, the method has few drawbacks. For health professionals, although they recognize that the method may have its advantages, there are risks that make them skeptical when it´s time to recommend it as a weaning method. Such risks are dietary disadvantages: energy and nutrient deficits (iron especially), excess fat, and saturated fat in particular, early contact with sugar, salt and processed foods and increased risk of choking. Research conducted so far showed that parents who choose BLW have different backgrounds from those who opt for the traditional weaning method: they have a higher level of education and socioeconomic status and have a less anxious and controlling personalities, which can also influence the favorable outcomes attributed to the method. It is also common practice among those who apply it to respect the six month World Health Organization (WHO) recommendations on exclusive breastfeeding period. Research and data on BLW are still incipient and are based essentially on observational studies, with small samples. More experimental studies with longer follow-up periods are necessary to properly assess its potential benefits or risks. Recently, the results of an important randomized trial that intends to evaluate the advantages of this method have been released and, in opposite to what observational studies seemed to suggest, BLW does not seem to be associated with lower body mass index. On the other hand, it also does not seem to be associated with a greater risk of vomiting and choking, therefore, there is a need to further investigate this form of weaning, with randomized studies, larger sample sizes and longer follow-up times of to better assess its risks and benefits.
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Keywords
Baby-Led Weaning Regulação do apetite Engasgamento Auto alimentação Appetite regulation Chocking Self-feeding