Comparison between baby led weaning and traditional spoon-feeding on iron status and growth in breastfed infants

Background: The current guideline recommends infants are initially offered smoothly pureed foods, known as the traditional method of spoon feeding. Currently, an alternative method known as 'baby-led weaning' (BLW) has been really popular. With BLW, infants are allowed to selffeed family foods in their whole form instead special-prepared foods. Infants following BLW may be at increased risk of faltering growth. Objective: To compare traditional and BLW methods in the risk of iron deficiency anemia (IDA) and growth faltering of breastfed infants. Methods: A cross-sectional study was undertaken in 9-15 months breastfed infants admitted to Bedah Hospital Surabaya from August-October 2017. Exclusion criteria were infants suffering from chronic conditions. Biochemical assessment of Haemoglobin (Hb), Serum Transferrin (ST) and Serum Ferritin (SF) was measured. Diagnosis of IDA and growth chart interpretation was made based on WHO criteria. Results: Out of all, 12/30 boys and 15/30 following BLW. Mean age was 12.6±2.14 months old. Mean Hb level, ST level and SF in BLW group was 10.9±0.55 g/dl, 11.6±7.13%, 19.1±18.40ug/dl prospectively, while in the traditional group were 12.5±0.75 g/dl, 24.6±7.92%, 57.6±18.78 ug/dl prospectively. IDA was higher in BLW group than in the traditional group. (13/15 vs 3/15, OR 26.000 95%CI 3.686-183.418, p <0.001). Underweight was higher in BLW. (13/15 vs 3/15, OR 26.000 95%CI 3.686-183.418, p <0.001). Stunted were higher in BLW (2/15 vs none, OR 1.667 95%CI 1.103-2.519. p=0.017). Conclusion: In breastfed infants, those who were following BLW are in higher risk of IDA, underweight and stunted than traditional spoon feeding.