No-BS breastfeeding resources (an ongoing project)

Suppose you're a normal mother-to-be who is planning to breastfeed... or, maybe thinking about it but not committed either way. You're looking forward to doing the sort of things the ordinary, everyday mothers around you do--you're planning a hospital birth with lots of nice drugs, you want to get your baby onto some vague sort of routine so you can plan the day, you'd certainly like baby to start "sleeping through" sooner rather than later, and you'll want to be able to leave your baby with your husband/mother-in-law/babysitter regularly so you can go out. You might go back to work while your child is still young.

Or maybe you're a second-time mother. You tried to breastfeed the first time round--oh, so very, very hard. And it didn't work out. Trouble is, by then you'd already spent months reading all the books and blogs--the ones that told you in no uncertain terms that your formula-fed child was going to be stupid, asthmatic and fat, that you wouldn't "bond" properly, and that anyway this was all your fault because you didn't have an all-natural birth bouncing up and down on a yoga ball, and because you caved and let the nurses take baby to the nursery for a couple of hours because you were too exhausted to see straight. A spiral into gloom, anxiety and hystronic post-partum depression was more or less guaranteed. Now you're girding your loins to try breastfeeding again. But the thought of reading those books again... the ones that were whispering in your ears at 3AM every morning while the tears rolled down your face...

I think you can see why most breastfeeding resources--the books, the blogs, the forums--are problematic for either one of these women. Such resources are heavily oriented towards natural birth, "natural" parenting, and natural just-about-everything-else, and waste no time in telling you about the horrors that await you and your child should you weaken and allow even a single bottle of that ghastly white stuff. And they are full of sloppy science, urban legends and pet theories.

Other books (usually not "breastfeeding books" but rather general how-to-look-after-your baby books) talk about routines and sleeping-through-the-night (almost fanatically, sometimes) yet fail to get the basics right regarding breastfeeding. For example, Gina Ford tells exhausted new mothers to start pumping pretty much from Day 1 in order to stretch out the gaps between feeds. Claire Byam-Cook and Tracy Hogg (the Baby Whisperer) tell women to measure how much milk they are producing by doing a "yield," i.e., pumping and measuring their output, apparently unaware that there are many women--including Yours Truly--who have a good supply but are mediocre at pumping. If I had followed these writers' advice, I would have been convinced that I was starving Little Seal with every feed.

For these reasons, I've decided to start compiling a comprehensive list of breastfeeding resources which I reckon are credible, science-based and reasonably representative of how most of us actually mother. I'll keep updating this as I come across more sources, but this is a start. There's some practical stuff here; there are also discussions of breastfeeding research and politics to muse on, or to wheel in as counter-evidence when someone online is talking bollocks.


Books

Actual breastfeeding books

As I moaned here, it is very hard to find breastfeeding books that don't seem to be written by someone with the shining light of the fanatic in her eyes. Marianne Neifert (in Dr. Mom's Guide to Breastfeeding and Great Expectations: Essential Guide to Breastfeeding advocates for breastfeeding but manages to do so without the harshly judgmental tone of other lactivists. She is almost alone in the breastfeeding book annals in her outspokenness about the difficulties and barriers many breastfeeders experience, and in stating frankly that low supply really exists and is not a myth. Most importantly, her books get all the nuts and bolts right; they are full of great, practical information about how the breasts work, the mechanics of breastfeeding, latching, troubleshooting, pumping and much, much more--everything you'll get in the Womanly Art of Breastfeeding, in short, but without the scaremongering and condescension. By the way, it was Estherar at Mainstream Parenting who first put me onto this book.; check out her review here. 

Solids ("weaning")

Weaning Made Easy is a fun yet evidence-based approach to weaning (=solids introduction, not breastfeeding cessation) which avoids the tedium of the gourmet-icecube tray approach (making overelaborate purees and then spending mealtimes trying to get it all inside the baby) and the pitfalls of the Gill Rapley baby-led weaning method (potential iron/zinc shortages, babies going for months on end without eating anything, neverending mess). It encourages parents to offer different foods in a variety of ways, including soft finger foods and purees of nutritious-yet-hard-to-eat things, based on sound nutritional principles--always with a stress on the individuality of each child and the need for you to feel comfortable with what you are doing. Which, I suspect, is how most people would wean anyway if we didn't have babycare writers telling us how to do it...

Sleep

I have half a dozen infant sleep books on my shelf (ordered by my husband in a fit of Amazon-inspired shopping mania). There they sit, their spines almost uncracked. When it comes to sleep there's only one book I use--Good Night, Sleep Tight by Kim West--and it's never failed me yet. This book (by a sleep specialist who's helped countless families) is moderate, eminently sensible, and flexible enough to work with a whole range of parenting "styles"--while she emphasizes sensible routines and self-soothing, she is also extremely sensitive to the needs and feelings of babies and young kids... and she has a gentler alternative to cry-it-out for those who can't quite face Ferberizing. She also breastfed both her daughters, and that's important because breastfeeding and formula feeding have subtly different dynamics that affect sleeping patterns. A lot of "sleep books".... well, they may give lip service to "bottles/breastfeeds" in their routines, but you can tell it's really formula feeders they have in mind. When a sleep book is written from the point of view of a breastfeeder, it makes the breastfeeding mother feel "This is advice that's realistic for my baby. I feel we have a chance of succeeding with this." With sleep advice it's vital to feel confident that it's achievable and practical for your situation, or you'll never be able to put it into practice. West is not super "into" bedsharing, but discusses it in a sensitive and nuanced manner--the various reasons people bedshare, how to do it safely, how to combine it with learning good sleep habits, and how to transition away from it when the time comes--unlike some other writers who just scold and shame parents who take their babies into bed with them. She is even not-rude about mothers who nurse longer than 12 months (not common in parenting books).

Colic/fussiness
The Happiest Baby on the Block is a mildly attachment parent-y book with some good and practical advice for getting through the colicky weeks months. Generally I'm all for keeping babies on a loose routine, but when colic is wreaking its merry hell, sometimes you just have to grit your teeth and do what's necessary to get through the day. I recommend going straight to the second half of the book and ignoring the first section, which goes on a bit too much about how primitive tribespeople's babies don't have colic because they are carried round all day long (or something).

Other possibilities (recommended by others--I haven't read them)
Milk Memos (nursing and working) sounds like a good and non-judgey read, looking at the Amazon reviews. Child of Mine: Feeding with Love and Good Sense (feeding in general) was recommended by a blog reader. Baby Love (baby's first year) by Robin Barker got a good write-up from several people: "No nonsense; and she calls a poo a poo."


Blogs and websites

Kellymom
Ah yes, Kellymom. I've moaned about Kellymom a few times on this blog (and will be writing a longer post on them in the future). And yet I've sent struggling new mothers off to Kellymom for information several times, and there is presumably a reason for that. Kellymom can be really useful as long as you confine yourself to the “How many wet/dirty diapers should my newborn be producing?” kind of stuff, and bear in mind that this is an attachment parenting promotion site more than anything else. I've compiled a list of pages that I think give decent advice, but with everything that comes from Kellymom keep your skepticism close at hand. If it smells like bullshit, it may well be.  Confirm with other sources if you are not sure!

Low supply
Milk supply worries
Breastfeeding and medications
Weight gain (but see the FFF also here and here for your pinch of skepticism)
Pumping  
Milk supply and the older baby
Newborn basics
 
Much of the other stuff on the site is dodgy, especially the stuff on weaning age, solids/iron and the exaggerated benefits claimed for nursing, especially extended nursing. The forums have some pretty crazy ladies.
PS: Stay away from the sleep advice on that site if you value your sanity.

Science of Mom

A blogger I have a girl-crush on. The post on why breastmilk is so low in iron shreds some myths and misunderstandings about iron and breastmilk. It's refreshing to see a mother who can describe the joys of nursing past a year while questioning some of the dodgy data being used to push this choice onto all mothers. Meanwhile, can breastmilk clear up an eye infection? Possibly yes (admittedly, most of the breastfeeding sites have similar information, but it's nice to see Science of Mom actually confirming this with some data). Other posts cover breastmilk and prematurity, maternal diet and colic, improving milk production in the NICU and more.

Seattle Mama Doc combines evidence-based advice (sleep, breastfeeding, nutrition and more) with a kind and non-judgmental tone that makes for reassuring reading. She's worth a read!

Good Enough Mum

A terrific set of posts from a terrific blogger. She writes about nightweaning for a breastfeeding mother, and breastfeeding the second time around, gives her view on the "Watch your language" thing, and on why brutally unpleasant lactivism is everyone's business, while giving her vision for what positive breastfeeding promotion could look like. She also shreds some of bad science surrounding extended nursing--it's not as beneficial as you think (which doesn't mean you shouldn't do it if you want to)--and takes issue with the idea that a single bottle of formula will ruin your child's "gut" forever.

Fearless Formula Feeder
The majority of breastfeeders will use formula at some point, yet most breastfeeding resources say little about formula other than "Don't" followed by a list of terrifying reasons why--or descriptions of "correct formula preparation" which one suspects have been presented with the deliberate intention of making formula use look as intimidating as possible. That's why the Fearless Formula Feeder site (and upcoming book) can be the breastfeeding mother's friend. Learn the real deal about combo feeding and supplementing, jaundice, the mechanics of formula feeding, spotting formula allergy/intolerance, why you can't use goat's/cow's milk as a formula replacement, growth charts for formula-fed and breastfed babies and much, much more. Suzanne's site is extremely respectful of all safe feeding choices for babies... and what's more, it manages to be scientifically rigorous, well-written and nice--three things that are very hard to combine in online writing.    

Mainstream Parenting, while now defunct, is still a great source of skeptical commentary and mythbusting, some of which covers breastfeeding.


Miscellaneous

Skeptically Speaking's 15-minute podcast on breastfeeding is well worth a listen for an interesting scientific slant on lactation.

Trolls With Wooden Spoons

Trolls (you have to join; oh, and despite the name, the group has nothing to do with the internet phenomenon of "trolling") was created by a bunch of Mothering.com escapees who had become disillusioned with the craziness and horrible moderation on that site. So it's crunchier than I am, yet is also one of the few places where you will seldom get extremist natural-parenting stuff pushed at you; people started this site to get away from all that. And it's full of experienced breastfeeding mothers. There is a refreshing absence of pretension and bullshit on the site. The Woo-Busters page is a good place to get a second opinion on anything which sounds like woo but you are not quite sure!

NB: Avoid Trolls threads on carseat safety or Thanksgiving.

Mammals Suck... Milk! looks at the science of lactation across the animal kingdom, including human beings. Not a "how to breastfeed" blog, certainly, but fascination stuff and great background information.

Bullshitometer: Breastmilk has more calories than any solid food

Mmm....food!

One of those internet memes that is always cropping up on online forums is "Breastmilk contains more calories than any other food." Like all internet memes, it comes in various forms--"Breastmilk contains more calories than almost any other food," "Breastmilk contains more calories and nutrients than any other food," "Breastmilk contains more calories than any other food except avocado""Breastmilk contains as many calories as melted icecream" and so on. It's usually something you hear when some mother is debating whether to start her baby on solids (because her baby seems hungry on breastmilk alone) or whether to offer more solids to her older baby or toddler who is nursing almost exclusively and is gaining poorly. Sometimes, just to add to the general drama, there is a pediatrician involved in the background who is apparently telling the mother to stop/reduce nursing because this is "filling the baby up on breastmilk" and preventing them from wanting their solids.

This is the point where someone will inevitably advising the mother to sack the pediatrician, nursenursenurse, and not bother about introducing solids/offering increased amounts of solids--or even cut back on the things or stop them completely. Given the "breastmilk contains more calories than any other food" meme, it's easy to see why. If you actually believe that breastmilk contains more calories than any other food, then logically, why would you introduce/increase solids in response to hunger or poor weight gain? In fact, if you took the idea to its logical conclusion, you should actually decrease solids or better still, take them away altogether, because surely the only thing those rotten, puny solids are going to do is fill the kid up and reduce their appetite for your calorie-festa boobie milkshakes. Clearly you should introduce solids as late as possible, or better still, never.

Since my own impression of breastmilk's flavor--oh come on, like you've never tasted your own--is that it does not taste like melted icecream, I did some research into the calories counts of solid foods commonly offered to babies using USDA figures. Very easy to do. Here's what I found:

Food	Kcal per 100g
Acorn Winter Squash (without salt, mashed, cooked, boiled)	34
Cooked spinach	40
Orange	47
Apple	52
Boiled carrots	54
Pear	58
Yoghurt (whole milk)	61
Breastmilk	67
Cottage cheese	103
Baby cereal oatmeal cooked with milk	116
Baked or broiled haddock	128
Egg	154
Chicken breast	195
Brown bread	210
Lamb chop	314
Egg yolk	322
Baby rice cereal (NB: See below)	391

This is a pretty reasonable "range" of vegetables, cereals, fruits and animal foods, and in terms of calorie count, breastmilk comes slap in the middle of the list; not a low-calorie food by any means, but not "melted icecream" or "richer in calories than any solid food" either, not by a long shot.

There are two conclusions one can draw from this. Firstly, look at the things in the upper part of the table with fewer calories than breastmilk: pear, carrot, squash and so on. Notice anything about them? Most of the the things which are offered to very young babies are actually pretty low in calories. So no, giving your five-month-old a few teaspoons of pureed carrot is not going to miraculously make her sleep through the night, as many disappointed parents have found out the hard way (seriously, is there anyone for whom this trick has ever actually worked?). Plus, let's face it, actually getting 100g of breastmilk into a young baby is usually easier than trying to get 100g of banana into them... as opposed to all over the floor, highchair, bib, baby's hair etc. etc.

How about rice cereal? Lest you are goggling at that last figure on the list, I should let you know that this appears to be the figure for dry baby rice; I can't seem to find a figure for rice cereal mixed with breastmilk, which is how it's usually served. Kellymom (which does things in ounces.... Americans, please get with the program and switch to metric like the rest of the planet!) gives 22kcal/ounce as the calorie count for breastmilk and 20kcal for a very watery-sounding "Baby rice cereal  (2 TBS dry cereal prepared in one oz water)," so I'm going to go right ahead and assume that 100g of regular-thickness breastmilk-mixed-with-rice-cereal probably contains somewhat more calories than 100g of breastmilk, though certainly not anywhere near as much as 391kcal. That said, The Sleep Lady is something of a goddess in my household, so when she says that of the countless parents she's worked with over the years who have dutifully given their babies rice cereal every night, she has never seen any cases where actual sleep improvements have resulted, I tend to believe her. Let's face it, there are a lot of reasons why young babies wake at night.

However. The second point one might take home from the chart is that it would appear to call into question the idea that introducing or increasing solids is unnecessary or harmful for on older baby/toddler who is eating very little food and is hungry or gaining poorly.

Three other points:

(1) Breastfeeding at the breast is quite hard work for the nursling, who has to suck hard for every mouthful, and the milk comes slowly. This of course is generally a good thing as it acts as a natural corrective to overfeeding, which is probably why excessive weight gain is less common with breastfed babies. On the other hand, if a mother has a hungry or failing-to-grow child and needs to "feed them up," I suspect that this feature of breastfeeding may become a hindrance, and easy-to-eat solid foods are probably more suited to her purpose.

(2) With breastmilk a mother limited to whatever her body can produce, and at times when it is available--i.e., she's probably going to have to feed throughout the night if she is to stand a chance of providing enough calories. With solids--assuming one is not living in the South Sudan famine belt or something--one can always just go to the fridge and get more.

Granted, some women no doubt can provide more than enough calories to sustain a baby up to a year or even beyond with little or no solid food, assuming they have a strong supply and are prepared to do plenty of night feedings. According to this USDA source, a 1-month-old baby boy requires about 472 calories a day, which means a mother of twin boys would need to produce 944 calories a day in breastmilk in order to exclusively breastfeed them. A single 12-month-old baby boy, on the other hand, requires just 844 calories a day (and bear in mind that breastmilk typically becomes more calorie-dense as your child grows older). Since there most certainly are mothers who manage to exclusively breastfeed twins to a month or well beyond, it would appear that some women, at least, are capable of producing more than enough calories to feed a child healthily to a year or so. There are other reasons why babies need solids by about six months or so (iron and zinc), but calorie-wise, a baby who takes to solids slowly is probably not a problem if they are gaining well and meeting milestones. But not everyone has a terrific supply. If a child is not growing well, they probably need more food.

(3) With the exception of infants in the Gerber puree stage, it's not like we human beings actually tend to sit down and eat Plain Boiled Carrot/Spinach With Nothing Else very often. You're more likely to eat, say, steamed veggies dressed with oil or butter, which boosts the calorie count quite a bit even for those low-cal foods at the top of the list. (And you'll notice that the super calorie-rich things like avocado and olive oil weren't even included on my chart.)

One thing which seem very hard to verify is whether overconsumption of breastmilk really can "fill a child up" and stop them eating enough solid foods. My own hunch would be that if you've a child who just plays with solids, restricting nursing for a bit might be worth a try, to see if it can kickstart a child's developing a bit more of an appetite for solids... some kids are just very reluctant to try anything new and may need an initial kick up the butt to get them going. If that doesn't work, an assessment for texture/aversion issues might be an idea. I very much doubt whether stopping nursing altogether is necessary; some pediatricians are genuinely biased against extended nursing and tend to see it automatically as being the cause of any problem that a child's parents complain of.

Bullshitometer verdict

Breastmilk appears to have plenty of calories--more than a few teaspoons of pear puree or whatever, anyway. That said, it's not true that it has more calories than any other food. If you have an mostly-breastfed older baby who's not growing too well, they probably need more solids. I think it's worth banging on about this a bit because while there is no real evidence that solids-introduction methods have any long-term effects on children, and the differences between breastmilk and formula are probably a lot smaller than many people believe, there is a ton of robust evidence suggesting that chronic shortages of calories (and iron) in the first couple of years can have long-term negative effects, especially on cognitive development.

It might seem like a no-brainer that a child not getting enough calories is bad for them, but it seems a few people really do need telling--and that people who have drunk deep of certain kinds of woo can start looking at their children through a kind of distorted lens. On Trolls With Wooden Spoons (an interesting forum created by former Mothering.com posters who had become disillusioned with the site), I remember an occasionally disturbing thread titled something along the lines of "What was the stupidest thing you ever did under the influence of Mothering.com?" (quoting from memory). One poster wrote something particularly sad. It was, roughly, "The stupidest thing I ever did because of MDC was exclusively breastfeeding my toddler, and telling myself again and again that he was a perfectly healthy toddler who just happened to be really tiny for his age." Yikes. As they say, "Rule No. 1: Feed the baby"!

Bullshitometer: Baby led weaning/Gill Rapley

Baby led weaning, a term invented by British health visitor Gill Rapley, may not be "breastfeeding" as such, but it's so popular on breastfeeding-centered boards and blogs that it's worth a little scrutiny. Confusingly for North Americans, BLW is not about weaning from the breast; rather, it refers to a method of solid food introduction which consists (roughly) of forgoing the traditional spoonfeeding of purees, and instead giving the baby large-ish pieces of table food to self-feed... or chuck on the floor if they are so disposed, the idea being that this is about "following the baby's lead" in terms of what and how much solid food they eat. BLWers usually wait at least six months--sometimes later--before starting solids, and BLW is typically characterized by a much slower shift towards solids than the spoonfeeding approach, with babies not infrequently getting little in the way of solids until they approach a year old.


Definitions
Because BLW has become quite fashionable, everyone seems to have started using the term and you will often hear people using it to describe what is more traditionally called "finger foods" ("We're doing some purees with a spoon, and also some BLW"). However, people who take BLW Very Very Seriously--I'm going to refer to them as the BLW purists--scoff at such approaches, saying that you can't do BLW by halves. The whole philosophy of bona fide BLW, you see, is based on the idea that babies should be entirely in charge of the feeding process; once you start doing any spoonfeeding, the whole weaning process becomes... like... not BLW. In this respect, the purists actually go even further than Rapley herself, who admits that a bit of spoonfeeding may be okay if you really have to. Gill Rapley's philosophy of BLW is set out in her book;  however, aficionados tend to say that this weaning method is as old as time itself ("What do you think people did before blenders?") and that by contrast, puree-based spoonfeeding is a new invention, necessitated by the invention of infant formula and pushed on parents by the babyfood industry, which has a vested interest in getting parents to give solids more and earlier than is natural for babies.

Finger foods are not the subject of this Bulshitometer post--everyone does finger foods and all pediatricians recommend them, including my parents' 1970-something Dr Spock book if I remember rightly. What I am scrutinizing is BLW as per the second definition, and the claims that have been made for it by Gill Rapley and her fans--namely, that there is a particular virtue in avoiding pureed/mashed foods and spoonfeeding, and that forgoing these things will lead to children with better eating habits, that parent-led feeding will make children more prone to obesity or pickiness, that children allowed to self-feed everything will gain better motor skills and instinctively avoid things they are allergic to, that pureed foods cause constipation, and that BLW is the "natural" way and represents the biological and historical norm for human babies.


Better eaters
Less obesity! Better eating habits! Children who eat vegetables without complaining! Rapley could hardly have come up with a more appealing laundry list of points with which to entice 21st century parents engaged in that very modern pursuit of worrying about food. Based on her 20-odd years as a health visitor, "Rapley believes that babies allowed to feed themselves tend to become less picky, develop better hand control more quickly and to avoid foods to which they are later found to be intolerant."

I'm sure she does believe all this. Similarly, people in the 17th century apparently believed that bloodletting cured all manner of ills and that fever could be cured by taking live pigeons to bed with you. All together now: "The plural of anecdote is not evidence."

Considering the fervor that BLW inspires in some of its devotees, it's striking how little evidence there is to support its claims--"little" as in basically "none." Rapley's book's claim that BLW will result in less picky eaters rests upon a single experiment conducted before WWII--a trial for which almost no data was ever presented and which can never be replicated for ethical reasons. Rapley also includes a study she conducted among a small group of babies which proved, not very excitingly, that if you present babies with a variety of table foods, by nine months they will be... eating a variety of table foods. So yes, if you want to skip the purees and go slower on solids, it's probably fine. But none of this provides any evidence for Rapley's other claims of less picky eaters or magic allergy avoidance.

The other "evidence" provided by the book consists largely of proud parents saying things like "I'm doing BLW with my nine-month-old and she's eating broccoli! See? BLW totes works!" No. Your child is eating green veggies with gusto because she is a baby. Come back when she's two and we'll talk. Two is generally when the food fussies kick in, probably for evolutionary reasons related to the fact that toddlers in neolithic societies were at real risk of being poisoned by unknown plants found in their environment. The BLW site's toddler forum is full of parents moaning that their two- and three-year-olds have suddenly started rejecting foods they used to eat with relish.

Other parents compare the fact that their BLW-ed younger child is a better eater than their traditionally weaned older child--a comparison which, on the individual level, tells us precisely nothing, given that in any pair of siblings, even those weaned in exactly the same way, one will typically be a better eater than the other simply because genes play a powerful role in our eating preferences.This is Bad Science 101--seriously, I could use exactly the same approach to "prove" the efficacy of homeopathy (or the live pigeon treatment, for that matter).

I mean, I do get that obesity and the dreaded "kiddie food" culture of bland junk foods are worries for parents; but these are problems that have become acute only in the last half-century, so it seems a bit odd to blame them on parent-led feeding of mashed foods, which has gone on for millennia (see below). Cross-culturally too, it's hard to see any patterns; as one poster notes here (with thinly disguised annoyance), French babies get bland mush on a spoon and cereal in their formula bottles, and still seem to end up better eaters than British and American children. So do Japanese kids, for that manner, in spite of their parents Doin It Rong in terms of first foods (spoon-fed gluey rice porridge, since you asked).


Better motor skills
Manipulating finger foods doubtless is indeed a way for babies to practice their fine motor skills, but in Rapley's claims that BLW results in better motor skills, I detect the whiff of a burning straw man; I don't think many people actually do wean babies on nothing but spoonfed mushes. Most parents have always given finger foods in addition to spoonfeeding, and it's hard to see how the benefits of finger food practice get magically erased as soon as you give the kid a bit of mashed potato on a spoon. As for the vague parental claims that their BLWed babies have better motor skills, see above comments about anecdotes vs evidence.


Purees cause constipation
There is no reason why pureed foods should cause constipation any more than non-pureed foods. A quick visit to Ask the Dietitian confirms that pureeing or even blenderizing foods leaves their fiber intact--although anyone who regularly consumes fruit smoothies can testify to their, ahem, bowel loosening effect without the need to go online. Perhaps Rapley is confusing pureeing with juicing, a very different process? Constipation is a common temporary effect of solids-introduction as the baby's gut tries to get used to new foods; if it is less noticeable with BLW, a simpler explanation is that if you are hardcore about the baby only eating what he/she can self-feed, it will probably take a while before they actually eat enough to have any effect on the digestive tract.


Tradition/"naturalness"
BLW is popularly considered to be more "natural" than feeding purees or mashes. Now..... trying to define what is "natural" for human beings is always a bit of a philosophical headache. However, it's not clear on what grounds BLW qualifies.

The whole "What Would Cavemama Do" approach to childrearing gets a bit daft, but for the sake of arguing.... Rapley's book states that prior to the 20th century, most babies didn't start solids till they were "eight or nine months old" (she gives no source for this alleged fact). It's surprisingly hard to find proper sources on solids introduction in pre-industrialized societies; from those which can be found, what kind of picture emerges? Well.... surprisingly, lots of mush, lots of parent-led feeding, and lots of starch, to be honest (see here, here, here and here, for example... if you don't want to wade through the last one, there is a summary here). Feeding babies foods that have been mashed in some way--between two rocks, your fingers or even your own jaws--has a long history, and no, you don't need a spoon or a blender (slummy mummies like me could have told you that already, though).

Do babies in "traditional" societies also self-feed? Probably: the casual nature of such culinary encounters is such that they probably aren't going to make it into an anthropologist's report, but given how grabby older babies are it would be surprising if this didn't happen. In other words, throughout human history, most babies most likely have received a mixture of parent-fed mushy things and larger pieces for self-feeding.... which, funnily enough, is pretty much what most parents in industrialized societies also end up doing.

What I can say is that I could not, in all my researches, come across any "traditional" societies that do solids-introduction the way Gill Rapley sets out (no parent-led feeding, baby only eats what baby self-feeds, blah blah). Not one. To be honest, I'm not even sure how Rapley-esque weaning would really work in a traditional society. For a start, I can't see women in a food-poor environment being cool with a baby throwing good food all over the floor in the name of play and exploration. They don't really do the whole "child-centered" thing in traditional societies.

Curiously, Rapley also mentions pre-chewing in her book, and says that she thinks it is fine; she does not, however, clarify how this differs from spoon-feeding (on which she blames for everything from gagging to pickiness to overeating).


Convenience
Rapley's devotees insist that BLW is the most convenient way of giving solids. I am not sure I agree. I think the most convenient way, for most people, is to do some finger foods and some parent-led feeding, depending on the food, the situation and what seems to suit you and your child best (unless you end up with one of those kids who simply refuses to be spoonfed at all). After all, traditional weaning has always included finger foods; Rapley's innovation is largely to say that pureeing and spoonfeeding should be ruled out. Ruling stuff out rarely makes the whole childrearing thing easier.

For example, giving baby an apple chunk/loaded spoon to nibble at (so you can eat your dinner) is one of the first things you learn in Mum School... it makes sense, especially, in the evening, since both baby and clothes will soon be going in the wash anyway. But when you are in a restaurant, it may not be very convenient (or polite) to basically allow your child to throw food everywhere--make no mistake, self-feeding is messy, and while you don't have to spend time mashing or feeding, you will probably spend about as much time cleaning up, changing clothes and getting food out of the kid's hair. One hears of hardcore BLWers carting splash mats and portable highchairs around with them, leaving honking tips for waiters to make up for the blizzard of mess, or sticking to "child-friendly" restaurants, rather than subject young Sparkleigh to the dreaded sp00nfeeding of d00m. One has to ask, would it not be easier to just sit Junior on your lap and offer them something mushed up on a spoon or finger?

Similarly, if you have to get to the doctor's at 2pm, it makes more sense to quickly and neatly spoon kiddo a bit of food, and then DONE. Rather than hang around waiting while the child thoughtfully pushes avocado chunks around on a food tray, then change clothes and wipe down the floor/bumbo/baby, and then have to stop on the way to nurse again, because the kid didn't actually get more a mouthful of food inside them.

Because that is the other thing about true, purist BLW; if your baby really does only eat what he or she is able to self-feed, most likely he or she will take to solids as a pretty slow pace--in some cases very slow (on crunchy forums one is constantly reading about children who are 12, 15, 18 months old and still almost completely breastfed). This may or may not suit your agenda. I can see it being convenient, maybe, for a SAHM who loves breastfeeding. But if you are working, you will have to pump (and sterilize and set up pumps, and store and defrost) more milk... unless you are happy to give formula as well. And I strongly suspect that nightweaning, and moving away from nursing to sleep and constant comfort feeding are psychologically easier to see through if you are seeing your baby put away a certain consistent amount of solids every day, so that you are not constantly fighting the voice in the back of your head that says "But what if she's still HUNGRY??"

Then there is the conundrum of what to do with foods that beg to be spoonfed (preloading spoons for the baby to self-feed with doesn't always work). As one poster here put it, "If we're eating pasta or noodles or a roast dinner DD eats with her hands. If it's soup or yoghurt or mash I use a spoon. Common sense. A friend went to such great lengths to avoid a spoon it was comedy. Chunks of pear dipped in yoghurt (which got chucked on the floor), toast dipped in porridge, yum! It's just a spoon FFS!" Some BLW purists apparently try to facilitate self-feeding by circumcising bananas with scissors (Freud'd have a field day with that one), lovingly rolling slippery foods in crushed cheerios, or snipping them up with crinkle cutters.  All good fun, no doubt, but it's unclear how any of this is actually less work than just offering said food on a spoon. Anyway, I'm pretty sure cavemama didn't have crinkle-cutters.

Finally, I LOLed at Rapley's suggestion that parents should get round the whole salt issue by simply not using any salt in their own cooking. Are there parents who actually do this... for everything they cook? Remind me never to eat at their houses. A stir-fry, a curry, a pasta sauce simply will not taste as tasty without a certain minimal amount of salt. I like eating tasty food. Sorry.

The nutrition thing
Many babies take to self-feeding early and easily--indeed, these babies often reject spoon-feeding altogether and clearly it makes sense to just let them get on with it. But other babies, particularly those whose motor skills are slower to develop, will not be able to self-feed useful amounts of food until they are much older than six months; if you really do have this strict rule about Baby Must Only Eat What Baby Puts In Own Mouth, it could be a really long time before they are able to actually eat more than minuscule amounts of food (as evidenced by all those non-eating older babies and toddlers on BLW forums). However, as I discuss here, once babies get much past six months they do start to need more nutrients than they can realistically need from breastmilk. The "food before one is just for fun" thing is one aspect of BLW that I just can't agree with. The Maternal and Child Nutrition Journal has expressed similar views, by the way--suggesting that while many babies will do OK with self-feeding alone, some could be put at risk of micronutrient deficiency if their parents are hardcore about not doing any spoon-feeding. I personally feel that offering foods in different ways and being flexible is probably the best approach.


Bullshitometer verdict
I have a confession: I actually really, really like most of the ideas found in BLW. I like the idea of giving children table foods where possible, including spicy and unusual things; I agree that babies can generally start finger foods as early as six months; I particularly like the idea of using BLW as a motivation for improving the food that the family eats as a whole. I just think it's a shame that Rapley had to spoil some sensible ideas with silly claims about purees being constipating and parent-led weaning causing bad eating habits, none of which is backed up by any data.

I think BLW was in some ways a necessary corrective to bossy Gina Ford types lecturing people about introducing the "right" foods in the "right order" and the "right amounts," and baby food manufacturers going on about "stages," causing parents whose babies didn't respond well to this to feel a lot of stress. But it's not much of an improvement if we just exchange that for all the self-conscious agonizing seen among many posters on BLW boards (debating about whether using a mesh feeder is "real" BLW weaning, whether we are "allowed" to hold food up to their mouths or is that helping them too much, blah blah), with parents fretting that if they break any of the "rules" their children will end up obese, terrible eaters or what have you.

I hereby propose the Breastfeeding Without Bullshit Patented Bone Idle Can't Be Bothered Weaning Method, which consists of trying out lots of things (finger foods, cereal, puree, finger feeding, mesh feeder, feeding them with a spoon, handing them loaded spoons, giving them pieces to self-feed, holding up bits for them to take a bit out, whatever) and doing what you and your child enjoy most and find the least hassle. Because at the end of the day it isn't going to make any long-term difference anyway.

Finally: if any mother, online or in real life, spends her time banging on to other mothers about how her proposed weaning "system" (BLW, gourmet-meals-in-an-icecube-tray or whatever) is inherently superior and guaranteed to produce a marvelous eater, the laws of karma dictate that her baby will grow into one of those toddlers who refuses to eat anything except luminous orange macaroni cheese. You Have Been Warned.

Further reading
Weaning Made Easy by Rana Conway. I discovered this book after writing this post; Conway discusses some of the ideas talked about here, with a good run-down of some of the advantages and potential issues with puree-only or "pure" baby led weaning approach, and recommends a mixed and flexible approach to feeding as being the best suited to the majority of parents and babies.