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Can my baby with special needs, or developmental delays do Baby Led Weaning?

We were recently asked to write a guest post about using Baby-Led Weaning to transition to solids for infants with Down syndrome for the awesome mamas of Able Appetites (IG: @ableappetites) which is a fabulous resource dedicated to providing parents of children with Down syndrome feeding support and ideas. This post contains much of the information from the posts we wrote for them, plus more depth info about using BLW with kiddos with special needs that we just couldn’t fit into a brief Instagram post.

Baby-Led Weaning and babies with special needs- are we sure that’s a good idea?

We stumbled on this method over 10 years ago and knew it was a game changer for most infants- especially those who were following a “typical” developmental progression. We realized pretty quickly that this method also had potential in our therapy practice with infants who had developmental delays, medical complexity, and special needs—but also knew there was no research to support this and many of our colleagues were against it.

So we stuck to using BLW with babies who are considered “typically developing” right at first. The incredible success and intuitive nature of BLW spurred us on though, to try this method with many of the infants we worked with at the hospital—many of whom had both high medical complexity and developmental delay.

We knew from our understanding of oral motor development and swallowing physiology (over 10 years each of doing Modified Barium Swallow Studies) that this method has risks but also could be both safe and highly effective for certain infants. We also witnessed first hand that most of the babies we worked with who were 6-18 months were struggling with purees (gagging, refusing) OR loved purées and we’re flat out refusing to move beyond purées to chewable foods. Something had to change for these babies or we had to accept that they were just inherently going to struggle with eating and were less capable of learning to chew and eat solids. We saw the incredible potential in our clients and couldn’t accept that these bright and adaptable babies were just incapable of learning to chew or that it was “unavoidable” that they would struggle with the transition to table foods. We felt strongly that the way the medical community was recommending babies with special needs transition to solids had to be at least in part to blame. So we started trying BLW—cautiously and slowly at first.

One of the first infants we used BLW with was a 7 month old girl in the Bone Marrow Transplant unit where we worked who wasn’t sitting up yet, who had been refusing bottles and had recently started gagging at the site of the Gerber baby food jar that the nurses were attempting to feed her. The very first time we brought in a tray of real food (steamed broccoli and strips of steak) she just looked at it and then at us and did nothing- no gagging but also no reaching out, no interest. We worked on getting her well positioned and then we started modeling by slowly picking up a piece of food and taking bites ourself to show her what she was supposed to do. Within one session she was independently picking up food and putting it in her mouth without any gagging! She was also using all the same protective reflexes we expect to see in typically developing babies to offer some protection against choking, to protect her own airway. We knew immediately: Baby-Led Weaving can work with babies who have developmental delay, who have complex medical needs, and/or who have special needs.