No difference in self-reported frequency of choking between infants introduced to solid foods using a baby-led weaning or traditional spoon-feeding approach

J Hum Nutr Diet. 2018 Aug;31(4):496-504. doi: 10.1111/jhn.12528. Epub 2017 Dec 5.


Background: Baby-led weaning (BLW) where infants self-feed family foods during the period that they are introduced to solid foods is growing in popularity. The method may promote healthier eating patterns, although concerns have been raised regarding its safety. The present study therefore explored choking frequency amongst babies who were being introduced to solid foods using a baby-led or traditional spoon-fed approach.

Methods: In total, 1151 mothers with an infant aged 4-12 months reported how they introduced solid foods to their infant (following a strict BLW, loose BLW or traditional weaning style) and frequency of spoon-feeding and puree use (percentage of mealtimes). Mothers recalled if their infant had ever choked and, if so, how many times and on what type of food (smooth puree, lumpy puree, finger food and specific food examples).

Results: In total, 13.6% of infants (n = 155) had ever choked. No significant association was found between weaning style and ever choking, or the frequency of spoon or puree use and ever choking. For infants who had ever choked, infants following a traditional weaning approach experience significantly more choking episodes for finger foods (F2,147 = 4.417, P = 0.014) and lumpy purees (F2,131 = 6.46, P = 0.002) than infants following a strict or loose baby-led approach.

Conclusions: Baby-led weaning was not associated with increased risk of choking and the highest frequency of choking on finger foods occurred in those who were given finger foods the least often. However, the limitations of noncausal results, a self-selecting sample and reliability of recall must be emphasised.

Keywords: baby-led weaning; choking; complementary food; infants; mothers; safety; solids; weaning.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Airway Obstruction / epidemiology*
  • Cooking and Eating Utensils
  • Feeding Behavior / physiology*
  • Feeding Methods / statistics & numerical data*
  • Female
  • Humans
  • Infant
  • Infant Food / statistics & numerical data
  • Infant Nutritional Physiological Phenomena
  • Mothers
  • Risk Factors
  • Self Report
  • Weaning*