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Comment & Response
February 2018

A Baby-Led Approach to Complementary Feeding—Reply

Author Affiliations
  • 1Department of Medicine, University of Otago, Dunedin, New Zealand
  • 2Department of Human Nutrition, University of Otago, Dunedin, New Zealand
JAMA Pediatr. 2018;172(2):197-198. doi:10.1001/jamapediatrics.2017.4683

In Reply In their letter, Gribble et al request clarification regarding 2 potential differences between the intervention and control groups in our randomized clinical trial of a modified version of baby-led weaning (Baby-Led Introduction to Solids [BLISS]).1 First, the authors point out that the intervention children were exclusively breastfed for longer than control children, and that this would be expected to influence (reduce) the prevalence of overweight and obesity. Indeed, the BLISS families did achieve an increase in the median number of weeks of exclusive breastfeeding of approximately 1 month, compared with the usual care group. Unfortunately, our study was not designed to enable us to determine the effect of a baby-led approach to complementary feeding separate from this longer exclusive breastfeeding duration. However, the few studies available suggest that unmodified baby-led weaning is also associated with a longer duration of exclusive2 and any3 breastfeeding compared with usual care. This means that any measurement of the real-life effect of a baby-led approach to complementary feeding needs to include the effect of extended breastfeeding duration, as does our study.

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