Oral Presentation Joint Annual Scientific Meeting of the Nutrition Society of NZ and the Nutrition Society of Australia

Impact of a baby-led approach to complementary feeding on iron status at 12 months of age: a randomised controlled trial (280)

Lisa Daniels 1 2 , Rachael W Taylor 2 3 , Rosalind S Gibson 1 , Samir Samman 1 , Jillian J Haszard 1 , Sheila M Williams 4 , Ben J Wheeler 3 5 , Barry J Taylor 3 5 , Anne-Louise M Heath 1
  1. Department of Human Nutrition, University of Otago, Dunedin, New Zealand
  2. Department of Medicine, University of Otago, Dunedin, New Zealand
  3. Edgar Diabetes and Obesity Research Centre, University of Otago, Dunedin, New Zealand
  4. Department of Preventative and Social Medicine, University of Otago, Dunedin, New Zealand
  5. Department of Women’s and Children’s Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

Background/Aims:The Baby-Led Introduction to SolidS (BLISS) study is a randomised controlled trial of a version of baby-led weaning (BLW) modified to address concerns including a proposed increased risk of iron deficiency. In BLISS and BLW the baby is given foods they pick up and feed themselves. The aim was to determine the extent to which BLISS prevents iron deficiency at 12 months of age. 

Methods:206 pregnant women were randomised into one of two groups: Usual care or BLISS (milk-feeding support from a lactation consultant from late pregnancy to 6 months, then advice from research staff on introducing “solids” using a baby-led approach). BLISS parents were encouraged to offer a high-iron food (red meat or iron-fortified infant cereal) at every meal. Venous blood was collected at 12 months to determine plasma ferritin (PF), soluble transferrin receptor, haemoglobin, C-reactive protein (CRP) and α1-acid-glycoprotein (AGP). PF was adjusted if CRP or AGP were elevated. Body iron was calculated and iron deficiency anaemia (IDA), iron deficient erythropoiesis (IDE) and iron depletion (ID) determined. 

Results:There was no significant difference in geometric mean PF concentration between BLISS (n=60; 26.3μg/L) and Usual care (n=59; 28.2μg/L) groups (difference: -6.8%; 95%CI: -27.4%,19.7%; p=0.58). Nor were there differences in body iron (difference: 0.2mg/kg; 95%CI: -0.9,1.3; p=0.72) or prevalence of IDA, IDE or ID (all p≥0.56).

Conclusions:Advice to frequently offer iron-rich foods may prevent the increased risk of iron deficiency expected to be associated with a baby-led approach to complementary feeding.

Funding:KPS, Perpetual Trust, Meat & Livestock Australia, Lottery Health Research