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58-641: BLW or blw may refer to: Baby-led weaning , an approach to adding complementary foods to a baby's diet of breast milk or formula Baldwin Locomotive Works , a defunct American manufacturer of railroad locomotives Brightline West , a future high-speed rail route BLW, the IATA code for Beledweyne Airport , Somalia BLW, the Indian Railways station code for Balawali railway station , Uttar Pradesh, India blw,

116-455: A bolus which is moved from one side of the oral cavity to the other by the tongue. Buccinator (VII) helps to contain the food against the occlusal surfaces of the teeth. The bolus is ready for swallowing when it is held together by saliva (largely mucus), sensed by the lingual nerve of the tongue (VII—chorda tympani and IX—lesser petrosal) (V 3 ). Any food that is too dry to form a bolus will not be swallowed. 3) Trough formation A trough

174-443: A failure of the reflex to swallow leads to a build-up of mucus or saliva in the throat and airways, producing a noise known as a death rattle (not to be confused with agonal respiration , which is an abnormal pattern of breathing due to cerebral ischemia or hypoxia). Abnormalities of the pharynx and/or oral cavity may lead to oropharyngeal dysphagia . Abnormalities of the esophagus may lead to esophageal dysphagia . The failure of

232-545: A food texture, the tongue lateralization reflex forces them to move their tongue to the side to lick and taste the food, and engages the phasic bite reflex. Through continued practice, infants learn to volitionally lateralize their tongue and bite—the first step in the development of a munching/chewing pattern. The basic principles of baby-led weaning are: BLW is closely linked to the way in which babies develop in their first year, particularly in how their nutritional needs dovetail with their motor development. As recommended by

290-632: A motor pattern: bring food in, move it back, swallow. Learning to ingest purees does not prepare a baby for chewing, which is problematic as most solid foods must be chewed after entering the mouth but before being moved back. Indeed, current research supports that delayed experience with eating lumpy foods leads to poor food acceptance in later years. Through playful exploration and handling food, babies learn about texture and are able to practice new oral motor skills without any pressure to eat. BLW also allows them to be in charge of what goes in their mouth, how it goes in, and when. Thus, they gradually develop

348-470: A speech pathologist to evaluate dysphagia include Fiberoptic Endoscopic Evaluation of Swallowing and Modified Barium Swallow Study. Occupational Therapists may also offer swallowing rehabilitation services as well as prescribing modified feeding techniques and utensils. Consultation with a dietician is essential, in order to ensure that the individual with dysphagia is able to consume sufficient calories and nutrients to maintain health. In terminally ill patients,

406-403: A strict schedule for breast feeding, limiting the time at breast and the frequency of feeds. As a result, many mothers had low milk supply (as breast milk is a supply-demand phenomenon), and therefore their babies “failed to thrive.” Infant formula became increasingly accepted as a way to supplement or replace breastmilk but there was also a move to introduce strained or mashed “baby foods” from

464-430: A younger age than is now known to be desirable. By the 1930s, a variety of commercial purees were available for purchase, with Gerber leading the way. Baby-led weaning (term self-attributed to Michael Barrientos ) places the emphasis on exploring taste, texture, color and smell as the baby sets their own pace for the meal, choosing which foods to concentrate on. Instead of the traditional method of spooning pureed food into

522-421: Is IX and efferent limb is the pharyngeal plexus- IX and X). They are scattered over the base of the tongue, the palatoglossal and palatopharyngeal arches, the tonsillar fossa, uvula and posterior pharyngeal wall. Stimuli from the receptors of this phase then provoke the pharyngeal phase. In fact, it has been shown that the swallowing reflex can be initiated entirely by peripheral stimulation of the internal branch of

580-404: Is a deep brainstem reflex present by 15 weeks gestation and well established by full term birth. Babies already know how to swallow, and thicker textures such as purees are considered both easier and safer for babies to swallow. For instance, young babies who have swallowing difficulty are often prescribed a diet of thickened milk (rather than drinking regular milk). Purees, however, do teach baby

638-408: Is an important part of eating and drinking . If the process fails and the material (such as food, drink, or medicine) goes through the trachea , then choking or pulmonary aspiration can occur. In the human body the automatic temporary closing of the epiglottis is controlled by the swallowing reflex . The portion of food, drink, or other material that will move through the neck in one swallow

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696-444: Is an interesting topic with extensive scientific literature . Eating and swallowing are complex neuromuscular activities consisting essentially of three phases, an oral , pharyngeal and esophageal phase. Each phase is controlled by a different neurological mechanism. The oral phase, which is entirely voluntary, is mainly controlled by the medial temporal lobes and limbic system of the cerebral cortex with contributions from

754-413: Is called a bolus . In colloquial English , the term "swallowing" is also used to describe the action of taking in a large mouthful of food without any biting . Swallowing comes so easily to most people that the process rarely prompts much thought. However, from the viewpoints of physiology , of speech–language pathology , and of health care for people with difficulty in swallowing (dysphagia) , it

812-483: Is different from Wikidata All article disambiguation pages All disambiguation pages Baby-led weaning Current infant feeding recommendations by the American Academy of Pediatrics are that infants should be breast fed for the first 6 months, then be gradually introduced to solid food between the age of 6 months and 1 year. However, for much of the twentieth century, mothers were told to maintain

870-595: Is high in infants and the role of breastmilk or infant formula remains important throughout this period. It is important that parents do not decrease the volume of milk feeds until the baby is taking in enough solid foods to support growth (AAP, 2013). Formula or breastfeeding is continued in conjunction with complementary foods and is always offered before solids in the first 12 months. By the time most typically developing babies reach six months, their digestive system and their fine motor skills have developed enough to allow them to self-feed. Baby-led weaning takes advantage of

928-975: Is lost. BLW allows for natural, developmentally appropriate interaction and play with food, which has the potential to develop a lifelong curiosity with food. As of June 2019, it was suggested that long-term studies need to be done on the effects of BLW on nutrition adequacy and safety in addition to previous evidence that it is useful in self-regulation of feeding with low risk of choking. American Academy of Pediatrics (2013). Ages & Stages: feeding & nutrition. Accessed 10 October 2013. http://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/default.aspx . Case-Smith, J & Humphry, R. (2005). Feeding Intervention. In J.Case-Smith (Ed.), Occupational therapy for children (pp. 481–520). St Louis, MO: Elsevier. Morris, S.E, & Dunn-Klein, M.(2000).Pre-feeding skills: A comprehensive resource for mealtime development (2nd ed.). Austin, TX: PRO-ED, Inc. Rapley, G. & Murkett, T. (2005). Baby Led Weaning:

986-408: Is more likely to develop positive interest in food. This may decrease “picky” eating behaviors in toddlers and young children. Researcher Joel Voss, a neuroscientist at Northwestern University states, "The bottom line is, if you're not the one who's controlling your learning, you're not going to learn as well". When an adult takes control of the activity, the inherent love of exploration and discovery

1044-445: Is similar to the techniques used by sword swallowers. In many birds, the esophagus is largely a mere gravity chute , and in such events as a seagull swallowing a fish or a stork swallowing a frog , swallowing consists largely of the bird lifting its head with its beak pointing up and guiding the prey with tongue and jaws so that the prey slides inside and down. In fish , the tongue is largely bony and much less mobile and getting

1102-482: Is then formed at the back of the tongue by the intrinsic muscles (XII). The trough obliterates against the hard palate from front to back, forcing the bolus to the back of the tongue. The intrinsic muscles of the tongue (XII) contract to make a trough (a longitudinal concave fold) at the back of the tongue. The tongue is then elevated to the roof of the mouth (by the mylohyoid (mylohyoid nerve—V 3 ), genioglossus , styloglossus and hyoglossus (the rest XII)) such that

1160-584: The University of Glasgow, Scotland found that while BLW works for most babies, it could lead to nutritional problems for children who develop more slowly than others. Wright concluded "that it is more realistic to encourage infants to self-feed with solid finger food during family meals, but also give them spoon fed purees." A study published in 2011 at the University of Nottingham by Ellen Townsend and Nicola J. Pitchford suggests that baby-led weaning may lead to less obesity in childhood . The authors conclude that

1218-487: The World Health Organization and several other health authorities across the world, there is no need to introduce solid food to a baby's diet until after 6 months. This guidance is based on research indicating that it is from this age that infants begin to need additional nutrients that cannot be supplied by breastmilk or formula alone. The time period from 6 to 18–24 months of age is when the risk of malnutrition

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1276-415: The auditory tube The actions of the levator palatini (pharyngeal plexus—IX, X), tensor palatini (Vc) and salpingopharyngeus (pharyngeal plexus—IX, X) in the closure of the nasopharynx and elevation of the pharynx opens the auditory tube, which equalises the pressure between the nasopharynx and the middle ear. This does not contribute to swallowing, but happens as a consequence of it. 8) Closure of

1334-418: The oropharynx The oropharynx is kept closed by palatoglossus (pharyngeal plexus—IX, X), the intrinsic muscles of tongue (XII) and styloglossus (XII). 9) Laryngeal closure The primary laryngopharyngeal protective mechanism to prevent aspiration during swallowing is via the closure of the true vocal folds. The adduction of the vocal cords is affected by the contraction of the lateral cricoarytenoids and

1392-422: The piriform fossa . Additionally, the larynx is pulled up with the pharynx under the tongue by stylopharyngeus (IX), salpingopharyngeus (pharyngeal plexus—IX, X), palatopharyngeus (pharyngeal plexus—IX, X) and inferior constrictor (pharyngeal plexus—IX, X). This phase is passively controlled reflexively and involves cranial nerves V, X (vagus) , XI (accessory) and XII (hypoglossal) . The respiratory center of

1450-448: The superior laryngeal nerve . This phase is voluntary and involves important cranial nerves : V (trigeminal) , VII (facial) and XII (hypoglossal) . For the pharyngeal phase to work properly all other egress from the pharynx must be occluded—this includes the nasopharynx and the larynx . When the pharyngeal phase begins, other activities such as chewing, breathing, coughing and vomiting are concomitantly inhibited. 5) Closure of

1508-417: The "results suggest that infants weaned through the baby-led approach learn to regulate their food intake in a manner, which leads to a lower BMI and a preference for healthy foods like carbohydrates ". Feeding specialist, Kary Rappaport, OTR/L, SWC, CLE also concludes that a BLW infant, who leads their own food exploration and is exposed to a consistent variety of tastes, textures, and smells at an early age

1566-536: The ISO 639-3 code for Balangao language , Luzon, Philippines Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with the title BLW . If an internal link led you here, you may wish to change the link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=BLW&oldid=1236648818 " Category : Disambiguation pages Hidden categories: Short description

1624-415: The arytenoids to appose each other (closes the laryngeal aditus by bringing the aryepiglottic folds together), and draws the epiglottis down to bring its lower half into contact with arytenoids, thus closing the aditus. Retroversion of the epiglottis, while not the primary mechanism of protecting the airway from laryngeal penetration and aspiration, acts to anatomically direct the food bolus laterally towards

1682-480: The baby has been exposed to different flavors via its mother's breast milk), it is also entirely possible to introduce a formula-fed baby to solids using the BLW approach. Formula-fed babies can successfully wean using BLW. Providing an infant with table foods initiates the development of strong oral motor control for chewing and swallowing, including tongue lateralization and eventual bolus formation. When an infant mouths

1740-452: The baby's mouth, the baby takes part in family mealtimes and is presented with a variety of foods in easy-to-grasp pieces, which he or she can freely choose and explore. Infants are offered a range of foods to provide a balanced diet from around 6 months. Ideally, these will be the same foods that the rest of the family is eating, provided these foods are suitable for the infant. Infants often begin by picking up and licking or sucking on

1798-435: The bolus The pharynx is pulled upwards and forwards by the suprahyoid and longitudinal pharyngeal muscles – stylopharyngeus (IX), salpingopharyngeus (pharyngeal plexus—IX, X) and palatopharyngeus (pharyngeal plexus—IX, X) to receive the bolus. The palatopharyngeal folds on each side of the pharynx are brought close together through the superior constrictor muscles, so that only a small bolus can pass. 7) Opening of

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1856-413: The bolus. The food bolus will trigger a gag response first and be expelled before it hits the laryngeal vestibule. Infants therefore utilize the gag reflex for learning three important concepts: the borders of their mouth, desensitizing their gag reflex, and how to protect their airway when volitionally swallowing solid foods. As infants get closer to one year old, the gag reflex moves posteriorly, closer to

1914-420: The child towards independence and often provides a stress-free alternative for meal times, for both the child and the parents. Some babies refuse to eat solids when offered with a spoon, but happily help themselves to finger food . The originators of BLW assert other strategies which are in line with traditional feeding safety guidelines. For example, it is recommended that infants are seated upright, either on

1972-399: The deglutition process is started, it is quite hard to stop it. Swallowing becomes a great concern for the elderly since strokes and Alzheimer's disease can interfere with the autonomic nervous system . Speech pathologists commonly diagnose and treat this condition since the speech process uses the same neuromuscular structures as swallowing. Diagnostic procedures commonly performed by

2030-459: The esophagus by pharyngeal peristalsis which takes place by sequential contraction of the superior, middle and inferior pharyngeal constrictor muscles (pharyngeal plexus—IX, X). The lower part of the inferior constrictor ( cricopharyngeus ) is normally closed and only opens for the advancing bolus. Gravity plays only a small part in the upright position—in fact, it is possible to swallow solid food even when standing on one's head. The velocity through

2088-400: The esophagus into the stomach. 13) Relaxation phase Finally the larynx and pharynx move down with the hyoid mostly by elastic recoil. Then the larynx and pharynx move down from the hyoid to their relaxed positions by elastic recoil. Swallowing therefore depends on coordinated interplay between many various muscles, and although the initial part of swallowing is under voluntary control, once

2146-427: The essential guide to introducing solid foods and helping your baby to grow up a happy and confident eater. New York, NY: The experiment, LLC. Swallowing Swallowing , also called deglutition or inglutition in scientific contexts, is the process in the body of a human that allows for a substance to pass from the mouth , to the pharynx , and into the esophagus , while shutting the epiglottis . Swallowing

2204-405: The infant’s appetite is respected with regard to which foods are chosen, the pace of eating, and how much is eaten. Initial self-feeding attempts often result in very little food ingested as the baby explores textures and tastes through play, but the baby will soon start to swallow and digest what is offered. Although breastfeeding is the ideal nutritional precursor to baby led weaning (as

2262-435: The laryngeal vestibule. This allows food to move closer to the laryngeal vestibule before triggering a gag. Parents following BLW are advised to avoid classic “choking hazards” or airway shaped foods: whole grapes, coin-shaped slices of hotdogs, cherry tomatoes, etc. Very little scientific research has been done regarding baby-led weaning. However, another 2020 study headed by child health specialist Charlotte M. Wright from

2320-443: The lips to form a tight seal of the oral cavity. Next, the superior longitudinal muscle elevates the apex of the tongue to make contact with the hard palate and the bolus is propelled to the posterior portion of the oral cavity. Once the bolus reaches the palatoglossal arch of the oropharynx, the pharyngeal phase, which is reflex and involuntary, then begins. Receptors initiating this reflex are proprioceptive (afferent limb of reflex

2378-416: The lower esophagus sphincter to respond properly to swallowing is called achalasia . M-Type Swallowing With practice, people can learn to swallow fluidly without closing the mouth by merely manipulating the tongue and jaw to drive fluids or foods down the esophagus. With a continuous motion, an individual forges breathing and priorities the swallowed matter. This intermediate level of muscle manipulation

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2436-482: The medulla is directly inhibited by the swallowing center for the very brief time that it takes to swallow. This means that it is briefly impossible to breathe during this phase of swallowing and the moment where breathing is prevented is known as deglutition apnea . 10) Hyoid elevation The hyoid is elevated by digastric (V & VII) and stylohyoid (VII), lifting the pharynx and larynx up even further. 11) Bolus transits pharynx The bolus moves down towards

2494-467: The motor cortex and other cortical areas. The pharyngeal swallow is started by the oral phase and subsequently is coordinated by the swallowing center on the medulla oblongata and pons . The reflex is initiated by touch receptors in the pharynx as a bolus of food is pushed to the back of the mouth by the tongue, or by stimulation of the palate (palatal reflex). Swallowing is a complex mechanism using both skeletal muscle ( tongue ) and smooth muscles of

2552-486: The mouth in a similar fashion to liquid . This is generally seen as an integral part of the process of introducing solid foods and an important step in the acquisition of chewing skills. Conversely, professionals experienced in BLW note that effective chewing tends to appear sooner in infants who are not exposed to purees. The skills required for chewing are vastly different than those required for spoon feeding, and most babies do not need to be taught how to swallow. Swallowing

2610-468: The nasopharynx The soft palate is tensed by tensor palatini (Vc), and then elevated by levator palatini (pharyngeal plexus—IX, X) to close the nasopharynx. There is also the simultaneous approximation of the walls of the pharynx to the posterior free border of the soft palate, which is carried out by the palatopharyngeus (pharyngeal plexus—IX, X) and the upper part of the superior constrictor (pharyngeal plexus—IX, X). 6) The pharynx prepares to receive

2668-613: The natural developmental progression of the child, both in relation to the age of beginning the transition to solid foods and to the gradual pace of this transition that happens when the infant is in control of the process. From infancy, the only oral motor pattern a baby knows is suck-swallow-breathe. This reflexive way of eating allows infants to feed from birth (from a breast or bottle) while protecting their airway and meeting their nutritional needs. The oral motor patterns required for eating and swallowing solids include tongue lateralization, tongue elevation, and munching/chewing, and unlike

2726-415: The normal and necessary actions to form the bolus, which is defined as the state of the food in which it is ready to be swallowed. 1) Moistening Food is moistened by saliva from the salivary glands ( parasympathetic ). 2) Mastication Food is mechanically broken down by the action of the teeth controlled by the muscles of mastication (V 3 ) acting on the temporomandibular joint . This results in

2784-413: The oblique and transverse arytenoids (all recurrent laryngeal nerve of vagus). Since the true vocal folds adduct during the swallow, a finite period of apnea (swallowing apnea) must necessarily take place with each swallow. When relating swallowing to respiration, it has been demonstrated that swallowing occurs most often during expiration, even at full expiration a fine air jet is expired probably to clear

2842-423: The ones guiding the sensory experience, starting and stopping when they are comfortable and ready. When food does move too posteriorly in the mouth triggering a gag reflex, the entire bolus is expelled from the mouth– something that is not possible with a puree. Also, solid food moves slowly in comparison to liquid, and is not often sucked into the pharynx, which would allow for laryngeal penetration or aspiration of

2900-450: The oral motor patterns required for mature bolus manipulation, chewing, and swallowing. The baby learns most effectively by watching and imitating others, while allowing her to eat the same food at the same time as the rest of the family contributes to a positive weaning experience. Self-feeding supports the child's motor development on many vital areas, such as their hand-eye coordination and dexterity, as well as chewing . It encourages

2958-462: The parent's lap, or in a supportive high chair, for all feeding experiences. This allows for easy expulsion of the bolus by gagging, and decreases accidental movement of the food into the pharynx. Additionally, a child who has the trunk and head control to sit independently though a meal (proximal stability) will more likely demonstrate coordinated ability to move the tongue and jaw for chewing. When infants bring solid foods to their own mouth, they are

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3016-434: The pharynx and esophagus . The autonomic nervous system (ANS) coordinates this process in the pharyngeal and esophageal phases. Prior to the following stages of the oral phase, the mandible depresses and the lips abduct to allow food or liquid to enter the oral cavity. Upon entering the oral cavity, the mandible elevates and the lips adduct to assist in oral containment of the food and liquid. The following stages describe

3074-407: The pharynx depends on a number of factors such as viscosity and volume of the bolus. In one study, bolus velocity in healthy adults was measured to be approximately 30–40 cm/s. 12) Esophageal peristalsis Like the pharyngeal phase of swallowing, the esophageal phase of swallowing is under involuntary neuromuscular control. However, propagation of the food bolus is significantly slower than in

3132-417: The pharynx. The bolus enters the esophagus and is propelled downwards first by striated muscle (recurrent laryngeal, X) then by the smooth muscle (X) at a rate of 3–5 cm/s. The upper esophageal sphincter relaxes to let food pass, after which various striated constrictor muscles of the pharynx as well as peristalsis and relaxation of the lower esophageal sphincter sequentially push the bolus of food through

3190-402: The piece food, before progressing to eating. Babies are typically able to begin self-feeding at around 6 months old, although some are ready and will reach for food as early as 5 months and some will wait until 7 or 8 months and can skip being spoon-fed baby food altogether. The intention of this process is that it is tailored to suit the individual baby and their personal development, and that

3248-427: The suck-swallow-breathe sequence, coordination of these oral motor patterns is learned, not reflexive, although reflexes are present to allow a baby to begin to develop these patterns. When an infant is offered a spoon of puree, the practiced or familiar oral motor pattern is sucking. Purees are thicker than formula or breast milk, but do not require chewing. They are therefore sucked off of a presented spoon and moved in

3306-446: The tongue slopes downwards posteriorly. The contraction of the genioglossus and styloglossus (both XII) also contributes to the formation of the central trough. 4) Movement of the bolus posteriorly At the end of the oral preparatory phase, the food bolus has been formed and is ready to be propelled posteriorly into the pharynx. In order for anterior to posterior transit of the bolus to occur, orbicularis oris contracts and adducts

3364-432: The upper larynx from food remnants or liquid. The clinical significance of this finding is that patients with a baseline of compromised lung function will, over a period of time, develop respiratory distress as a meal progresses. Subsequently, false vocal fold adduction, adduction of the aryepiglottic folds and retroversion of the epiglottis take place. The aryepiglotticus (recurrent laryngeal nerve of vagus) contracts, causing

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