title: Baby-Led Introduction to SolidS (BLISS) study: a randomised controlled trial of a baby-led approach to complementary feeding.
abstract: BACKGROUND
  In 2002, the World Health Organization recommended that the age for starting complementary feeding should be changed from 4 to 6 months of age to 6 months. Although this change in age has generated substantial debate, surprisingly little attention has been paid to whether advice on how to introduce complementary foods should also be changed. It has been proposed that by 6 months of age most infants will have developed sufficient motor skills to be able to feed themselves rather than needing to be spoon-fed by an adult. This has the potential to predispose infants to better growth by fostering better energy self-regulation, however no randomised controlled trials have been conducted to determine the benefits and risks of such a "baby-led" approach to complementary feeding. This is of particular interest given the widespread use of "Baby-Led Weaning" by parents internationally.
  
  
  METHODS
  The Baby-Led Introduction to SolidS (BLISS) study aims to assess the efficacy and acceptability of a modified version of Baby-Led Weaning that has been altered to address potential concerns with iron status, choking and growth faltering. The BLISS study will recruit 200 families from Dunedin, New Zealand, who book into the region's only maternity hospital. Parents will be randomised into an intervention (BLISS) or control group for a 12-month intervention with further follow-up at 24 months of age. Both groups will receive the standard Well Child care provided to all parents in New Zealand. The intervention group will receive additional parent contacts (n = 8) for support and education on BLISS from before birth to 12 months of age. Outcomes of interest include body mass index at 12 months of age (primary outcome), energy self-regulation, iron and zinc intake and status, diet quality, choking, growth faltering and acceptability to parents.
  
  
  CONCLUSIONS
  This study is expected to provide insight into the feasibility of a baby-led approach to complementary feeding and the extent to which this method of feeding affects infant body weight, diet quality and iron and zinc status. Results of this study will provide important information for health care professionals, parents and health policy makers.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12612001133820 .
authors.affiliation: Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. lisa.daniels@otago.ac.nz.|Department of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. lisa.daniels@otago.ac.nz.
authors.forename: Lisa
authors.initials: L
authors.lastname: Daniels
authors.affiliation: Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. anne-louise.heath@otago.ac.nz.
authors.forename: Anne-Louise M
authors.initials: AL
authors.lastname: Heath
authors.affiliation: Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. sheila.williams@otago.ac.nz.
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Williams
authors.affiliation: Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. sonya.cameron@otago.ac.nz.
authors.forename: Sonya L
authors.initials: SL
authors.lastname: Cameron
authors.affiliation: Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. liz.fleming@otago.ac.nz.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Fleming
authors.affiliation: Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. barry.taylor@otago.ac.nz.|Edgar Diabetes and Obesity Research Centre, Dunedin School of Medicine, University of Otago, PO Box 65, Dunedin, 9054, New Zealand. barry.taylor@otago.ac.nz.
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Taylor
authors.affiliation: Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. ben.wheeler@otago.ac.nz.|Edgar Diabetes and Obesity Research Centre, Dunedin School of Medicine, University of Otago, PO Box 65, Dunedin, 9054, New Zealand. ben.wheeler@otago.ac.nz.
authors.forename: Ben J
authors.initials: BJ
authors.lastname: Wheeler
authors.affiliation: Department of Human Nutrition, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. rosalind.gibson@otago.ac.nz.
authors.forename: Rosalind S
authors.initials: RS
authors.lastname: Gibson
authors.affiliation: Department of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. rachael.taylor@otago.ac.nz.|Edgar Diabetes and Obesity Research Centre, Dunedin School of Medicine, University of Otago, PO Box 65, Dunedin, 9054, New Zealand. rachael.taylor@otago.ac.nz.
authors.forename: Rachael W
authors.initials: RW
authors.lastname: Taylor
mesh_terms: D000367:Age Factors; D000402:Airway Obstruction / Q000209:etiology; D001315:Australia; D002657:Child Development / Q000502:physiology; D005247:Feeding Behavior; D006801:Humans; D007223:Infant; D018730:Infant Behavior; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena; D000090463:Iron Deficiencies; D009048:Motor Skills; D009520:New Zealand; D010290:Parents / Q000523:psychology; D063766:Pediatric Obesity / Q000517:prevention & control; D012307:Risk Factors