感謝社團內 Betty Lai媽咪熱心分享她寫給Gill博士收到的回信, 內容是有關混餵是否會增加風險的
Gill博士的回信讓我對混餵有了全新的學習, 也感謝 Betty Lai媽咪願意讓我們公開這封信並置頂一段時間

#結論寫在前頭:社團仍舊不建議混餵,混餵其實就是TW+FF, 那就不是BLW了!
但從此以後我們不會再強調混餵會增加風險(也許最早開始這麼說的人, 覺得這個理由很有說服力, 而後人就跟著三人成虎了?)

Dear Betty,

As far as I know there is no evidence that combining finger foods with conventional weaning is dangerous. In fact, conventional weaning includes finger feeding. I don't know much about weaning practices in Taiwan but in the UK, at least, parents have for many years been advised to give their baby food to hold as soon as he is able to sit up and chew, that is, from about 6 or 7 months. This is how things were before 2002, in the years when it was considered appropriate to start babies on pureed food as young as 4 months old (and before that, 3 months). Most babies were already being fed with purees when they started finger foods and they continued to have both together. So giving finger foods at 6 months is not new, nor is combining finger foods with purees.

The theory of BLW says that, if solids foods are not started until 6 months, there is no need to offer the baby purees, since he is already able to feed himself with his fingers. It does not say that using a combination of purees and finger foods is dangerous, just that it is unnecessary.

My own research (http://create.canterbury.ac.uk/14177/) challenges the assumption that purees and spoon feeding are a safe way to feed babies (at any age) and suggests that it may be safer for babies over 6 months to feed themselves, using their fingers (and, later, spoons, forks, chopsticks etc). But there is no proof that it is or isn't safe - just questions.

I do think it is important to be sure parents and professionals understand that baby-led weaning (BLW) is not just about finger feeding - and that conventional weaning (CW - what you call TW) is not just about spoon feeding. The differences are bigger than that:
BLW puts the baby in control of his eating; in CW/TW the adult is in control.
In BLW, the baby is trusted to know what he needs and how to get it; in CW/TW he is not - these decisions aremade for him.
In BLW, the baby eats with the family; in CW/TW he often eats alone.
So it is not correct to present 'TW' (or CW) as the opposite of 'FF'. The true explanation is that:
Finger foods (that is, pieces of food) are the opposite of purees.
Self-feeding by the baby - using the fingers or hands - is the opposite of spoon feeding by an adult.
BLW and CW/TW are alternative (and opposing) approaches to weaning.
So: It is possible to combine finger foods with purees. It is also possible to combine self-feeding with spoon feeding. But it is not possible to combine a baby-led approach with the conventional approach.

I hope this is helpful.

With best wishes,
Gill

親愛的Betty,

就我所知目前沒有證據顯示手指食物與傳統餵食並行是有危險的. 事實上, 傳統餵食本身就包括了手指食物. 我不太清楚台灣的副食品引介方式, 但至少在英國這邊, 多年來家長們被建議在寶寶6~7個月大, 能夠坐直並咀嚼的時候, 盡快讓寶寶拿食物吃. 這是在2002年以前的狀況, 當時認為四個月大的寶寶就可以開始吃泥狀食物 (在那之前認為三個月大就可以開始). 大部分的寶寶在接觸手指食物之前都已經被餵泥一段時間了, 而開始吃手指食物之後也持續被餵泥. 所以, 6個月大開始吃手指食物不是什麼新鮮事, 手指食物+餵食物泥也不是.

BLW的理論是說: 如果寶寶在六個月大可以接觸固體食物, 餵泥就沒有必要了, 因為寶寶已經可以自己用手拿食物吃. (注: 世界衛生組織及英美都建議在寶寶六個月大時添加副食品) 並沒有說手指食物與泥狀食物併行會有危險, 單純地只是沒有必要.

我自己的研究報告(http://create.canterbury.ac.uk/14177/)質疑餵(任何年紀)寶寶泥狀食物與湯匙餵食的安全性, 並提出讓六個月大以上的寶寶用手(再大一點, 用湯匙、叉子、筷子或其他餐具)自己吃也許是比較安全的. 但沒有證據證明哪一種安不安全-只是提出質疑而已.

我認為非常重要的是: 確保家長和專業人士瞭解BLW並不只是用手吃東西而已 - 同時常規餵食 (CW - 也就是妳說的傳統餵食 TW) 並不只是局限於湯匙餵. 兩者之間的不同遠大於此 :
#BLW讓寶寶掌控自己的用餐; 而CW/TW是成人在掌控.
#BLW相信寶寶知道自己需要什麼及如何得到; 而CW/TW則認為寶寶不懂這些 - 這些是由大人替寶寶決定的.
#BLW的寶寶跟著家人一起用餐; 而CW/TW的寶寶通常是單獨吃飯(因為大人要忙著餵食, 大人通常錯開在寶寶餐前或餐後吃飯).

所以, 說傳統餵食'TW' (或常規餵食CW)是手指食物'FF'的相反詞是不正確的. 真正的解釋是:
"手指食物" (也就是食物塊) 的相反是 "泥狀食物".
"讓寶寶自己用手吃" 的相反是 "讓大人用湯匙餵".
"BLW" 跟 "CW/TW" 是二選一(且相反的)副食品引介方式.

結論: 給手指食物的同時餵食物泥是可行的. 讓寶寶自己吃的同時又讓大人餵也是可行的. 但要BLW的同時又TWCW是不可行的!

希望有幫上忙
.
誠摯的祝福,
Gill

※本社此篇留言串有許多媽咪精彩的翻譯, 都翻得非常好! 讓我不知道怎麼取捨, 只好自己翻這個版本...入社後鼓勵大家可以參考看看本篇留言串內其他精采的翻譯唷! ^^

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