The association of baby‐led weaning and picky eating in children aged 2–5 years

Abstract

Objectives

Baby‐Led Weaning (BLW) has been anecdotally linked to healthier eating habits and lower picky eating tendencies, yet empirical evidence remains limited. This study investigates the association between BLW and picky eating in children aged 2–5 years, comparing it with traditional spoon‐feeding methods.

Methods

A cross‐sectional study was conducted in Metro Manila, Philippines (June to August 2024), using convenience and snowball sampling. Parents (n = 284) reported their child's complementary feeding method, classified it as: (1) Strict BLW (BLW > 90%), (2) Predominantly BLW (BLW 51%–90%), (3) Predominantly traditional spoon‐feeding (BLW 10%–50%), or (4) Strict Traditional Spoon‐Feeding (BLW < 10%). Picky eating was assessed using the Food Fussiness (FF) subscale of the Children's Eating Behavior Questionnaire (CEBQ), with FF $\ge$ 3 indicating picky eating. Logistic regression examined associations between feeding method and picky eating, with sensitivity analyses using FF $\ge$2.8 and FF $\ge$3.2, and linear regression modeling FF as continuous outcome. Associations with other CEBQ subscales were also explored.

Results

Strictly BLW was associated with a 95.4% lower likelihood of picky eating compared to strict traditionally spoon‐feeding (p < 0.01). Findings remained robust across alternative cut‐offs when FF was modeled as a continuous outcome. Satiety responsiveness, slowness in eating, and emotional undereating were positively associated with fussiness, while higher enjoyment of food and food responsiveness were inversely related.

Conclusion

BLW is consistently associated with substantially lower odds of picky eating in early childhood. These findings support BLW as a potentially effective approach to fostering positive feeding behavior and food acceptance in early childhood.

What is Known

• •Baby‐led weaning (BLW) is an alternative approach to traditional spoon‐feeding during complementary feeding.
• •BLW has been anecdotally associated with better eating habits.
• •Empirical research on BLW, especially on its impact on picky eating, is limited.

What is New

• •This study examines the link between BLW and picky eating in young children in a Filipino population.
• •Children who underwent strict BLW had a 95.4% lower likelihood of picky eating versus traditionally spoon‐fed peers.
• •Findings support BLW as a potential strategy from infancy to reduce picky eating behaviors.

1. INTRODUCTION

Picky eating is a common source of stress among parents, which has been associated with constipation, malnutrition, and even behavioral problems in later childhood. ¹ Multiple factors have been identified as contributory to picky eating, including late introduction of lumpy food during complementary feeding, ¹ , ² , ³ non‐responsive feeding practices, ⁴ , ⁵ , ⁶ pressuring the child to eat, ¹ , ⁴ , ⁵ , ⁷ anxious, controlling, or permissive parenting styles, ⁸ and lack of exposure to diverse textures and chewing practice. ¹ , ⁹ , ¹⁰

Baby‐led weaning (BLW) has emerged over the past decade as an alternative approach to traditional spoon‐feeding. BLW encourages infants to self‐feed nutritious whole foods during family mealtimes, without any pressure. It emphasizes infant autonomy over what, how much, and how quickly to eat from the foods offered. This approach is believed to foster greater attunement to internal hunger and satiety cues, broadens dietary variety through early exposure to diverse textures and flavors, and encourages the infant's active engagement in shared mealtimes, with the family as role models for healthy food choices and proper mealtime behavior. ¹¹ , ¹² , ¹³ These factors support the development of positive feeding experiences and healthier eating behaviors, potentially reducing the risk of picky eating.

Despite increasing popularity and anecdotal support of BLW, empirical evidence on its relationship to picky eating remains limited. This study aimed to determine the association of baby‐led weaning and picky eating in young Filipino children.

2. METHODS

2.1. Ethics statement

The study received ethical approval from The Medical City Institutional Review Board.

2.2. Study design

A cross‐sectional study was conducted in Metro Manila, Philippines, from June to August 2024. Using data from Jellison, S.E.J.W (North Dakota State University. Dissertation; 2021), (odds ratio [OR] 0.49; 72% picky eating in parent‐led weaning), a minimum of 294 participants was required (95% confidence interval [CI]; 80% power, 1:1 ratio). Calculations done using OpenEpi. Participants were recruited via convenience and snowball sampling. Posters with a QR code linking to the informed consent form and research survey were publicly shared on social media.

2.3. Inclusion criteria

Included in the study were parents of children aged 2–5 years old, regardless of complementary feeding method. Among 304 respondents, 20 were excluded due to developmental disorders (Autism Spectrum Disorder, Global Developmental Delay), as these were considered potential sources of bias in feeding behavior outcomes. No participants had other exclusionary conditions such as prematurity (born < 37 weeks), neurological, gastrointestinal, or congenital disorders. A total of 284 participants were included in the final analysis (see Supporting Information: Figure 1).

2.4. Data collection

The study protocol and questionnaire were reviewed by The Medical City Institutional Review Board to ensure feasibility and clarity. A pre‐test was done with 10 parents to ensure comprehension of items, and were not included in the final analysis.

Recruitment was conducted via research posters on Instagram and Facebook, with a QR code linking to the online survey. Parents provided informed consent prior to participation.

Demographic information was collected via an online parent‐report questionnaire: Maternal age and highest educational attainment, child's age and gender, child's comorbidities, gestational age at birth, breastfeeding duration, and child's age at introduction of complementary feeding (in months). Items were phrased simply with predefined response choices to minimize bias. Only maternal age and child's comorbidities allowed respondents to answer as free text.

Participants were explicitly asked, “How did you introduce complementary feeding to your child?,” and were provided with four specific choices using classifications by Kominou et al. ¹⁴ : (1) Strict BLW (>90% of the time), (2) predominantly BLW (51%–90% of the time), (3) predominantly traditional spoon‐feeding (BLW 10%–50% of the time), and (4) strict traditional spoon‐feeding (BLW < 10% of the time). Such definitions of each category were also provided.

Picky eating was assessed using the Children's Eating Behavior Questionnaire (CEBQ) Food Fussiness (FF) Subscale. The CEBQ is a comprehensive, internationally validated, 35‐item parent‐report tool, comprising 4 “Food Approach” subscales (Food Responsiveness, Enjoyment of Food, Emotional Overeating, and Desire to Drink); and 4 “Food Avoidance” subscales (Food Fussiness, Slowness in Eating, Satiety Responsiveness, and Emotional Undereating.) ¹⁵

Items are rated on a 5‐point Likert scale (“Never” to “Always”) and averaged per subscale. A mean score of FF ≥ 3.0 based on Steinsbekk et al. ¹⁶ indicates clinically significant picky eating. Those with Food Fussiness mean score of ≥ 3.0 were categorized as picky eaters, while those < 3.0 were categorized as non‐picky.

The CEBQ demonstrates strong internal consistency (Cronbach's α 0.7–0.9), and good construct and external validity across multiple studies. ¹⁷ , ¹⁸ , ¹⁹ , ²⁰ , ²¹

2.5. Statistical analysis

There was no missing data; all fields required completion before electronic submission. Descriptive statistics summarized the sample, Associations between picky eating and categorical variables were assessed using Chi‐square tests or Fisher's exact tests, as appropriate. Crude odds ratios supported bivariate associations.

Participants were analyzed according to reported method of complementary feeding. To evaluate the association between feeding approach and picky eating, binary logistic regression was performed to obtain odds ratios, using FF ≥ 3.0 as primary outcome. Sensitivity analyses tested robustness by (a) varying the categorical cut‐off points (FF ≥ 2.8, FF ≥ 3.2) and (b) modeling FF as continuous outcome using linear regression.

Model diagnostics were undertaken to ensure validity and fit. For logistic models, these included Nagelkerke R ², overall model significance, classification accuracy, and the Hosmer–Lemeshow goodness‐of‐fit test. For linear regression, multicollinearity was assessed using variance inflation factors (VIFs) and tolerance values, alongside evaluation of model significance (F‐test) and residual outliners.

Spearman's rho examined correlations using CEBQ subscales, appropriate for the non‐normal distribution of all subscale scores. Associations between the seven other CEBQ subscales and picky eating behavior were examined using Mann–Whitney Test.

Analyses were done using Google Sheets, MedCalc, and SPSS, independently conducted and verified by a statistician.

3. RESULTS

The median age of participating mothers was 34 years (IQR 31–37), and children had a median age of 3 (IQR 2–4) (see Supporting Information: Table 1) The distribution across feeding approaches was relatively even: Strict BLW (24.6%), predominantly BLW (22.9%), predominantly traditional spoon‐feeding (27.5%), and strict traditional spoon‐feeding (25%) (see Supporting Information: Table 2 ). Most mothers were at least college graduates (65.4%). 52.8% of children were female. The majority of children (72.2%) were breastfed for ≥6 months, and 77.8% began complementary feeding at 6 months of age. Based on Food Fussiness cut‐off of ≥3, 54.2% were picky eaters, 45.8% were non‐picky, and analyzed as such.

Shorter breastfeeding duration and delayed introduction of solids were both associated with picky eating. Among picky eaters, 30.5% were breastfed <6 months, compared to 17.7% among non‐picky eaters. Children breastfed <6 months had twice the odds of picky eating (OR = 2.02, 95% CI 1.15–3.58), suggesting that longer breastfeeding duration is protective against picky eating (See Table 1). Those “never breastfed” showed a lower crude odds ratio but wide confidence intervals, suggesting unstable estimates due to small subgroup size.

Table 1.

Association of picky eating with categorical characteristics.

Characteristics	Categories	Picky eating status
		Picky eater		Non‐picky eater			Crude
		Count	Column %	Count	Column %	p‐value	OR	95% Confidence interval
Method of weaning	Strict traditional spoon‐feeding	61	39.60%	10	7.70%	<0.001	Ref.
	Predominantly traditional spoon‐feeding	47	30.50%	31	23.80%		0.249	0.111	0.558
	Predominantly baby‐led weaning	37	24.00%	28	21.50%		0.217	0.095	0.497
	Strict baby‐led weaning	9	5.8%	61	46.9%		0.024	0.009	0.064
Mother's highest educa‐tional attainment	Post‐graduate	49	31.80%	43	33.10%	0.263*	1840679153	0
	College	104	67.50%	82	63.10%		2048660322	0
	High school	1	0.60%	4	3.10%		403822467.3	0
	Grade school	0	0.00%	1	0.80%		Ref.
Gender of child	Male	74	48.10%	60	46.20%	0.75	Ref.
	Female	80	51.90%	70	53.80%		0.927	0.58	1.479
Age of gestation at birth	Full term	154	100%	130	100%		N/A
	Preterm	0	0%	0	0%
Duration of breast feeding	≥6 months	103	66.90%	102	78.50%	0.0037*	Ref
	<6 months	47	30.50%	23	17.70%		2.024	1.146	3.575
	Never breastfed	4	2.60%	5	3.80%		0.792	0.207	3.035
Age of complementary feeding	At 6 months, before 7 months	113	73.40%	108	83.10%	0.023	Ref
	<6 months	19	12.30%	16	12.30%		1.135	0.555	2.321
	≥7 months	22	14.30%	6	4.60%		3.504	1.368	8.975

Abbreviation: OR, odds ratio.

^*Based on Fisher's exact test, instead of chi‐square given violation of frequency assumptions.

Delayed introduction of complementary food at ≥7 months had 3.5 times higher odds of picky eating (OR = 3.50, 95% CI 1.37–8.98), relative to timely introduction at 6 months; whereas earlier introduction <6 months showed no significant association.

Among CEBQ food approach behaviors, Enjoyment of Food (r = −0.676, strong negative correlation) and Food Responsiveness (r = −0.352, moderate negative correlation) were both associated with lower food fussiness, indicating less picky eating with greater enjoyment and responsiveness to food (See Table 2). Similarly, Emotional Overeating (r = −0.119, weak negative correlation) was modestly associated with reduced fussiness, suggesting that those who eat more in response to emotions may display less restrictive eating behaviors.

Table 2.

Correlation analysis of CEBQ subscales.

Variable	Spearman's rho	Food fussiness	Food responsiveness	Emotional overeating	Enjoyment of food	Desire to drink	Satiety responsiveness	Slowness in eating	Emotional undereating
Food fussiness	Correlation coefficient	—
	Sig. (2‐tailed)	.
Food responsiveness	Correlation coefficient	–0.352**	—
	Sig. (2‐tailed)	<0.001	.
Emotional overeating	Correlation coefficient	−0.119*	0.484**	—
	Sig. (2‐tailed)	0.044	<0.001	.
Enjoyment of food	Correlation coefficient	−0.676**	0.514**	0.227**	—
	Sig. (2‐tailed)	<0.001	<0.001	<0.001	.
Desire to drink	Correlation coefficient	0.120*	0.200**	0.188**	−0.029	—
	Sig. (2‐tailed)	0.044	<0.001	0.001	0.63	.
Satiety responsiveness	Correlation coefficient	0.443**	−0.276**	−0.085	−0.505**	0.214**	—
	Sig. (2‐tailed)	<0.001	<0.001	0.152	<0.001	<0.001	.
Slowness in rating	Correlation coefficient	0.434**	−0.226**	−0.032	−0.482**	0.073	0.482**	—
	Sig. (2‐tailed)	<0.001	<0.001	0.594	<0.001	0.223	<0.001	.
Emotional undereating	Correlation coefficient	0.155**	0.053	0.066	−0.103	0.103	0.296**	0.305**	—
	Sig. (2‐tailed)	0.009	0.375	0.268	0.083	0.083	<0.001	<0.001	.

Note: Based on Spearman's Rho since all CEBQ scores were found to be non‐normally distributed based on Kolmogorov–Smirnov tests (p > 0.05).

Abbreviations: CEBQ, Children's Eating Behavior Questionnaire.

^*Correlation is significant at the 0.05 level (2‐tailed),

^**Correlation is significant at the 0.01 level (2‐tailed).

Food Avoidance behaviors were positively correlated with fussiness. Satiety responsiveness (r = +0.443, moderate positive correlation) and Slowness in Eating (r = +0.434, moderate positive correlation) demonstrated significant associations with food fussiness, suggesting that children who are more sensitive to satiety cues or who eat slowly are more likely to exhibit picky eating behavior (See Table 2). Emotional undereating (r = +0.155, weak positive correlation) and Desire to Drink (r = +0.120, weak positive correlation) also correlated positively with food fussiness, indicating that picky eaters may be more prone to reduced food intake when emotionally distressed, or prefer beverages such as milk over solid foods. These patterns align with typical picky eating profiles characterized by early fullness, slower pace, and reduced engagement with food.

Using FF ≥ 3.0 to define picky eating, the complementary feeding approach showed a strong crude association with picky eating (p < 0.001). Compared with strict traditional spoon‐feeding, the odds of picky eating were markedly lower for all other groups: Predominantly traditional spoon‐feeding (OR = 0.25, 95% CI 0.11–0.56), Predominantly BLW (OR = 0.22, 95% CI 0.10–0.50), and Strict BLW (OR = 0.02, 95% CI 0.01–0.06) (See Table 3).

Table 3.

Estimating the effect of weaning to picky eating (primary FF cut‐off at 3; sensitivity analysis at cut‐offs 2.8 and 3.2).

Variables	Categories	At FF cut‐off = 3 (picky if FF ≥3)[ a , b ]								At FF cut‐off = 2.8 (picky if FF ≥2.8)[ c ]				At FF cut‐off = 3.2 (picky if FF ≥3.2)[ d ]
		Crude OR	95% CI		p‐value	Adj. OR	95% CI		p‐value	Adj OR	95% CI		p‐value	Adj OR	95% CI		p‐value
Method of weaning	Strict Traditional Spoon feeding				<0.001								<0.001				0.002
	Predominantly Traditional Spoonfeeding	0.249	0.111	0.558	<0.001	0.473	0.168	1.333	0.157	0.456	0.152	1.368	0.161	0.354	0.147	0.855	0.021
	Predominantly Baby‐Led Weaning	0.217	0.095	0.497	<0.001	0.450	0.147	1.374	0.161	0.426	0.135	1.350	0.147	0.315	0.123	0.805	0.016
	Strict Baby‐Led Weaning	0.024	0.009	0.064	<0.001	0.046	0.013	0.163	<0.001	0.093	0.028	0.304	<0.001	0.123	0.042	0.362	<0.001
Breastfeeding duration	≥6 months				0.044				0.134				0.840				0.755
	<6 months	2.024	1.146	3.575	0.015	1.157	0.500	2.679	0.734	0.800	0.352	1.819	0.595	0.965	0.458	2.032	0.925
	Never breastfed	0.792	0.207	3.035	0.734	0.086	0.007	1.033	0.053	1.300	0.114	14.768	0.832	0.442	0.052	3.747	0.454
Age of complementary feeding	At 6 mo., before 7 mo.				0.033				0.057				0.266				0.598
	<6 months	1.135	0.555	2.321	0.729	0.993	0.350	2.816	0.990	1.221	0.448	3.329	0.696	0.833	0.320	2.169	0.708
	≥7 months	3.504	1.368	8.975	0.009	4.444	1.295	12.251	0.018	2.816	0.803	9.879	0.106	1.581	0.567	4.412	0.381
Maternal age		1.076	1.023	1.133	0.005	1.117	1.034	1.208	0.005	1.074	0.999	1.155	0.053	1.023	0.957	1.093	0.500
Food responsiveness		0.429	0.305	0.605	<0.001	0.828	0.432	1.585	0.568	1.026	0.570	1.844	0.932	0.808	0.451	1.446	0.473
Emotional overeating		0.731	0.488	1.094	0.128	1.062	0.552	2.043	0.857	1.423	0.758	2.669	0.272	1.354	0.733	2.502	0.333
Enjoyment of food		0.118	0.072	0.196	<0.001	0.269	0.137	0.530	<0.001	0.246	0.125	0.486	<0.001	0.247	0.133	0.457	<0.001
Desire to drink		1.185	0.910	1.542	0.208	1.107	0.719	1.705	0.645	1.267	0.845	1.899	0.251	1.161	0.780	1.728	0.462
Satiety responsiveness		4.583	2.844	7.387	<0.001	2.184	1.046	4.559	0.037	1.193	0.593	2.402	0.620	1.519	0.788	2.929	0.212
Slowness in eating		3.145	2.173	4.551	<0.001	1.413	0.817	2.442	0.216	1.484	0.875	2.518	0.143	1.204	0.737	1.966	0.459
Emotional undereating		1.470	1.060	2.037	0.021	1.582	0.901	2.779	0.110	1.495	0.888	2.518	0.130	1.470	0.887	2.435	0.135
Constant						0.081			0.332	0.845			0.946	3.842			0.554

Abbreviations: CI, confidence interval; FF, Food Fussiness; OR, odds ratio.

^[a] This is the primary model. Variables with p‐value <0.20 in the bivariate analysis was included in the final multivariate model.

^[b] For cut‐off ≥ 3: The logistic regression model was statistically significant, χ ²(15) = 180.90, p < 0.001. The model explained 63.0% (Nagelkerke R ²) of the variance in picky eating and correctly classified 84.5% of cases. The Hosmer and Lemeshow Test indicated a good fit, χ ²(8) = 14.11, p = 0.079.

^[c] For cut‐off ≥ 2.8: The logistic regression model was statistically significant, χ ²(15) = 144.45, p < 0.001. The model explained 54.3% (Nagelkerke R ²) of the variance in picky eating and correctly classified 81.3#% of cases. The Hosmer and Lemeshow Test indicated a good fit, χ ²(8) = 4.11, p = 0.847.

^[d] For cut‐off ≥ 3.2. The logistic regression model was statistically significant, χ ²(15) = 139.10, p < 0.001. The model explained 52.0% (Nagelkerke R ²) of the variance in picky eating and correctly classified 78.5% of cases. The Hosmer and Lemeshow Test indicated a good fit, χ ²(8) = 8.04, p = 0.429.

Other crude associations including older maternal age (OR = 1.08, 95% CI 1.02–1.13) and higher scores in satiety responsiveness (OR = 4.58, 95% CI 2.84–7.39), slowness in eating (OR = 3.15, 95% CI 2.17–4.55), and emotional undereating (OR = 1.47, 95% CI 1.06–2.04) were positively associated with picky eating; whereas enjoyment of food (OR = 0.12, 95% CI 0.07–0.20) and food responsiveness (OR = 0.43, 95% CI 0.31–0.61) were inversely associated.

After adjusting for covariates for the main cut‐off (FF ≥ 3), the feeding method remained a significant predictor of picky eating status (p < 0.001). Compared with strict traditional spoon‐feeding, the odds of being a picky eater were 95.4% lower for children who did strict BLW (aOR = 0.05, 95% CI 0.01–0.16, p < 0.001), 55.0% lower for children who did predominantly BLW (aOR = 0.45, 95% CI 0.15–1.37, p = 0.16), and 52.7% lower for children who did predominantly traditional spoon‐feeding (aOR=0.47, 95% CI 0.17–1.33, p = 0.16) (See Table 3). Note that only those who did Strict BLW remained significant. The direction of confounding for the method of weaning is negative, suggesting that other factors in the model—particularly maternal age (positively associated with picky eating), and enjoyment of food (negatively associated)—were potentially masking part of the true relationship of weaning and picky eating.

The overall model was statistically significant (χ²(15) = 180.90, p < 0.001), explained 63.0% of the variance (Nagelkerke R ² = 0.63), and showed excellent fit (Hosmer–Lemeshow p = 0.079).

3.1. Sensitivity analysis

When a lower cut‐off (FF ≥ 2.8) was applied, all alternative weaning categories remained protective compared with strict traditional spoon‐feeding. Consistent with the main model (FF ≥ 3.0), only strict BLW retained statistical significance (aOR = 0.09, 95% CI 0.03–0.30, p < 0.001).

At a higher cut‐off (FF ≥ 3.2), the protective direction persisted for all non‐reference categories. Predominantly traditional spoon‐feeding (aOR = 0.35, 95% CI 0.15–0.86, p = 0.021, and predominantly BLW (aOR=0.32, 95% CI 0.12–0.81, p = 0.016) showed larger relative reduction in odds; while Strict BLW (aOR = 0.12, 95% CI, 0.04–0.36, p < 0.001) exhibited a smaller yet still significant reduction.

These consistent findings across thresholds confirm that the baby‐led approach remains protective against picky eating irrespective of the operational definition applied.

In a linear regression model examining FF as a continuous outcome (R ² = 0.575, F(15,268) = 24.13, p < 0.001) while adjusting for apriori confounders, all non‐reference feeding methods were associated with significantly lower fussiness scores, indicating a protective effect: Predominantly traditional spoon‐feeding (β = −0.18, B = −0.35, 95% CI [−0.55, −0.15], p < 0.001), predominantly BLW (β = −0.18, B = −0.36, 95% CI [−0.58, −0.15], p < 0.001), and strict BLW (β = −0.34, B = −0.68, 95% CI [−0.91, −0.46], p < 0.001) (See Table 4). These findings demonstrate a dose‐response gradient; with greater child autonomy of feeding, characteristic of baby‐led approaches, corresponding to lower picky eating tendencies.

Table 4.

Sensitivity analysis: Estimating the effect of weaning to picky eating (Food fussiness score).^a

Variables	Standard coefficient (β)	Unstandardized coefficient			Sig.
		β	95% CI
(Constant)b		4.051	3.055	5.048	<0.001
Weaning: Predominantly Traditional Spoon‐Feeding	−0.183	−0.352	−0.552	−0.152	<0.001
Weaning: Predominantly Baby‐Led Weaning	−0.178	−0.363	−0.576	−0.151	<0.001
Weaning: Strict Baby‐Led Weaning	−0.343	−0.684	−0.911	−0.457	<0.001
Duration: Less than 6 months	−0.062	−0.123	−0.286	0.04	0.138
Duration: Never breastfed	−0.045	−0.22	−0.618	0.177	0.276
Age of complementary feeding: Less than 6 months	0.007	0.019	−0.192	0.23	0.859
Age of complementary feeding: 7 months and beyond	0.093	0.269	0.035	0.503	0.024
Maternal age	0.013	0.002	−0.012	0.017	0.761
Food responsiveness	−0.038	−0.042	−0.162	0.078	0.496
Emotional overeating	0.026	0.038	−0.094	0.171	0.570
Enjoyment of Food	−0.451	−0.465	−0.593	−0.338	<0.001
Desire to Drink	0.076	0.073	−0.009	0.155	0.082
Satiety Responsiveness	0.086	0.11	−0.026	0.247	0.113
Slowness in Eating	0.076	0.083	−0.025	0.192	0.130
Emotional undereating	0.057	0.067	−0.034	0.168	0.193

Note: R‐squared value: 0.575; ANOVA Regression Model p < 0.001 (F‐stat = 24.13, df = 15); only 1 patient had standardized residual of > 3 but this is still near the cut off at 3.016; all VIF < 3 and tolerance is between 0.57 and 0.95.

Abbreviations: ANOVA, analysis of variance; CI, confidence interval; Sig, significance; VIF, variance inflation factors.

^a Dependent variable: Picky eating (Food Fussiness score).

^b Reference categories were excluded for weaning (Strict Traditional Spoon‐Feeding), Duration of Breastfeeding ( ≥ 6 months), Age of complementary feeding (at 6 months, before 7 months old).

Across crude, adjusted, sensitivity, and continuous models, BLW consistently demonstrated a protective association with picky eating. Strict BLW showed the strongest and most stable effects across all analyses.

4. DISCUSSION

Picky eating is a common feeding difficulty in early childhood, characterized by limited dietary variety, ²² , ²³ , ²⁴ particularly of vegetables, ²⁵ , ²⁶ and certain textures, ²² , ²³ , ²⁶ unwillingness to try new food, ⁴ , ²⁴ , ²⁶ and strong food preferences requiring special meals for the child. ²² , ²⁷ Within the CEBQ framework, Wardle et al ¹⁵ conceptualize this behavioral core of picky eating through the Food Fussiness subscale, reflecting refusal of familiar and unfamiliar food, selectivity, neophobia, limited dietary variety, and low enjoyment of eating—thus serves as the operational definition in this study.

Previous literature have also associated picky eating with lengthy meal times, slowness in eating, ⁴ , ²² , ²⁵ reliance formula milk as substitute to solids, ²⁸ , ²⁹ and need mealtime distractions with screentime. ³⁰ In this study, picky eaters demonstrated a similar profile: Higher Food Avoidance traits (slowness in eating, satiety responsiveness, emotional undereating), and lower Food Approach traits (enjoyment of food, food responsiveness), consistent with Tharner's latent profile analysis ²⁵ and a cross‐sectional study by Fildes et al. ³¹ Higher scores in food avoidance domains were associated with greater odds of picky eating, while higher scores in food approach domains were inversely associated.

These patterns support the characterization of picky eaters food neophobic, selective, slower to eat, and more sensitive to fullness; whereas non‐picky eaters tend to be show greater enjoyment and food responsiveness. Interactions among CEBQ subscales suggest interdependence—higher enjoyment of food may buffer satiety responsiveness, while high satiety responsiveness combined with slowness in eating may amplify avoidance.

It's worth noting that picky eating is a multidimensional construct shaped by a complex interplay of parental feeding practices, child appetitive traits, and environmental factors. Responsive, low‐pressure feeding reduces picky eating, ⁴ , ⁵ , ⁷ , ²⁷ , ³² , ³³ whereas controlling or pressuring strategies reinforce refusal. ⁴ , ⁵ , ⁷ , ²⁷ , ³⁴ Early, repeated exposure to varied textures and flavors also promote acceptance ³⁵ , ³⁶ Although the CEBQ FF subscale captures the behavioral dimension, it does not encompass such broader psychosocial and environmental influences, underscoring the complexity of feeding.

This study provides robust evidence that BLW is strongly associated with picky eating tendencies among children aged 2–5 years. Strict BLW was associated with greatest reduction in picky eating, with consistency across sensitivity analyses and continuous modeling of food fussiness. This aligns with several observation studies reporting reduced food fussiness ³⁷ , ³⁸ , ³⁹ and overall positive feeding behaviors.

A dose‐response pattern was also observed: Strict BLW showed the lowest likelihood of picky eating, suggesting that the positive outcomes of the BLW approach requires consistent self‐feeding of at least 90% of the time to experience its best effects. Meanwhile, BLW 51%–90% of the time (Predominant BLW) showed 55% lower likelihood, and BLW 10%–50% of the time (Predominantly traditional spoon‐feeding) showed 52.7% lower likelihood of picky eating. Greater child autonomy during feeding, characteristic of BLW, was associated with lower picky eating tendencies.

BLW, by its fundamental approach of introducing complementary food, supports the development of such healthy feeding behaviors. BLW benefits likely arise from fostering positive, pressure‐free mealtimes, early texture exposure, and self‐regulation. BLW positions the infant as an active participant in family mealtimes, ¹² , ⁴⁰ rather than a passive recipient to be fed, ⁴¹ promotes enjoyment, ¹¹ , ⁴⁰ , ⁴² and responsiveness to hunger and satiety cues, ⁸ , ⁴² , ⁴³ factors known to reduce picky eating. Infants who are Baby‐Led Weaned are also naturally exposed to lumpier food earlier, and become skilled in texture variety, ¹¹ , ⁴³ known to be protective of picky eating.2 These core principles of BLW may all be contributory to healthy eating behaviors and reduced picky eating, rather than self‐weaning in isolation.

The Baby‐Led Introduction to Solids (BLISS) randomized trial by Taylor et al. ⁴⁴ reported more modest effects of BLW on picky eating, with reduced fussiness at 12 months, but not at 24 months; though displayed great enjoyment of food at both time periods. The BLISS approach retained certain philosophies of BLW, with guidance on food, preparation, and responsive feeding. However, it did not specify whether infants joined family mealtimes—an essential BLW principle that provides role‐modeling for food choices and mealtime behavior ¹² —which may have influenced the results.

In this study, higher maternal age demonstrated a positive association with picky eating, similar to Taylor et al.'s findings in the Avon Longitudinal study of Parents and Children cohort, ¹ , ²⁴ while other studies show mixed results. ⁴⁵ , ⁴⁶ Underlying mechanisms are likely multifactorial, as older mothers may adopt more cautious or controlling feeding styles, which have been linked to food avoidance ¹ , ⁴ , ⁵ , ⁷ , ²⁵ , ⁴⁵ , ⁴⁶ ; or may be more attentive to feeding difficulties, resulting in higher reporting.

Breastfeeding <6 months and delayed complementary feeding (≥7 months) were also associated with higher odds of picky eating, consistent with previous literature, ¹ , ³⁹ , ⁴⁷ possibly due to delayed texture introduction. This emphasizes the importance of breastfeeding and timely initiation of complementary feeding.

The cultural practice in the Philippines—where strict traditional spoon‐feeding remains the norm, and children are often cared for by extended family or household help—may limit generalizability of these findings. Caregiver‐led complementary feeding remains the cultural standard, while BLW is still met with some resistance.

5. CONCLUSION

This study provides evidence that Baby‐Led Weaning is associated with substantially lower picky eating behavior among children aged 2–5 years, a relationship that persisted across multiple sensitivity analyses. These findings support BLW as a potentially effective approach to fostering positive feeding behavior and food acceptance in early childhood.

The benefits of BLW appear to reflect its foundational principles—responsive feeding, infant autonomy, absence of parental pressure, early and repeated exposure to varied tastes and textures, and participation in family meals—rather than a particular feeding method in isolation. Promoting these principles can empower caregivers to foster positive mealtime experiences, strengthen children's relationship with food, reduce picky eating, and support healthier long‐term eating habits. Feeding decisions remain shaped by cultural norms, caregiver confidence, and parental preferences, but incorporating responsive and autonomy‐supportive practices may benefit young children.

5.1. Study limitations and recommendations

This study's cross‐sectional research design limits causal inference. Reverse causation in possible; wherein perceived signs of food fussiness may have influenced parents' choice of feeding approach, rather than the feeding approach shaping later picky eating. Child temperament and sensory sensitivities, which also influence feeding, were not measured.

All data were self‐reported by parents, potentially introducing recall and misclassification bias, particularly for older children and those who mixed BLW with spoon‐feeding. Although feeding categories were clearly defined, retrospective recall of BLW proportions may vary.

Although models adjusted for maternal age, breastfeeding duration, and complementary feeding timing, certain unmeasured variables such as socioeconomic circumstances, parental dietary habits, parenting and feeding style, feeding pressure, mealtime dynamics, and dietary variety could have introduced residual confounding, possibly influencing the observed associations in either direction.

The use of convenience and snowball sampling may have introduced selection and reporting bias. Parents had higher educational attainment, potentially indicating stronger health literacy and greater likelihood of adopting responsive feeding practices or BLW. This sample differs systematically from the densely populated areas of Metro Manila of lower socioeconomic background. No statistical weighting was applied to address this. As all data were parent‐reported, recall and social desirability bias may have influenced responses. These limit generalizability to broader populations.

Picky eating was assessed solely through the CEBQ Food Fussiness subscale. While validated and comprehensive for behavioral aspects, it doesn't capture the complexity of picky eating. As a parent‐reported tool, this introduces potential observer bias, recall inaccuracies, or misclassification. Future research may use an alternative tool to measure picky eating, a second validated tool, and objective observational methods to better characterize picky eating.

Longitudinal prospective cohort studies and randomized controlled trials with a larger sample size are recommended to explore temporal relationships and potential causal pathways between feeding methods and picky eating. Additional research incorporating latent profile analysis may help capture the multidimensional construct of picky eating, offering a more comprehensive understanding of feeding profiles by integrating multiple CEBQ subscales.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflict of interest.

Supporting information

Supplemental Figure 1. Research workflow.

Supplementary Table S1.

Supplementary Table S2.