Hi there!

I’m Chesca Layug-Dionglay, a General Pediatrician from the Philippines, and a Developmental Screener with a special interest in pediatric feeding and functional medicine. I am grateful for the opportunity to share a perspective from the frontlines of pediatric care in a low- to middle-income country, where feeding challenges are common, complex, and deeply shaped by culture and circumstance.

In the Philippine setting, feeding rarely involves parents alone. Many families rely heavily on grandparents and househelpers for day-to-day childcare, as both parents often work outside the home. With parents away, caregivers tend to be understandably risk-averse, prioritizing what feels safest and most familiar. As a result, traditional spoon-feeding and non-responsive feeding practices remain the norm, while responsive or child-led feeding approaches are often viewed with hesitation and concern.

Although there are currently no local prevalence studies on picky eating in the Philippines, in everyday clinical practice, we see a significant number of children struggling with picky eating. Feeding concerns are among the most frequent issues encountered in routine pediatric and developmental screening visits. Compounding this is a long-standing cultural belief that a chubby child is a healthy child. Because of this, many caregivers place greater emphasis on formula milk intake – often prolonged and increased bottle-feeding – rather than on the quality, variety, and progression of solid food. While well-intentioned, this approach can inadvertently contribute to problematic feeding skills, nutritional imbalance, and feeding difficulties later in childhood.

Baby-Led Weaning (BLW) and responsive feeding practices have only just started gaining traction in the Philippines, but still with much hesitation. In 2024, I conducted a cross-sectional study on the association of Baby-Led Weaning and picky eating in children 2-5 years old. The findings showed that children who underwent strict BLW had a 95% lower likelihood of picky eating compared to those who did strict traditional spoon-feeding. However, these families who practiced BLW largely came from more socioeconomically privileged backgrounds, with higher educational attainment and greater access to information on child health and nutrition.

Beyond research outcomes, BLW and responsive-feeding practices offer several other well-established benefits, including supporting appetite self-regulation, fostering a more positive relationship with eating, encouraging sensory exploration through food, and promoting fine motor development. Importantly, these principles can be adapted to Filipino households with proper guidance for the entire family.

Many traditional Filipino foods naturally lend themselves to BLW when prepared safely and appropriately. Examples include soft-cooked vegetables such as kalabasa (‘squash’), kamote (‘sweet potato), carrots, and sayote, which are all common in many Filipino dishes; ripe fruits like mango and banana; and tender protein such as chicken leg cooked in broth (tinola). These foods can be incorporated thoughtfully, allowing children to participate in family meals while exploring texture, taste, and self-feeding within a responsive and supervised feeding environment, rather than force-fed. BLW principles also naturally align well with the Filipino tradition of shared family meals, allowing children to observe, participate, and eat alongside caregivers using the same food, fostering inclusion and modeling healthy eating behaviors.

Feeding outcomes are not just about methods, but about access, education, and empowerment. While BLW may not be feasible for every family, every parent and caregiver deserves clear, culturally sensitive guidance on proper feeding and nutrition. My personal passion lies not in promoting a single feeding approach, but in reducing misconceptions, supporting responsive feeding practices, and helping families understand how nutrition supports growth, development, behavior, and long-term health.

At The Medical City Center for Developmental Pediatrics, through the hard work of my esteemed mentors Dr Jacqueline Navarro, Dr Mary Jean Guno, and Dr Kaye Napalinga, we are proud to be the first and only center in the country to establish a dedicated Feeding Clinic, where we assess and manage pediatric feeding problems through a developmental and family-centered lens. Our goal is to identify feeding challenges, understand the child within their social and caregiving context, and partner with families and caregivers to create practical, sustainable strategies that work in real homes.

Feeding is never just about food. It reflects culture, beliefs, access, and love. By meeting families where they are and equipping them with accurate information and compassionate support, I believe we can improve feeding experiences and outcomes for children – one family, one community at a time.

Thank you for allowing me to share a glimpse into pediatric feeding in the Philippines. I look forward to learning from and collaborating with this global community as we continue to advocate for children and families everywhere.

If any part of this resonates with you and you’d like to continue the conversation, please feel free to email me at chescalayugmd@gmail.com. Thank you very much for reading and for being part of this community.