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Science base of complementary feeding practice in infancy
Kim F Michaelsen1, Anni Larnkjaer, Lotte Lauritzen
1Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Denmark.
Insights
Introducing complementary foods around 4-6 months is safe, with potential long-term benefits like reduced adult overweight risk. Early introduction of allergenic foods is now recommended, but more research on food composition and timing is needed.
Area of Science:
- Pediatrics
- Nutrition Science
- Public Health
Background:
- Complementary feeding practices are evolving following the 2008 ESPGHAN position paper.
- Global recommendations (WHO) for introducing solids at 6 months are variably adopted, with some mothers initiating earlier.
Purpose of the Study:
- To review recent publications (2008-2009) on complementary feeding in industrialized nations.
- To synthesize current evidence on the timing and composition of complementary foods.
Main Methods:
- Literature review of publications from 2008-2009.
- Analysis of findings from the European Food Safety Authority (EFSA) and other randomized studies.
Main Results:
- Introduction of complementary feeding between 4-6 months is considered safe by EFSA.
- Delaying complementary feeding until 6 months may reduce the risk of adult overweight.
- No evidence supports delaying the introduction of hyperallergenic foods; early introduction may lower allergy risk.
- Docosahexaenoic acid (DHA) may influence cardiovascular regulation.
Conclusions:
- Further large-scale randomized studies are required.
- Investigate the impact of complementary feeding timing and composition on growth, development, and long-term disease risk.
Purpose Of Review:
The review presents a selection of publications on complementary feeding in industrialized countries during 2008-2009, after the publication of the ESPGHAN position paper in early 2008.
Recent Findings:
The WHO recommendation for introduction of complementary feeding at 6 months is adapted in many countries, but the issue is still discussed and many mothers introduce complementary feeding as early as before 4 months. The European Food Safety Authority recently published a comprehensive review on the appropriate age for the introduction of complementary feeding and concluded that introduction between 4 and 6 months is safe. One study showed that delaying introduction of complementary feeding up to 6 months resulted in lower risk of overweight as adult. Milk protein is stimulating insulin-like growth factor-1 and growth and a recent study supports a long-term programming of the insulin-like growth factor-1 axis. There is now a broad consensus that there is no need to delay the introduction of hyperallergenic foods, which might even increase the risk of allergic disease. Randomized studies show that docosahexaenoic acid may affect heart rate and thereby cardiovascular regulation.
Summary:
Despite some recent interesting publications, there is still a need for more large randomized studies to further explore to what degree the time of introduction and composition of complementary foods have effects on growth, development and especially the long-term risk of diseases.
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