Can Optimal Complementary Feeding Improve Later Health and Development?

Nutrition and growth during early infancy influence later health and development, but most research has focused on the period of milk feeding, and the possibility that the timing, content or method of complementary feeding (CF) might have similar later effects has received less attention. Such effects are plausible, given that the CF period is one of rapid growth and development when infants are susceptible to nutrient deficiencies and excesses, and during which there are marked changes in diet with exposure to many new foods, tastes and feeding experiences. CF practices could influence later outcome by several potential mechanisms, including programming effects, but also direct effects on food preferences, appetite and eating behavior. Investigating these issues is challenging given the diversity and complexity of CF practices, which limit the feasibility and generalizability of randomized trials in this field. Available evidence relating CF practices to later health and development are currently limited in quantity and quality, but suggest that avoiding the introduction of solid foods before 4 months may reduce the risk of subsequent obesity and allergy. Whilst recommendations for different aspects of CF may be developed in the future based on broad principles, they will need to be tailored for different populations.