Feeding Practices in the Introduction of Complementary Feeding and Implications for Future Healthy Eating

Complementary feeding (CF) is the process of introducing foods that starts when breast milk or formula alone can no longer meet infant's nutritional requirements. Nevertheless, the goal of introducing solid foods is to supplement, not replace, human milk or infant formula. The timing of introduction of CF is a pivotal issue in paediatrics.

According to the World Health organization (WHO), ideally CF begins at 6 months of age and continues until 23 months, although breastfeeding may extend beyond this period. In low-resource setting areas due to food and water hygiene issues and less availability of complementary foods (CFs) with good nutritional quality, early CF represents a harm. In the meantime, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and European Food Safety Authority (EFSA) recommend that CF should start between 17 and 26 weeks of age. This indication is provided because an early introduction of CFs before 4 months has harming results for both renal and gastrointestinal function and is inadequate with respect to neurodevelopmental skills. The concern about late introduction after 6 months mainly arises from inadequacy of breast milk in providing critical nutrients, particularly iron. Moreover, accumulating evidence suggests a potential higher risk of food allergies (i.e., peanut) when delaying exposure to allergens, rather than preventing their occurrence.