Consensus statements on Singapore guidelines for feeding and eating in infants and young children

Optimal nutrition during the first 1000 days of a child's life is crucial for healthy growth and development. Caregiver feeding practices can significantly affect what foods are offered, which foods are preferred and how healthy eating patterns are established, highlighting the need for clear guidance and recommendations. Currently, there are no national guidelines focused on the transition from being fed at birth to independent eating by 2 years old. This study aimed to develop concise, evidence-based recommendations to support healthy eating behaviours in children aged 0-2 years.

A systematic literature search was conducted on PubMed, Cumulated Index to Nursing and Allied Health Literature and Excerpta Medica Database to identify relevant articles. The GRADE-ADOLOPMENT methodology was employed to adopt, adapt or develop evidence-based recommendations for feeding and eating practices in infants and young children. This includes using the Evidence-to-Decision framework to ensure recommendations considered the balance of benefits and harms, feasibility and cultural appropriateness. A multidisciplinary panel of domain experts reviewed and refined the recommendations, with consensus defined as ≥70% agreement. A total of 64 articles were reviewed, comprising eight observational cohort studies, 25 randomised controlled trials and 31 systematic reviews (including four meta-analyses). The included studies examined key aspects of complementary feeding: 20 focused on timing, 30 on types of food, 13 on self-regulation and one on the feeding environment.

Seven consensus statements were developed based on the evidence and organised into four main domains: Variety, Autonomy, Setting and Timing. All statements achieved unanimous agreement among domain experts.

These guidelines provide clear, evidence-based recommendations for practical nutrition strategies during early childhood.