Complementary Feeding in Developed Countries

Editor(s): O. Hernell Annales Nestlé Vol.70 / 1,  2012


Although there is overall agreement with regards to breastfeeding as the best source of nutrition for the suckling baby, there is still debate about when and how complementary feeding should be introduced. In this issue of the Annales, the latest scientific findings are summarized around complementary feeding in general and in specific conditions, such as preterm birth or celiac disease. Finally, the impact of introduction of complementary foods is discussed with regards to its short and long term health consequences and to the establishment of food preferences later in life.

  • Timing of Introduction of Complementary Food: Short- and Long-Term Health Consequences

    Author(s): H. Przyrembel

    Complementary food is needed when breast milk (or infant formula) alone is no longer sufficient for both nutritional and developmental reasons. The timing of its introduction, therefore, is an individual decision, although 6 months of exclusive breastfeeding can be recommended for most healthy term infants. The new foods are intended to ‘complement’ ongoing breastfeeding with those dietary items whose intake has become marginal or insufficient. Both breastfeeding and complementary feeding can have direct or later con- sequences on health. The evaluation of consequences of both early and late introduction of complementary food can neither disregard the effect of breastfeeding compared to formula feeding nor the composition or quality of the complementary food. Possible short-term health effects concern growth velocity and infections, and possible long-term effects may relate to atopic diseases, type 1 and 2 diabetes, obesity and neuromuscular development. On the basis of the currently available evidence, it is impossible to exactly determine the age when risks related to the start of complementary feeding are lowest or highest for most of these effects, with the possible exception of infections and early growth velocity. The present knowledge on undesirable health effects, however, is mainly based on observational studies, and although some mechanisms have been proposed, further prospective studies have to clarify these unsolved issues. Even less evidence on the consequences of the timing of complementary food introduction is available for formula-fed infants.

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