Complementary Feeding in Infancy

Complementary feeding is a crucial phase in a child's life that helps them transition from exclusive breastfeeding or infant formula to a more varied diet. It is the process of introducing solid foods into an infant's diet, supplementing breast milk or formula to meet their evolving nutritional requirements. The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life, followed by the gradual introduction of complementary foods. This period is essential for a child's optimal growth and development, as a lack of proper feeding habits can worsen childhood morbidity and death.

The timing of introducing solid foods is crucial for nutritional and developmental reasons. WHO recommends that infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues up to two years of age. In the UK, the Department of Health adopted the WHO Global Infant Feeding Recommendation, which advises exclusive breastfeeding for the first six months. However, some debate exists about whether it is better to follow the WHO recommendation of exclusive breastfeeding until six months or four months. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the UK Scientific Advisory Committee on Nutrition (SACN) recently reviewed the evidence and found no harm associated with the introduction of solid foods between four and six months of age, but no benefit associated with the introduction before six months.

Responsive feeding is essential for good complementary feeding practices. Parents and caregivers should recognize and respond appropriately to infant cues that signal hunger or fullness, allowing the infant to self-regulate how much milk they drink or how much solid food they eat. This approach supports the infant's ability to monitor their own hunger and fullness signals, which is essential for healthy eating habits.

Introducing allergenic foods is another important consideration. Previously, advice was to delay introducing these foods to children at high risk of food allergy. However, recent research suggests that high-risk children may benefit from earlier introduction of peanut-containing foods. The Learning Early About Peanut Allergy (LEAP) study found that introduction of peanuts at four compared with six months of age decreased the frequency of the development of peanut allergy among children at high risk for this allergy.

In conclusion, complementary feeding is an essential phase in a child's life that helps them transition from exclusive breastfeeding or infant formula to a more varied diet. The timing of introducing solid foods is crucial for nutritional and developmental reasons, and responsive feeding practices are essential for good complementary feeding. Healthcare professionals must take cultural, socio-economic, and lifestyle factors into account when advising parents and caregivers about infant feeding.