Appropriate age range for introduction of complementary feeding into an infant's diet

Nutrition, Novel Foods Efsa Panel on; Castenmiller, Jacqueline; Henauw, Stefaan De; Hirsch‐Ernst, Karen‐Ildico; Kearney, John; Knutsen, Helle Katrine; Maciuk, Alexandre; Mangelsdorf, Inge; McArdle, Harry J; Naska, Androniki; Peláez, Carmen; Pentieva, Kristina; Siani, Alfonso; Thiès, Frank; Tsabouri, Sophia; Vinceti, Marco; Bresson, Jean‐Louis; Fewtrell, Mary; Kersting, Mathilde; Przyrembel, Hildegard; Dumas, Céline; Titz, Ariane; Turck, Dominique

doi:10.2903/j.efsa.2019.5780

Cited by 85 publications

(119 citation statements)

References 364 publications

(936 reference statements)

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“…A recent survey, promoted by the Italian Society of Pediatrics and conducted among primary care pediatricians, showed the wide variability in the time of preterms' introduction to complementary feeding and the type of foods proposed [10]. The European Food Safety Authority (EFSA) Panel on Nutrition recently underlined the lack of evidence [44], reporting a single randomized controlled trial (RCT) that concluded that weaning at 4 vs. 6 months corrected age does not affect anthropometric measures at 12 months corrected age in preterm infants <34 weeks of gestation [33]. However, the Panel raised doubts on the generalizability of these results to the European setting, given the specific characteristics of the population considered by Gupta et al's RCT.…”

Section: Nutrition During Weaning In Preterm Infantsmentioning

confidence: 99%

Preterm’s Nutrition from Hospital to Solid Foods: Are We Still Navigating by Sight?

et al. 2020

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As preterm birth rates are globally increasing, together with research on preterms’ peculiar needs, neonatologists are still facing the challenge of how to properly feed them. The need to strike a balance between excessive catch-up growth and extrauterine growth retardation, both leading to adverse outcomes, is made even more difficult by the broad range of preterms’ needs. Although mother’s fresh milk is undoubtedly the best nourishment, its availability during hospital stay is often lower than recommended, and its fortification at discharge is still an open issue. Formula milks are available as an alternative to breast milk. However, choosing the right formula requires a thorough evaluation of the infant’s perinatal history and targets. Last but not least, adequate timing and initiation of weaning in premature babies are still a poorly explored matter. This narrative review aims at evaluating the multitude of issues to consider when feeding preterms in the three stages of their first life: in-hospital care, discharge, and, eventually, weaning. Given the current absence of internationally shared guidelines, understanding the potential pitfalls of preterms’ nutrition could help us trace the right path for the right preterm.

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Section: Nutrition During Weaning In Preterm Infantsmentioning

confidence: 99%

Preterm’s Nutrition from Hospital to Solid Foods: Are We Still Navigating by Sight?

et al. 2020

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“…The World Health Organization (WHO) recommends exclusively breastfeeding infants up to six months of age and introducing complementary foods thereafter [ 18 ]. The European Food and Safety Authority (EFSA) and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) support the desirable goal to exclusively breastfeed until six months of age, as recommended by the WHO, however they elaborate on the possibilities to introduce complementary foods between the age of four and six months [ 19 , 20 , 21 ]. The EFSA recently concluded that no precise age for the start of complementary feeding can be determined, as this heavily depends on the infant’s characteristics and development [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…The European Food and Safety Authority (EFSA) and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) support the desirable goal to exclusively breastfeed until six months of age, as recommended by the WHO, however they elaborate on the possibilities to introduce complementary foods between the age of four and six months [ 19 , 20 , 21 ]. The EFSA recently concluded that no precise age for the start of complementary feeding can be determined, as this heavily depends on the infant’s characteristics and development [ 21 ]. In particular, they highlight that “Most infants do not need complementary foods for nutritional reasons up to around six months of age, with the exception of some infants at risk of iron depletion” (p. 5) and “that an infant might be developmentally ready for complementary foods before six months does not imply that this is necessary or desirable” (p. 5) [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Complementary Feeding Practices and Parental Pressure to Eat among Spanish Infants and Toddlers: A Cross-Sectional Study

Klerks

Román

Bernal

et al. 2021

IJERPH

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The introduction of complementary foods is a crucial stage in the development and determination of infants' health status in both the short and longer-term. This study describes complementary feeding practices among infants and toddlers in Spain. Also, relationships among sample characteristics (both parents and their child), feeding practices (timing, type of complementary food), and parental pressure to eat were explored. Cognitive interviewing with 18 parents was used to refine the survey questions. Responses from a national random sample of 630 parents, who were responsible for feeding their infants and toddlers aged 3–18 months, were obtained. Solids, often cereals and/or fruits first, were introduced at a median age of five months. Fish and eggs were introduced around the age of nine and ten months. Almost all children were fed with home-prepared foods at least once per week (93%), and in 36% of the cases, salt was added. Interestingly, higher levels of parental pressure to eat were found in female infants, younger parents, parents with a full-time job, the southern regions of Spain, and in infants who were not fed with home-prepared foods. Our insights underline the importance of clear feeding recommendations that can support health care professionals in promoting effective strategies to improve parental feeding practices.

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“…In contrast, pediatric organizations and government bodies in Europe, such as the European Food Safety Authority, consider this definition unhelpful and even confusing. Given that many infants receive formula during the 1st year of life either alongside breastfeeding or as the sole diet, in Europe, complementary foods are generally defined as all solid and liquid foods provided to infants other than breastmilk, or infant and follow-on formula (14)(15)(16)(17). From a pediatric perspective, homemade and commercial complementary foods are meant to be provided alongside breastfeeding and not as a replacement for breastfeeding, and hence, these are not considered as BMSs.…”

Section: Our Positionmentioning

confidence: 99%

Promoting Breastfeeding and Interaction of Pediatric Associations With Providers of Nutritional Products

Bognár¹,

Luca

Domellöf

et al. 2020

Front. Pediatr.

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Pediatric associations have been urged not to interact with and not to accept support from commercial providers of breast milk substitutes (BMSs), based on the assumption that such interaction would lead to diminished promotion and support of breastfeeding. The leadership of seven European pediatric learned societies reviewed the issue and share their position and policy conclusions here. We consider breastfeeding as the best way of infant feeding and strongly encourage its active promotion, protection, and support. We support the World Health Organization (WHO) Code of Marketing of BMSs. Infant formula and follow-on formula for older infants should not be advertised to families or the public, to avoid undermining breastfeeding. With consistently restricted marketing of BMSs, families need counseling on infant feeding choices by well-informed pediatricians. Current and trustworthy information is shared through congresses and other medical education directed and supervised by independent pediatric organizations or public bodies. Financial support from commercial organizations for congresses, educational, and scientific activities of pediatric organizations is an acceptable option if scientific, ethical, societal, and legal standards are followed; any influence of commercial organizations on the program is excluded, and transparency is ensured. Public–private research collaborations for improving and evaluating pharmaceuticals, vaccines, medical devices, dietetic products, and other products and services for children are actively encouraged, provided they are guided by the goal of enhancing child health and are performed following established high standards. We support increasing investment of public funding for research aiming at promoting child health, as well as for medical education.

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Appropriate age range for introduction of complementary feeding into an infant's diet

Abstract: Following a request from the European Commission, the Panel on Nutrition, Novel

Cited by 85 publications

References 364 publications

Preterm’s Nutrition from Hospital to Solid Foods: Are We Still Navigating by Sight?

Preterm’s Nutrition from Hospital to Solid Foods: Are We Still Navigating by Sight?

Complementary Feeding Practices and Parental Pressure to Eat among Spanish Infants and Toddlers: A Cross-Sectional Study

Promoting Breastfeeding and Interaction of Pediatric Associations With Providers of Nutritional Products

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