Reaching consensus on a ‘vegetables first’ approach to complementary feeding

Abstract

On 5 May 2016, the British Nutrition Foundation (BNF) invited leading infant feeding experts to discuss and debate the strength of the evidence base on a 'vegetables first' approach to complementary feeding. Consensus was reached on the translation of the science into practical messages for parents/carers. In particular, it is known that familiarising infants with a variety of vegetables from the start of complementary feeding increases the likelihood that vegetables will be accepted throughout childhood, though currently in the UK vegetables tend not to be prioritised as first foods. Infant feeding guidance could include recommendations to offer tastes of a variety of vegetables when complementary feeding begins, as a first step in the transition from milk to solid foods, so that liking and acceptance are established during this early window of opportunity. This report describes the main themes emerging from the discussions and the specific messaging recommendations which could be included within infant feeding guidance.

Nutrition in the early years – laying the foundations for healthy eating

“…This period is important as preferences established in infancy are known to track into later childhood (Venter & Harris ; Chambers ; Chambers et al . ).…”

“…Adopting a ‘vegetables first, frequently and in variety’ approach to complementary feeding is likely to steer children towards a healthier diet (Chambers ), and the consensus reached by the team assembled by the British Nutrition Foundation (BNF) has identified health visitors as key opinion leaders to guide families in offering tastes of a variety of vegetables when complementary feeding begins (Chambers et al . ). This could be an essential step in the transition from milk to solid foods, so that liking and acceptance are established.…”

“…During the period of complementary feeding, infants are provided with the opportunity to learn about a variety of foods, flavours and textures. This period is important as preferences established in infancy are known to track into later childhood (Venter & Harris 2009;Chambers 2016;Chambers et al 2016).…”

“…To make the most of this crucial period when babies are receptive to new foods, it has been suggested that offering vegetables exclusively for the first few weeks of complementary feeding with a 'vegetables first' approach enhances liking and facilitates acceptance of these foods (Chambers 2016;Chambers et al 2016). Currently, as discussed by Cichero (2016), offering vegetables as a first food tends to be associated with baby-led weaning more than traditional spoon feeding.…”

Is the British diet improving?

“…Something is going wrong in the process of converting the objective of eating five portions a day into a concrete plan for the individual person to change their behaviour. One issue is probably the need to introduce children to a wide range of flavours, textures and appearances, including fruit and vegetables from a very young age (Chambers et al 2016). Otherwise, children tend to develop with conservative preferences for high-fat and sweet foods that were useful evolutionarily when they needed to maximise energy intake in conditions with limited opportunity for fat and sugars consumption, but may be detrimental to health in conditions of food surplus.…”