New Recommendations from ESPGHAN for Complementary feeding

ESPGHAN has recently updated its position on complementary feeding that was originally published in 2008. This document issues several recommendations about this period of rapid growth, development and marked changes in the diet (new foods, tastes, and feeding experiences).

In this document, ESPGHAN reinforces their recommendations about timing of introduction of complementary feeding:

  • Exclusive or full breast-feeding should be promoted for at least 4 months (17 weeks, beginning of the 5th month of life) and exclusive or predominant breast-feeding for approximately 6 months (26 weeks, beginning of the 7th month) is a desirable goal.
  • Complementary foods (solids and liquids other than breast milk or infant formula) should not be introduced before 4 months but should not be delayed beyond 6 months.
  • In addition, ESPGHAN wants to promote variety in complementary feeding and recommends offering foods with a variety of flavors and textures including bitter tasting green vegetables, while keeping continued breast-feeding alongside complementary feeding and avoiding whole cow’s milk as the main drink before 12 months of age.  

ESPGHAN has introduced a new positioning about the introduction of allergenic foods and gluten, that confirms the recent research about these topics:

  • Allergenic foods may be introduced when complementary feeding is commenced any time after 4 months.
  • Peanut introduction in infants at high risk should be done between 4 and 11 months, following evaluation by an appropriately trained specialist.
  • Gluten may be introduced between 4 and 12 months, but consumption of large quantities should be avoided during the first weeks after gluten introduction and later during infancy.

Finally, ESPGHAN is again issuing recommendations about avoidance of salt and sugar addition to complementary foods and remarks that vegan diets for infants should only be used under appropriate medical or dietetic supervision and parents should understand the serious consequences of failing to follow advice regarding supplementation of the diet.

With this document, ESPGHAN updates their position about complementary food and while keeping their recommendations about timing of introduction, they draw clearly their position about the early and controlled exposure to allergenic foods and gluten.