title: Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition.
abstract: This position paper on complementary feeding summarizes evidence for health effects of complementary foods. It focuses on healthy infants in Europe. After reviewing current knowledge and practices, we have formulated these conclusions: Exclusive or full breast-feeding for about 6 months is a desirable goal. Complementary feeding (ie, solid foods and liquids other than breast milk or infant formula and follow-on formula) should not be introduced before 17 weeks and not later than 26 weeks. There is no convincing scientific evidence that avoidance or delayed introduction of potentially allergenic foods, such as fish and eggs, reduces allergies, either in infants considered at increased risk for the development of allergy or in those not considered to be at increased risk. During the complementary feeding period, >90% of the iron requirements of a breast-fed infant must be met by complementary foods, which should provide sufficient bioavailable iron. Cow's milk is a poor source of iron and should not be used as the main drink before 12 months, although small volumes may be added to complementary foods. It is prudent to avoid both early (<4 months) and late (>or=7 months) introduction of gluten, and to introduce gluten gradually while the infant is still breast-fed, inasmuch as this may reduce the risk of celiac disease, type 1 diabetes mellitus, and wheat allergy. Infants and young children receiving a vegetarian diet should receive a sufficient amount ( approximately 500 mL) of breast milk or formula and dairy products. Infants and young children should not be fed a vegan diet.
authors.affiliation: Department of Pediatrics, San Paolo Hospital, University of Milano, Milano, Italy. carlo.agostoni@unimi.it
authors.forename: Carlo
authors.initials: C
authors.lastname: Agostoni
authors.forename: Tamas
authors.initials: T
authors.lastname: Decsi
authors.forename: Mary
authors.initials: M
authors.lastname: Fewtrell
authors.forename: Olivier
authors.initials: O
authors.lastname: Goulet
authors.forename: Sanja
authors.initials: S
authors.lastname: Kolacek
authors.forename: Berthold
authors.initials: B
authors.lastname: Koletzko
authors.forename: Kim Fleischer
authors.initials: KF
authors.lastname: Michaelsen
authors.forename: Luis
authors.initials: L
authors.lastname: Moreno
authors.forename: John
authors.initials: J
authors.lastname: Puntis
authors.forename: Jacques
authors.initials: J
authors.lastname: Rigo
authors.forename: Raanan
authors.initials: R
authors.lastname: Shamir
authors.forename: Hania
authors.initials: H
authors.lastname: Szajewska
authors.forename: Dominique
authors.initials: D
authors.lastname: Turck
authors.forename: Johannes
authors.initials: J
authors.lastname: van Goudoever
mesh_terms: D000375:Aging; D000818:Animals; D002417:Cattle; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D004032:Diet; D005512:Food Hypersensitivity / Q000517:prevention & control; D006801:Humans; D007223:Infant; D007225:Infant Food; D041943:Infant Formula; D007227:Infant Nutritional Physiological Phenomena; D008892:Milk; D008895:Milk, Human