Complementary feeding: A commentary by the ESPGHAN committee on nutrition

Carlo Agostoni, Tamas Decsi, Mary Fewtrell, Olivier Goulet, Sanja Kolacek, Berthold Koletzko, Kim Fleischer Michaelsen, Luis Moreno, John Puntis, Jacques Rigo, Raanan Shamir, Hania Szajewska, Dominique Turck, Johannes van Goudoever, Helena Ferreira*

*Corresponding author for this work

Research output: Contribution to journalComment/debate


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 (>=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 (∼500 ml) of breast milk or formula and dairy products. Infants and young children should not be fed a vegan diet.

Original languageEnglish
Pages (from-to)87-89
Number of pages3
JournalNascer e Crescer
Issue number2
StatePublished - 2008


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