WHO/Jo-Ann Muriel
                                Baby eating her first solid food.
                                ? Credits

                                Complementary feeding

                                  Overview

                                  Around the age of 6 months, an infant’s need for energy and nutrients starts to exceed what is provided by breast milk, and complementary foods are necessary to meet those needs. An infant of this age is also developmentally ready for other foods. This transition is referred to as complementary feeding.

                                  If complementary foods are not introduced around the age of 6 months, or if they are given inappropriately, an infant’s growth may falter.

                                  Ensuring that infants nutritional needs are met requires that complementary foods be:

                                  • timely – meaning that they are introduced when the need for energy and nutrients exceeds what can be provided through exclusive breastfeeding;
                                  • adequate – meaning that they provide sufficient energy, protein and micronutrients to meet a growing child’s nutritional needs;
                                  • safe – meaning that they are hygienically stored and prepared, and fed with clean hands using clean utensils and not bottles and teats;
                                  • properly fed – meaning that they are given consistent with a child’s signals of appetite and satiety, and that meal frequency and feeding are suitable for age.

                                  Caregivers should take active care in the feeding of infants by being responsive to the child’s clues for hunger and also encouraging the child to eat. 

                                  Recommendation

                                  WHO recommends that infants start receiving complementary foods at 6 months of age in addition to breast milk. Initially, they should receive complementary foods 2–3 times a day between 6–8 months and increase to 3–4 times daily between 9–11 months and 12–24 months. Additional nutritious snacks should also be offered 1–2 times per day for ages 12–24 months, as desired. 

                                  Gradually increase food consistency and variety as the infant gets older, adapting to the infant’s requirements and abilities. Infants can eat pureed, mashed and semi-solid foods beginning at 6 months. By 8 months most infants can also eat “finger foods” (snacks that can be eaten by children alone). 

                                  By 12 months, most children can eat the same types of foods as consumed by the rest of the family, while keeping in mind the need for nutrient-dense foods, including animal-sourced foods like meat, poultry, fish, eggs and dairy products. 

                                  Avoid foods in a form that may cause choking, such as whole grapes or raw carrots. Avoid giving drinks with low nutrient value, such as tea, coffee and sugary soft drinks. Limit the amount of juice offered, to avoid displacing more nutrient-rich foods.

                                  WHO response

                                  WHO is committed to support countries with implementation and monitoring of the "Comprehensive implementation plan on maternal, infant and young child nutrition”, which includes 6 targets, including reducing the number of children under-5 who are stunted by 40% by 2025. The "Global strategy for infant and young child feeding", also aims to protect, promote and support appropriate infant and young child feeding.

                                  Appropriate complementary feeding depends on accurate information and skilled support from the family, community and health care system. WHO works with Member States to ensure key populations have adequate knowledge about appropriate foods and feeding practices in order to prevent malnutrition. 

                                  WHO developed the guide "Complementary feeding: family foods for breastfed children", which gives more detailed guidance for health workers on how to support complementary feeding. The guidelines are also included as part of WHO’s Infant and young child feeding counselling course and the Complementary feeding counselling course for health workers.  

                                   

                                  45%

                                  of child deaths

                                  Undernutrition is associated with 45% of child deaths.

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                                  Less than a fourth

                                  infants 6–23 months

                                  Less than a fourth of infants aged 6–23 months have age-appropriate dietary diversity.

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                                  144 million

                                  children under 5 yrs

                                  Globally, 144 million children under 5 yrs of age are too short for their age (stunted).

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                                  Infant and young child feeding counselling: an integrated course: trainer’s guide, 2nd ed

                                  Breastfeeding and appropriate, safe, and timely complementary feeding are fundamental to the health and development of children and important for the health...

                                  Infant and young child feeding counselling: an integrated course: course handouts

                                  Breastfeeding and appropriate, safe, and timely complementary feeding are fundamental to the health and development of children and important for the health...

                                  Infant and young child feeding: counselling cards for health workers

                                  Breastfeeding and appropriate, safe, and timely complementary feeding are fundamental to the health and development of children and important for the health...

                                  Infant and young child feeding counselling: an integrated course: participant’s manual, 2nd ed

                                  Breastfeeding and appropriate, safe, and timely complementary feeding are fundamental to the health and development of children and important for the health...

                                  Infant and young child feeding counselling: an integrated course: guidance on the use of counselling cards

                                  Breastfeeding and appropriate, safe, and timely complementary feeding are fundamental to the health and development of children and important for the health...

                                  Infant and young child feeding counselling: an integrated course: director’s guide, 2nd ed

                                  Breastfeeding and appropriate, safe, and timely complementary feeding are fundamental to the health and development of children and important for the health...

                                  Advocacy brief: nutrition for growth year of action: nine SMART breastfeeding pledges

                                  This advocacy brief is organized into two separate papers. The first half acts as a standalone briefing that highlights the importance of the Nutrition...

                                  Guideline: infant feeding in areas of Zika virus transmission, 2nd edition

                                  The objective of this guideline is to provide global, science-informed recommendations on infant feeding in areas of Zika virus transmission. The primary...

                                  Training

                                  Infant and young child feeding counselling: an integrated course: trainer’s guide, 2nd ed

                                  Breastfeeding and appropriate, safe, and timely complementary feeding are fundamental to the health and development of children and important for the health...

                                  Infant and young child feeding counselling: an integrated course: course handouts

                                  Breastfeeding and appropriate, safe, and timely complementary feeding are fundamental to the health and development of children and important for the health...

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