Berthold Koletzko1, Nathali Lehmann Hirsch2, Jo Martin Jewell2, Quenia Dos Santos2, João Breda3, Mary Fewtrell4, Martin W Weber2. 1. LMU_- Ludwig-Maximilians-Universität München, Dr. von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany. 2. WHO Regional Office for Europe, Marmorvej, Copenhagen, Denmark. 3. WHO European Office for Prevention and Control of Noncommunicable Diseases, 9LeontyevskyPereulok, Moscow, Russian Federation. 4. Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK.
Abstract
OBJECTIVES: Complementary feeding should provide a healthy diet with critical nutrients for growth and development. Information is limited on child and infant feeding recommendations within the World Health Organization (WHO) European Region. METHODS: The WHO Regional Office for Europe and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) performed a survey of national recommendations on infant and young child nutrition aimed at national government departments of health and national paediatric experts. Questions addressed national recommendations on breast-feeding and complementary feeding. RESULTS: Information was available from 48 of the 53 Member States. Forty-five of 48 countries (94%) have national recommendations on infant and young child feeding, of which 41 are endorsed by official public health authorities. Regarding introduction of complementary feeding, 25 countries (out of 34, 74%) recommend 6 months of age as the ideal age. The earliest age of introduction recommended varies from 4 to 5 months in (31/38 countries, 82%) to 6 months (6/38, 16%) and 7 months (1/38, 2.6%). The recommended meal composition varies widely; introduction of iron-rich foods (meat, fish, eggs) at the age of 6 months is recommended in 30 out of 43 countries, whereas 13 (30%) recommend later introduction. CONCLUSIONS: National infant feeding recommendations vary widely between studied countries and partly differ from international recommendations. Too early introduction of complementary feeding can reduce duration of exclusive breast-feeding (EBF). Too late introduction of iron-rich complementary foods might increase anemia risk and adversely affect child development. A review and further harmonization of national recommendations appears desirable.
OBJECTIVES: Complementary feeding should provide a healthy diet with critical nutrients for growth and development. Information is limited on child and infant feeding recommendations within the World Health Organization (WHO) European Region. METHODS: The WHO Regional Office for Europe and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) performed a survey of national recommendations on infant and young child nutrition aimed at national government departments of health and national paediatric experts. Questions addressed national recommendations on breast-feeding and complementary feeding. RESULTS: Information was available from 48 of the 53 Member States. Forty-five of 48 countries (94%) have national recommendations on infant and young child feeding, of which 41 are endorsed by official public health authorities. Regarding introduction of complementary feeding, 25 countries (out of 34, 74%) recommend 6 months of age as the ideal age. The earliest age of introduction recommended varies from 4 to 5 months in (31/38 countries, 82%) to 6 months (6/38, 16%) and 7 months (1/38, 2.6%). The recommended meal composition varies widely; introduction of iron-rich foods (meat, fish, eggs) at the age of 6 months is recommended in 30 out of 43 countries, whereas 13 (30%) recommend later introduction. CONCLUSIONS: National infant feeding recommendations vary widely between studied countries and partly differ from international recommendations. Too early introduction of complementary feeding can reduce duration of exclusive breast-feeding (EBF). Too late introduction of iron-rich complementary foods might increase anemia risk and adversely affect child development. A review and further harmonization of national recommendations appears desirable.