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Complementary Feeding: Introduction, Foods & Tips

Complementary feeding refers to all foods and drinks given to infants in addition to breast milk or formula. It is a key developmental step in the first year of life.

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Things worth knowing about "Complementary feeding"

Complementary feeding refers to all foods and drinks given to infants in addition to breast milk or formula. It is a key developmental step in the first year of life.

What is Complementary Feeding?

Complementary feeding refers to the introduction of solid and semi-solid foods and beverages – other than breast milk or infant formula – to an infant's diet. The term reflects that these foods complement, rather than replace, milk feeding. Introducing complementary foods is a major developmental milestone that gradually prepares babies for a varied, family-based diet.

When Should Complementary Feeding Begin?

According to the World Health Organization (WHO), complementary feeding should begin at around 6 months of age, while continuing breastfeeding. It should not start before the end of the 4th month, as the infant's digestive system and immune defenses are not yet sufficiently mature. Most guidelines, including those from the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), recommend introducing complementary foods between 4 and 6 completed months of age, depending on the individual readiness of the baby.

Signs that a baby may be ready for complementary feeding include:

Ability to hold the head steady and upright
Sitting with support
Showing interest in food eaten by others
Reduction of the tongue-thrust reflex (the instinct to push food out of the mouth)

Which Foods Are Suitable as First Complementary Foods?

A gradual introduction of pureed or mashed foods is commonly recommended. Suitable first complementary foods include:

Vegetable purees: e.g., carrot, courgette, parsnip – mild-tasting and easy to digest
Potato as a carbohydrate source
Meat in small amounts (e.g., beef, turkey) for its high iron content
Cereal porridges (e.g., oat, semolina) as an evening meal
Fruit purees (e.g., apple, pear, banana) as a dessert or snack

An increasingly popular alternative is Baby-led Weaning (BLW), in which soft finger foods are offered from the start and the baby self-feeds. Both approaches – purees and finger foods – can be combined successfully.

What Should Be Avoided During Complementary Feeding?

Certain foods and ingredients are not appropriate for infants:

Honey: Risk of infant botulism (Clostridium botulinum spores)
Salt and sugar: Should be avoided entirely to protect kidney function and avoid setting preferences for overly sweet or salty tastes
Cow's milk as a drink (not recommended before 12 months; small amounts in cooking are acceptable from around 7 months)
Whole nuts, hard raw vegetables and small round foods (choking hazard)
Raw animal products (raw meat, raw fish, raw eggs): infection risk
Highly allergenic foods should not be systematically avoided – current guidelines recommend early, gradual introduction (e.g., peanut, egg, gluten) to help prevent the development of food allergies

Complementary Feeding and Breastfeeding

Starting complementary feeding does not mean breastfeeding must stop. The WHO recommends continued breastfeeding alongside complementary foods – ideally up to 2 years of age or beyond, as long as mother and child wish to continue. Breast milk remains a valuable source of nutrients and immune-protective factors throughout the complementary feeding period.

Key Nutrients During Complementary Feeding

As complementary feeding begins, certain nutrients deserve special attention:

Iron: From around 6 months, the infant's natural iron stores begin to deplete. Iron-rich foods (meat, legumes, iron-fortified cereals) are important.
Zinc: Supports growth and immune function; found in meat, legumes, and whole grains.
Vitamin D: Supplementation is recommended independently of complementary feeding, typically until at least 12–24 months of age.
Omega-3 fatty acids (DHA): Important for brain development; found in fish and DHA-fortified foods.

References

World Health Organization (WHO): Complementary Feeding. www.who.int (2023).
ESPGHAN Committee on Nutrition: Complementary Feeding: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition. Journal of Pediatric Gastroenterology and Nutrition, 64(1):119–132 (2017).
Fewtrell M. et al.: Complementary Feeding: A Position Paper by the ESPGHAN Committee on Nutrition. JPGN, 64(1):119–132 (2017).

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