Complementary Feeding Introduction – When and How to Start
Complementary feeding introduction is the gradual transition from exclusive breastfeeding or formula feeding to solid foods in infants, recommended from around 6 months of age.
Things worth knowing about "Introduction of Complementary Feeding"
Complementary feeding introduction is the gradual transition from exclusive breastfeeding or formula feeding to solid foods in infants, recommended from around 6 months of age.
What Is Complementary Feeding Introduction?
Complementary feeding introduction (also known as weaning or starting solids) is the process by which an infant begins to receive foods and liquids other than breast milk or infant formula. This developmental milestone typically begins around 6 months of age and is a critical phase for establishing lifelong healthy eating habits. The World Health Organization (WHO) and major pediatric nutrition bodies recommend introducing complementary foods no earlier than the start of the 5th month and no later than the beginning of the 7th month of life.
When Is the Right Time to Start?
The ideal timing for introducing complementary foods depends not only on age but also on the infant´s developmental readiness. Signs that a baby may be ready include:
- The ability to hold the head steady and upright.
- Showing interest in food and watching others eat.
- The tongue-thrust reflex (the automatic pushing out of food from the mouth) has diminished.
- The ability to sit upright with support.
Which Foods Are Suitable?
The First Puree
A vegetable-potato-meat puree is commonly recommended as the first complementary food. It provides essential nutrients, especially iron, which becomes increasingly important in the second half of infancy as a newborn iron stores are gradually depleted. When introducing new foods, it is best to offer one ingredient at a time and wait a few days before adding another to monitor for any reactions.
Additional Puree Types
Following the vegetable puree, a milk-cereal porridge (e.g., with whole milk and grain flakes) and a cereal-fruit puree are typically introduced. These three meals progressively replace breastfeeding or formula feeding sessions.
Finger Foods and Baby-Led Weaning
An alternative or complementary approach is Baby-Led Weaning (BLW), in which soft, age-appropriate pieces of food are offered to the infant from the start, allowing them to self-feed. This method supports fine motor skill development and encourages self-regulation of food intake.
Key Guidelines for Introducing Solids
- No added salt or sugar should be used in infant food preparation.
- No honey in the first year of life, as it may contain Clostridium botulinum spores, which can cause infant botulism.
- No cows milk as the main drink before 12 months (it can be used as an ingredient in porridge from 6 months onward).
- Common allergens such as peanuts, eggs, fish, and wheat should be introduced early according to current evidence, as this may help reduce the risk of food allergy development.
- Watch for signs of intolerance or allergic reactions after introducing new foods.
Nutritional Needs During the Complementary Feeding Phase
As complementary feeding begins, certain nutrients become especially important:
- Iron: Found in meat, legumes, and fortified cereals. Pairing iron-rich foods with vitamin C (e.g., from fruit) enhances absorption.
- Zinc: Essential for immune function and healthy growth.
- Vitamin D: Supplementation should continue until the child receives adequate sun exposure and eats a varied diet.
- Omega-3 fatty acids (DHA): Important for brain development; found in oily fish.
Complementary Feeding and Breastfeeding
The introduction of complementary foods does not mean breastfeeding must stop. The WHO recommends continued breastfeeding alongside complementary foods up to 2 years of age and beyond. Breast milk continues to be a valuable source of nutrition and immune protection throughout the complementary feeding period.
References
- World Health Organization (WHO): Complementary feeding - Guiding Principles for Complementary Feeding of the Breastfed Child. WHO, Geneva, 2023. Available at: https://www.who.int
- Fewtrell M. et al.: Complementary Feeding: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). Journal of Pediatric Gastroenterology and Nutrition, 2017; 64(1): 119-132.
- American Academy of Pediatrics (AAP): Starting Solid Foods. Pediatrics, 2022. Available at: https://www.healthychildren.org
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