Attachment 1: Health effects associated with age of complementary feeding Table summarises the key findings and conclusion from three recent reviews on the timing of solid food introduction to infants and risk of adverse health outcomes. BF = breast feeding; EBF = exclusive breastfeeding; FF = formula-feeding; CF = complementary feeding KEY FINDINGS: 6 Conclusion based on ESPGHAN1 EFSA (2009)1 Hornell et al (2013)2 combined findings of these reviews Review Type Medical Position Scientific Opinion Systematic review Main focus Complementary feeding Complementary feeding Duration of exclusive breast feeding Health effects: Age of CF not specifically Insufficient data age of CF in Association to duration of EBF Either no association or Energy – intake addressed. terms of energy intake needs to examined: EBF to 6 months insufficient data to indicate the be decided for individual infant meets energy requirements and energy intake is compromised by (larger infants have greater does not compromise infant age of introducing CF. energy requirements. growth. Nutritional Timing of CF not specifically Reviewed studies on whether Not addressed. No association but some infants adequacy addressed although concluded EBF provides adequate nutrients may require foods at 4–6 that nutritional deficiencies to 6 months; concludes that months for Fe and Zn during CF period (defined as some infants need CF at 4–6 sufficiency. after 17 weeks and before 26 months for Fe and Zn weeks) are unlikely. sufficiency. Minimal evidence that solid foods CF introduced before 6 months EBF for 4 months gives similar No evidence of association Growth introduced at 4–6 months affects does not have strong impact on growth rates compared to EBF between CF introduced at 4–6 growth. growth rate. Late introduction for 6 months. months and growth rate. 6 months) may reduce length and weight gain. No specific data on age of CF Insufficient data to make Not addressed. Insufficient data to make reviewed but limited evidence conclusion conclusion that low intake of LCPUFA (oily fish) and Fe may have adverse effect on neurodevelopment.
Attachment 1: Health effects associated with age of complementary feeding Table summarises the key findings and conclusion from three recent reviews on the timing of solid food introduction to infants and risk of adverse health outcomes. BF = breast feeding; EBF = exclusive breastfeeding; FF = formula-feeding; CF = complementary feeding KEY FINDINGS: 6 ESPGHAN1 EFSA (2009)1 Hornell et al (2013)2 Conclusion based on combined findings of these reviews Review Type Medical Position Scientific Opinion Systematic review Main focus Complementary feeding Complementary feeding Duration of exclusive breast feeding Health effects: Energy intake Age of CF not specifically addressed. Insufficient data – age of CF in terms of energy intake needs to be decided for individual infant (larger infants have greater energy requirements. Association to duration of EBF examined: EBF to 6 months meets energy requirements and does not compromise infant growth. Either no association or insufficient data to indicate the energy intake is compromised by age of introducing CF. Nutritional adequacy Timing of CF not specifically addressed although concluded that nutritional deficiencies during CF period (defined as after 17 weeks and before 26 weeks) are unlikely. Reviewed studies on whether EBF provides adequate nutrients to 6 months; concludes that some infants need CF at 4–6 months for Fe and Zn sufficiency. Not addressed. No association but some infants may require foods at 4–6 months for Fe and Zn sufficiency. Growth Minimal evidence that solid foods introduced at 4–6 months affects growth. CF introduced before 6 months does not have strong impact on growth rate. Late introduction 6 months) may reduce length and weight gain. EBF for 4 months gives similar growth rates compared to EBF for 6 months. No evidence of association between CF introduced at 4–6 months and growth rate. No specific data on age of CF reviewed but limited evidence that low intake of LCPUFA (oily fish) and Fe may have adverse effect on neurodevelopment. Insufficient data to make conclusion Not addressed. Insufficient data to make conclusion