Guidance for healthy complementary feeding practices for allergy prevention in developed countries: An EAACI interest group report.

Abstract

The goals of the complementary feeding period starting from 4 to 6 months of age are to fulfill the infant's nutritional need for nutrients and expose the infant to foods of varying flavors and textures to encourage acceptance of a diverse and nutritionally complete diet. Healthy complementary feeding consists of the timely introduction of a high diversity of whole, nutrient dense, and home-cooked foods or alternatively commercially frozen meals based on whole ingredients without added sugar or salt. These meals consist of predominantly plant-based foods, such as fruits, vegetables, legumes, grains, as well as fermented foods such as yoghurt. Healthy complementary foods are rich in fiber, iron, zinc, omega-3, and low in sugar, salt, and ultra-processed ingredients. In addition, these foods are hygienically safe, properly prepared, and include the early introduction of family-adjusted and country-specific food allergens. In this way regular complementary foods contribute to taste development, age-appropriate oral motor skills, and the prevention of allergic disease, not only by early introduction of food allergens but also by its impact on a healthy and diverse gut microbial development, a healthy immune maturation, and mucosal tolerance. Thus, individualized timing and selection of appropriate foods are essential while avoiding overreliance on infant formula and commercial baby foods as well as non-recommended feeding styles. This paper provides a rationale and guidance for health care professionals on healthy choices for complementary foods beyond early introduction of common allergens in children up to 24 months of age in developed countries.