e-Library of Evidence for Nutrition Actions (eLENA)


An online library of evidence-informed guidelines for nutrition interventions and single point of reference for the latest nutrition guidelines, recommendations and related information.

Alternate Text All interventions

Appropriate complementary feeding

Intervention | Last updated: 9 August 2023


Complementary feeding is defined as the process starting when breast milk alone is no longer sufficient to meet the nutritional requirements of infants, and therefore other foods and liquids are needed, along with breast milk. The transition from exclusive breastfeeding to family foods – referred to as complementary feeding – typically covers the period from 6–24 months of age, even though breastfeeding may continue to two years of age and beyond. This is a critical period of growth during which nutrient deficiencies and illnesses contribute globally to higher rates of undernutrition among children under five years of age.

A number of successful strategies have been developed to improve complementary feeding practices in low- and middle-income countries, where practical difficulties can limit adherence to complementary feeding guidelines.

WHO Recommendations


Infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health.

Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary foods, while continuing to breastfeed for up to two years or beyond.



Evidence


Related Cochrane reviews


Educational interventions for improving primary caregiver complementary feeding practices for children aged 24 months and under

Arikpo D, Edet ES, Chibuzor MT, Odey F, Caldwell DM. Cochrane Database of Systematic Reviews. 2018; Issue 5. Art. No.: CD011768.


Effectiveness of provision of animal‐source foods for supporting optimal growth and development in children 6 to 59 months of age

Eaton JC, Rothpletz‐Puglia P, Dreker MR, Iannotti L, Lutter C, Kaganda J, Rayco‐Solon P. Cochrane Database of Systematic Reviews. 2019; Issue 2. Art. No.: CD012818.


Other related systematic reviews


Impact of education and provision of complementary feeding on growth and morbidity in children less than 2 years of age in developing countries: a systematic review

Lassi ZS, Das JK, Zahid G, Imdad A, Bhutta ZA. BMC Public Health. 2013; 13 Suppl3:S13.


Systematic review of the efficacy and effectiveness of complementary feeding interventions in developing countries

Dewey KG, Adu-Afarwuah S. Maternal & Child Nutrition. 2008; 4:24–85.


Impact of maternal education about complementary feeding and provision of complementary foods on child growth in developing countries

Imdad A, Yakoob MY, Bhutta ZA. BMC Public Health. 2011; 13;11 Suppl 3:S25.