IFM Position on Complementary Feeding

The first two years of a child’s life are a “critical window” for the promotion of optimal growth, health and behavioural development. It is of the utmost importance that complementary feeding does not begin too early or too late and that foods are nutritionally adequate and safe. Home prepared complementary foods, however, usually lack the necessary nutrient density, food variety and microbiological safety to ensure optimal nutrition. For these reasons, ISDI strongly commends the science-based process undertaken by the WHO to develop a global strategy aimed at promoting timely, adequate, safe and appropriate complementary feeding practices: the WHO’s Global Strategy on Infant and Young Child Feeding, Guiding Principles for Feeding Non-breastfed Children 6-24 Months of Age and Health-related Millennium Development Goals: update (EB117/13) and The WHO Expert Consultation on Complementary Feeding.

• Malnutrition - ISDI shares WHO’s alarm “at the degree to which inappropriate infant and young-child feeding practices contribute to the global burden of disease, including malnutrition and its consequences such as blindness and mortality due to vitamin A deficiency, impaired psychomotor development due to iron deficiency and anaemia, irreversible brain damage as a consequence of iodine deficiency, the massive impact on morbidity and mortality of protein-energy malnutrition, and the later-life consequences of childhood obesity” .
  
  
• Problem Nutrients - The WHO Expert Consultation highlights problem nutrients that exist in most developing countries and certain populations. Some of these include iron, zinc, and vitamin B6, riboflavin and niacin as well as folate, thiamine and calcium, vitamins A and C. Infant food manufacturers make available complementary foods that are calorie-dense and made of vitamin rich vegetables, fruits and cereals (cereals, jarred foods, juices, etc.), and which include the concentrated micronutrients needed to fulfil the nutritional requirements of children aged 6-24 months.
  
  
• Nutrient Content / Variety - The WHO’s Guiding Principles note that, “Milk products are rich sources of calcium and several other nutrients.  Diets that do not contain animal-source foods (meat, poultry, fish or eggs, plus milk products) cannot meet all nutrient needs at this age unless fortified products or nutrient supplements are used”. When fortified foods or supplements are not available, follow-on formula can make a good nutritional contribution to the diet.
  
  
• Scientific Research – R&D by manufacturers is a continual, complex and costly process. Development of complementary foods is based on scientific data that demonstrate the healthiest options for infant and young children. Scientific research covers a wide variety of areas such as macro-nutrients (protein, CH, lipids) and micronutrients, the interaction of nutrients (e.g., iron wit zinc), ways to increase the variety of texture, flavour, aroma and appearance appropriate to a child’s successive stages of growth, as well as their metabolism and cognitive development.
  
  
• Food Quality – National legislation or Codex Alimentarius Standards determine the nutritional composition of complementary foods.  Manufacturers also work closely with paediatricians and nutritionists to develop nutritionally balanced foods that are specifically tailored to meet a child’s changing nutritional or physiological needs.
  
  
• Food Safety –Manufacturers exercise stringent food quality and safety controls at every stage.They regularly consult leading toxicologists and microbiologists and apply procedures to analyze food-borne hazards and identify potential risks. They closely monitor suppliers’ raw materials to ensure they comply with quality standards. By using specially farmed vegetables, fruits and cereals, manufacturers can also guarantee a near zero level of pesticides.
  
  
• Consumer Information - Product labels provide consumers with all the information required by applicable legislation, including the name of the manufacturer, specific composition and weight of the product, its nutritional value and appropriate methods of preparation and storage.
  
  
• Education - Poor complementary feeding practices are one of the principal causes of malnutrition during the first two years of life, and manufacturers ensure that caregivers are provided with appropriate guidance on such complex matters as hygiene and proper preparation. Feeding plans established in cooperation with paediatricians, nutritionists and other health workers also look at child development and optimal composition of baby foods for every age, their palatability, absorption, metabolism, instinctive reactions, psychological aspects, how they ease the transition to table foods, etc. 

Conclusion:

• Processed complementary foods that meet Codex Alimentarius standards make a valuable contribution towards optimal nutrition. As noted in The WHO Expert Consultation, the advantages of processed complementary foods include convenience, the ability to provide an appropriate balance of nutrients, and the possibility of reducing microbial contamination by using, for example, fermented or pasteurized products. Improvements in manufacturing techniques and local production of blended cereal products also make processed foods more affordable for low-income families.
  
  
• The infant food industry also plays a constructive role in researching, defining, producing and informing health workers and parents about the optimal way to feed infants in the weaning period, when the infant needs exceed those provided by exclusive breastfeeding or infant formula.

Posted February 2006