"Complementary Feeding in Infancy"

This module addresses timely and appropriate complementary feeding practices for infants and young children and their importance for healthy growth and development. Current, international recommendations for the timing of introduction of complementary foods are provided along with the current scientific recommendations addressing the health effects of both early and late introduction of complementary foods. Detailed recommendations on the food types, amounts and frequency of meals to provide to infants and young children is discussed along with practical examples of complementary foods to provide in different regions of the world. The biological and developmental aspects during the complementary feeding period are explained which help to deepen understanding as to why complementary feeding is so important. This module focuses especially on the nutrition needs of normal healthy infants while also addressing special nutrition needs of infants during illness and some specific issues associated with complementary feeding in developing countries.

This module has received accreditation by the German Medical Association with 12 CME credits.

This module has received accreditation by the European Accreditation Council for Continuing Medical Education (EACCME) with 9 CME credits.

Module overview
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Adequate nutrition during infancy and early childhood is crucial for normal, healthy growth and development. This first unit presents an overview of complementary feeding during infancy and provides an outline of the various definitions of complementary feeding by international organizations. Based on a short summary of the history of infant feeding, significant changes and advances which have occurred throughout the 20th and 21st century are highlighted. The importance of complementary feeding, as well as the nutritional inadequacy of prolonged exclusive breastfeeding is discussed, with a focus on the “critical period” of development and the nutritional deficiencies which can occur without appropriate complementary feeding practices. The learner is given a comprehensive insight into the current international recommendations of complementary feeding along with an outline of the current complementary feeding practices in different regions of the world.

Based on current studies reporting the age at which complementary foods are introduced, this unit outlines how the timing of complementary foods can have immediate or later health consequences. Both too early and too late introduction of complementary foods can have undesirable health effects. Divided into several lessons, the user will learn about health outcomes such as obesity, atopic diseases and cardiovascular disease, as well as some other health effects associated with complementary feeding such as the risk of dental caries, and the risk of infections. This unit presents the learner with some specific issues associated with complementary feeding in developing countries including the health impacts of inadequate provision of complementary foods, addressing specific nutritional deficiencies and stunting.

This unit provides current, scientifically based recommendations on the practical aspects including the preparation and composition of complementary foods. The aim of unit 3 is to give the user an overview of appropriate complementary feeding in infants, such as the types and consistency of complementary foods during infancy, the nutrient and energy content and the amount and meal frequency of complementary foods. In addition, the unit provides evidence for the recommendations on vegetarian and vegan diets during the complementary feeding period. Moreover, the learner gains an overview on the safe preparation and storage of complementary foods as well as feeding advice during and after illness.

During the first years of life, the infant’s diet undergoes its biggest change from an exclusively liquid diet to a diet with an increasing variety of complementary foods in addition to milk. During this transition, the infant is likely to encounter a variety of foods and textures for which adequate oral motor skills and a mature digestive, renal and immune system are needed. This unit addresses the biological and developmental aspects during the complementary feeding period. The physiological maturation of renal and gastrointestinal function that is required for non milk foods as well as the neuro-developmental changes necessary for safe and effective transition to family foods are explained to the learner. Moreover, the development of taste and food preferences is discussed as well as growth patterns during the complementary feeding period.

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