Abstract
The complementary feeding (CF) period that takes place between 6 and 24 months of age is of key importance for nutritional and developmental reasons during the transition from exclusively feeding on milk to family meals. In 2021, a multidisciplinary panel of experts from four Italian scientific pediatric societies elaborated a consensus document on CF, focusing in particular on healthy term infants. The aim was to provide healthcare providers with useful guidelines for clinical practice. Complementary feeding is also the time window when iron deficiency (ID) and iron deficiency anemia (IDA) are most prevalent. Thus, it is appropriate to address the problem of iron deficiency through nutritional interventions. Adequate iron intake during the first two years is critical since rapid growth in that period increases iron requirements per kilogram more than at any other developmental stage. Complementary foods should be introduced at around six months of age, taking into account infant iron status.
Highlights
As a cross-cutting area in the health and development sectors, nutrition is an integral part of the World Health Organization (WHO) 13th General Program of Work (GPW13)2019–2023 [1]
In the first months of life, disruption of the sophisticated mechanisms involved in iron absorption, storage and metabolism can lead to growth alterations and iron overload in the developing central nervous system (CNS) [24–28] It’s noteworthy that nowadays, there is still a lack of randomized controlled trials regarding the optimal iron supplementation in infancy and the long-term effects of infant formulas with different iron fortification on neurocognitive performance
Seven out of eight studies analyzed in this review showed a significantly higher risk of developing iron deficiency anemia (IDA) in infants fed cow’s milk (CM) than those who received iron-fortified follow-on formula
Summary
As a cross-cutting area in the health and development sectors, nutrition is an integral part of the World Health Organization (WHO) 13th General Program of Work (GPW13). There is growing scientific evidence that nutrition in early childhood is associated with the risk of developing non-communicable diseases (NCDs). These include obesity, dyslipidemia, diabetes, hypertension, cardiovascular diseases, chronic lung diseases, cancer, and musculoskeletal, mental, and neurological disorders [3]. Nutrition is one of the modifiable environmental factors that can affect growth, development, infant metabolism, and the immune system It is an example of phenotypic plasticity, allowing a genotype to give different physiological states. The complementary feeding phase (CF), when foods are introduced to complement milk feeding, is generally between 6 and 23 months of age This period is characterized by rapid development and growth, exposing infants to an increased risk of nutrient excesses or deficiencies, especially ID and IDA, which are most common at this age [8]. The nutrition committees of the Italian Society for Preventive and Social Pediatrics (SIPPS), the Italian Society for Developmental Origins of Health and Disease (SIDOHaD), the Italian Federation of Pediatricians (FIMP), and the Italian Society of Pediatric Nutrition (SINUPE) provided an update of the available clinical literature
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