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Vol. 26 - Num. 103

Special Articles

Critical analysis of the new WHO guidelines on complementary feeding for infants from 6 to 23 months of age

M.ª Vega Almazán Fernández de Bobadillaa, M.ª José García Méridab, Esther Ruiz Chércolesc, Marta Castell Miñanad, Juan Rodríguez Delgadoe, Ángel José Carbajo Ferreiraf, Grupo de Gastroenterología y Nutricióng

aPediatra. CS Maracena. Granada. España.
bPediatra de Atención Primaria. Servicio de Promoción de la Salud de la Dirección General de Salud Pública. Servicio Canario de la Salud. Santa Cruz de Tenerife. España.
cPediatra. CS María Jesús Hereza. Leganés. Madrid. España.
dPediatra. CS Campanar. Valencia. España
ePediatra. CS de Alpedrete. Madrid. España
fPediatra. CS Reyes Magos. Alcalá de Henares. Madrid. España.
gAsociación Española de Pediatría de Atención Primaria (AEPap) .

Correspondence: MV Almazán. E-mail: vegalmazanfdb@gmail.com

Reference of this article: Almazán Fernández de Bobadilla MV, García Mérida MJ, Ruiz Chércoles E, Castell Miñana M, Rodríguez Delgado J, Carbajo Ferreira ÁJ, et al. Critical analysis of the new WHO guidelines on complementary feeding for infants from 6 to 23 months of age . Rev Pediatr Aten Primaria. 2024;26:e51-e65. https://doi.org/10.60147/17e0ce48

Published in Internet: 03-09-2024 - Visits: 6014

Abstract

Introduction: the World Health Organization (WHO) has issued new recommendations on complementary feeding (CF) in 2023. The introduction of CF takes place with the period of greatest nutritional risk for the toddler. Inadequate CF increases risk for altered physical and cognitive development and the risk of chronic non-communicable diseases. The WHO sets out seven main recommendations based on the review of the available evidence.

Objective: present a critical review of the new WHO guidelines on CF.

Methods: the analysis has been carried out by the Spanish Group of Gastroenterology and Nutrition of the Spanish Association of Primary Care Paediatrics and has included an exhaustive review of the WHO guidelines and documents of particular relevance in infant feeding from scientific societies of our environment in order to adapt them to our environment.

Results: the certainty of the scientific evidence is low or very low for six of the seven recommendations. There is a lack of randomized clinical trials to provide certainty in decision-making and to define health outcomes for each recommendation. The absence of specific recommendations on new trends in food and allergenic foods as well as adaptation to first world countries is noteworthy.

Conclusions: the start of adequate CF is key for health in early life. In line with WHO, we conclude that breastfeeding should be promoted as the exclusive food for the first 6 months of life, especially in low resource areas. The introduction of CF should take place around 180 days of life through a diversified and adequate diet. CF involves the acquisition of healthy feeding behaviour. Adaptation of the recommendations to our environment is necessary, in addition to other aspects not considered by the WHO guidelines.

Keywords

Breastfeeding Complementary feeding Cow milk Infant Infant formula Infant nutrition Malnutrition Obesity Outcome health care Prevention

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