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PAHO/WHO Guiding principles for Complementary Feeding of the Breastfed Child

Author: PAHO/ WHO
Year: 2001
Resource type: Field tool

A review of feeding guidelines promoted by various national and international organizations has shown that there are inconsistencies in the specific recommendations for feeding infants and young children (Dewey). Some of the feeding guidelines are based more on tradition and speculation than on scientific evidence, or are far more prescriptive than is necessary regarding issues such as the order of foods introduced and the amounts of specific foods to be given. To avoid confusion, a set of unified, scientifically based guidelines is needed, which can be adapted to local feeding practices and conditions.

The guidelines described herein were developed from discussions at several technical consultations and documents on complementary feeding (WHO/UNICEF, 1998; WHO/UNICEF Technical Consultation on Infant and Young Child Feeding, 2000; WHO Global Consultation on Complementary Feeding, 2001; Academy for Educational Development, 1997; Dewey and Brown, 2002). The target group for these guidelines is breastfed children during the first two years of life. This document does not cover specific feeding recommendations for non-breastfed children, although many of the guidelines are also appropriate for such children (except for the recommendations regarding meal frequency and nutrient content of complementary foods).

Appropriate diets for children who are not breastfed (such as those of HIV-positive mothers who choose not to breastfeed), often referred to as “replacement feeding”, are the subject of other documents (Guiding principles of feeding non-breastfed children 6-24 months, WHO 2005; available in this resource library) WHO/UNICEF HIV and Infant Feeding Counseling: A training Course, 2000).

It should also be noted that the guidelines herein apply to normal, term infants (this includes low birth weight infants born at > 37 weeks gestation). Infants or children recovering from acute malnutrition or serious illnesses may need specialized feeding, which is covered by clinical manuals (for example, the WHO manual “Management of the Child with a Serious Infection or Severe Malnutrition”, 2000). Preterm infants may also need special feeding. However, the guidelines in this document can be used as the basis for developing recommendations on complementary feeding for these subgroups.

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PAHO/ WHO (2001). PAHO/WHO Guiding principles for Complementary Feeding of the Breastfed Child. www.ennonline.net/compfeedingprinciples