Guideline for complementary feeding of infants and young children 6–23 months of age
Publication year: 2023
Complementary feeding, defined as the
process of providing foods in addition to
milk when breast milk or milk formula
alone are no longer adequate to meet
nutritional requirements, generally starts
at age 6 months and continues until
23 months of age, although breastfeeding
may continue beyond this period (4). This
is a developmental period when it is critical
for children to learn to accept healthy foods
and beverages and establish long-term
dietary patterns (5). It also coincides with
the peak period for risk of growth faltering
and nutrient deficiencies (6).
The immediate consequences of
malnutrition during these formative years –
as well as in utero and the first 6 months of
life – include impaired growth, significant
morbidity and mortality, and delayed motor,
cognitive, and socio-emotional development.
It can later lead to increased risk of
noncommunicable diseases (NCDs). In the
long term, undernutrition in early childhood
leads to reduced work capacity and earnings
and, among girls, reduced reproductive
capacity (6). Inappropriate complementary
feeding can result in overweight, type 2
diabetes and disability in adulthood (7). The
first two years of life are also a critical period
for brain development, the acquisition of
language and sensory pathways for vision
and hearing, and the development of higher
cognitive functions (8).
Purpose of the guideline
This guideline provides evidence-based
recommendations on complementary
feeding of infants and young children
6–23 months of age living in low, middleand high-income countries. It considers
the needs of both breastfed and nonbreastfed children. These are public
health recommendations, recognizing that
children should be managed individually
so that inadequate growth, overweight, or
other adverse outcomes are identified, and
appropriate action taken. This guideline
does not address the needs of pre-term
and low-birthweight infants, children with
or recovering from acute malnutrition
and serious illness, children living in
emergencies, or children who are disabled.
Except for children with disabilities, the
needs of these other groups of children are
addressed in other WHO guidelines.