Expert consensus on comprehensive assessment before the introduction of complementary foods in infants

Subspecialty Committee on Early Childhood Development, Chinese Maternal and Child Health Association

Chinese Journal of Child Health Care ›› 2026, Vol. 34 ›› Issue (4) : 349-356.

PDF(1207 KB)
PDF(1207 KB)
Chinese Journal of Child Health Care ›› 2026, Vol. 34 ›› Issue (4) : 349-356. DOI: 10.11852/zgetbjzz2026-0311
Expert Consensus

Expert consensus on comprehensive assessment before the introduction of complementary foods in infants

  • Subspecialty Committee on Early Childhood Development, Chinese Maternal and Child Health Association
Author information +
History +

Abstract

When an infant reaches 6 months of age, this milestone represents not merely a routine progression in chronological age, but a critical period marking the transition to family-led complementary feeding across all domains of infant development. To scientifically determine whether an infant′s developmental status can support a smooth initiation of complementary feeding at home, and to ensure the safety of complementary feeding while safeguarding subsequent healthy development in infants and toddlers, this consensus addresses assessment across several dimensions: feeding status, maturation of the digestive enzyme system and gastrointestinal tract, motor skill development, psychological and emotional readiness of both the infant and mother for complementary feeding, and prevention of food allergy. It further incorporates anticipatory guidance and proactive planning, proposing stratified, front-loaded, and full-cycle nutritional management strategies for special populations including preterm infants, low birth weight infants, and those with growth faltering, wasting, or overweight/obesity. Through maternal and child health institutions, this consensus aims to guide clinical child health practitioners, pediatricians, and family caregivers in identifying the appropriate timing for introducing complementary foods, progressively enhancing infants′ and toddlers′ perception and acceptance of new foods, fostering healthy dietary habits, and laying a foundation for long-term health.

Key words

infants / introduction of complementary foods / comprehensive assessment / developmental maturity / feeding readiness / expert consensus

Cite this article

Download Citations
Subspecialty Committee on Early Childhood Development, Chinese Maternal and Child Health Association. Expert consensus on comprehensive assessment before the introduction of complementary foods in infants[J]. Chinese Journal of Child Health Care. 2026, 34(4): 349-356 https://doi.org/10.11852/zgetbjzz2026-0311

References

[1] Pearce J, Taylor MA, Langley-Evans SC.Timing of the introduction of complementary feeding and risk of childhood obesity: A systematic review[J].Int J Obes (Lond), 2013, 37(10): 1295-306.
[2] 宗心南, 李辉, 张亚钦, 等.中国7岁以下儿童生长标准的修订[J].中华儿科杂志, 2023, 61(12): 1103-1108.
Zong XN, Li H, Zhang YQ, et al.Updated growth standards for Chinese children under 7 years of age[J].Chin J Pediatr, 2023, 61(12): 1103-1108.(in Chinese)
[3] European Society for Paediatric Gastroenterology, Hepatology & Nutrition (ESPGHAN), European Academy of Paediatrics, European Society for Paediatric Research (ESPR), et al.World Health Organization (WHO) guideline on the complementary feeding of infants and young children aged 6-23 months 2023: A multisociety response[J].J Pediatr Gastroenterol Nutr, 2024, 79(1): 181-188.
[4] 中国营养学会.中国居民膳食指南[M].北京:人民卫生出版社,2022.
[5] Ferreira RDS, Mendonça LABM, Ribeiro CFA, et al.Relationship between intestinal microbiota, diet and biological systems: An integrated view[J].Crit Rev Food Sci Nutr, 2022, 62(5): 1166-1186.
[6] Dbar S, Akhmadullina O, Sabelnikova E, et al.Patients with functional bowel disorder have disaccharidase deficiency: A single-center study from Russia[J].World J Clin Cases, 2021, 9(17): 4178-4187.
[7] Mehta DI, He Z, Bornstein J, et al.Report on the short endoscopic exocrine pancreatic function test in children and young adults[J].Pancreas, 2020, 49(5): 642-649.
[8] Indrio F, Neu J, Pettoello-Mantovani M, et al.Development of the gastrointestinal tract in newborns as a challenge for an appropriate nutrition: A narrative review[J].Nutrients, 2022, 14(7):1405.
[9] 李承浩, 安阳, 段小红, 等.先天口面裂的分级分类诊疗专家共识[J].华西口腔医学杂志, 2025, 43(1): 1-14.
Li CH, An Y, Duan XH, et al.Expert consensus on classification and diagnosis of congenital orofacial cleft[J].West China Journal of Stomatology, 2025, 43(1): 1-14.(in Chinese)
[10] Miller CK.Updates on pediatric feeding and swallowing problems[J].Curr Opin Otolaryngol Head Neck Surg, 2009, 17(3): 194-199.
[11] 张亚钦, 李阳, 李辉, 等.2015年中国九城市婴幼儿乳牙发育状况调查[J].中华儿科杂志, 2019, 57(9): 680-685.
Zhang YQ, Li Y, Li H, et al.Development of primary teeth among infants and toddlers in nine cities of China in 2015[J].Chin J Pediatr,2019, 57(9): 680-685.(in Chinese)
[12] Hetherington MM, Cecil JE, Jackson DM, et al.Feeding infants and young children.From guidelines to practice[J].Appetite, 2011, 57(3): 791-795.
[13] Schwartz C, Scholtens PA, Lalanne A, et al.Development of healthy eating habits early in life.Review of recent evidence and selected guidelines[J].Appetite, 2011, 57(3): 796-807.
[14] Forestell CA, Mennella JA.The relationship between infant facial expressions and food acceptance[J].Curr Nutr Rep, 2017, 6(2): 141-147.
[15] Samady W, Campbell E, Aktas ON, et al.Recommendations on complementary food introduction among pediatric practitioners[J].JAMA Network Open, 2020, 3(8): e2013070.
[16] Fewtrell M, Bronsky J, Campoy C, et al.Complementary feeding: A position paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on nutrition[J].J Pediatr Gastroenterol Nutr, 2017, 64(1): 119-132.
[17] Campoy C, Campos D, Cerdó T, et al.Complementary feeding in developed countries: The 3 Ws (When, What, and Why?)[J].Ann Nutr Metab, 2018, 73(Suppl 1):27-36.
[18] de Paiva CSS, Nunes LM, Bernardi JR, et al.Choking, gagging and complementary feeding methods in the first year of life: A randomized clinical trial[J].J Pediatr (Rio J), 2023, 99(6):574-581.
[19] Hewitt L, Kerr E, Stanley RM, et al.Tummy time and infant health outcomes: A systematic review[J].Pediatrics, 2020,145(6):e20192168.
[20] Gerber RJ, Wilks T, Erdie-Lalena C.Developmental milestones: Motor development[J].Pediatr Rev, 2010, 31(7): 267.
[21] 徐晓飞, 陈慧萍, 杨继国.儿童消化系统发育生理研究进展[J].中国儿童保健杂志, 2019, 27(11): 1196-1200.
Xu XF, Chen HP, Yang JG.Progress on the developmental physiology of digestive system in children[J].Chin J Child Health Care, 2019, 27(11): 1196-1200.(in Chinese)
[22] Viswanathan S, Jadcherla S.Feeding and swallowing difficulties in neonates[J].Clin Perinatol, 2020, 47(2):223-241.
[23] Isazadeh R, Moradi N, Malakian A, et al.Mothers′ involvement in assessing feeding skills of premature infants[J].Int J Pediatr Otorhinolaryngol, 2022, 155:111069.
[24] Li L, Liu L, Chen F, et al.Clinical effects of oral motor intervention combined with non-nutritive sucking on oral feeding in preterm infants with dysphagia[J].J Pediatr (Rio J), 2022,98(6):635-640.
[25] 中国医师协会新生儿科医师分会循证专业委员会, 中华儿科杂志编辑委员会.早产儿经口喂养临床实践专家共识(2025)[J].中华儿科杂志, 2025, 63(1): 27-38.
The Evidence-Based Medicine Group, Neonatologist Society, Chinese Medical Doctor Association the Editorial Board, Chinese Journal of Pediatrics.Expert consensus on clinical practice for oral feeding in preterm infants (2025)[J].Chin J Pediatr,2025, 63(1): 27-38.(in Chinese)
[26] Gulati IK, Sultana Z, Jadcherla SR.Approach to feeding difficulties in neonates and infants: A comprehensive overview[J].Clin Perinatol, 2020, 47(2):265-276.
[27] Ostadi M, Jokar F, Armanian AM, et al.The effects of swallowing exercise and non-nutritive sucking exercise on oral feeding readiness in preterm infants: A randomized controlled trial[J].Int J Pediatr Otorhinolaryngol, 2021, 142:110602.
[28] Somaraki M, de Lauzon-Guillain B, Camier A, et al.Timing of food pieces introduction and neurodevelopment: Findings from a nationwide birth cohort[J].Int J Behav Nutr Phys Act, 2024, 21(1):118.
[29] Verduci E, Fiore G, Agostinelli M, et al.Feeding practices in the introduction of complementary feeding and implications for future healthy eating[J].Ann Nutr Metab, 2025, 81(Suppl 2):44-55.
[30] 杨玉凤.儿童发育行为评估量表[M].2版.北京: 人民卫生出版社, 2016.
[31] World Health Organization.WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations[M].Geneva: World Health Organization, 2020.
[32] 秦锐, 何守森, 荫士安, 等.儿童铁缺乏症和缺铁性贫血防治专家共识[J].中国妇幼健康研究, 2023, 34(6): 1-11.
Infant and Child Care Committee of China Association of Good Birth and Good Birth.Expert consensus on the prevention and treatment of iron deficiency and iron deficiency anemia in children[J].Chinese Journal of Woman and Child Health Research,2023,34(6):1-11.(in Chinese)
[33] Yuan C, Qu C, Ji W.Vitamin D supplementation for improving children with bone mineral density: A protocol for systematic review and meta-analysis[J].Medicine (Baltimore), 2020, 99(52): e23475.
[34] Munns CF, Shaw N, Kiely M, et al.Global consensus re-commendations on prevention and management of nutritional rickets[J].Horm Res Paediatr, 2016, 85(2): 83-106.
[35] 中华医学会儿科学分会儿童保健学组, 《中华儿科杂志》编辑委员会.儿童微量营养素缺乏防治建议[J].中华儿科杂志, 2010, 48(7): 502-509.
The Subspecialty Group of Child Health Care, The Society of Pediatrics, Chinese Medical Association,The Editorial Board of Chinese Journal of Pediatrics.Recommendations for prevention and treatment of trace nutrients deficiency in children[J].Chin J Pediatr, 2010, 48(7): 502-509.(in Chinese)
[36] Greer FR, Sicherer SH, Burks AW.The effects of early nutritional interventions on the development of atopic disease in infants and children: The role of maternal dietary restriction, breastfeeding, hydrolyzed formulas, and timing of introduction of allergenic complementary foods[J].Pediatrics, 2019, 143(4):e20190281.
[37] Meyer R, Vandenplas Y, Lozinsky AC, et al.Diagnosis and management of food allergy-induced constipation in young children-An EAACI position paper[J].Pediatr Allergy Immunol, 2024, 35(6): e14163.
[38] Sharp WG.Intensive multidisciplinary feeding intervention for high-risk infants[J].Clin Perinatol, 2023, 50(1): 239-251.
[39] Baldassarre ME, Panza R, Cresi F, et al.Complementary feeding in preterm infants: A position paper by Italian neonatal, paediatric and paediatric gastroenterology joint societies[J].Ital J Pediatr, 2022, 48(1):143.
[40] Stewart A, Govender R, Eaton S, et al.The characteristics of eating, drinking and oro-pharyngeal swallowing difficulties associated with repaired oesophageal atresia/tracheo-oesophageal fistula: A systematic review and meta-proportional analysis[J].Orphanet J Rare Dis, 2024, 19(1): 253.
[41] 国家市场监督管理总局, 国家标准化管理委员会.婴幼儿及儿童家具安全技术规范[S].北京: 中国标准出版社, 2024.
[42] Swanepoel L, Henderson J, Maher J.Mothers′ experiences with complementary feeding: Conventional and baby-led approaches[J].Nutr Diet, 2020, 77(3): 373-381.
[43] Appiah KB, Cheyuo EK, Alhassan AM, et al.Mothers′ knowledge and attitudes regarding child feeding recommendations, complementary feeding practices and determinants of adequate diet[J].BMC Nutrition, 2020, 6(1):67.
[44] Herman H, Mansur AR, Chang YJ.Factors associated with appropriate complementary feeding: A scoping review[J].J Pediatr Nurs, 2023, 71: e75-e89.
[45] Gyamfi A, Spatz DL, Jefferson UT, et al.Breastfeeding social support among african american women in the United States[J].Adv Neonatal Care, 2023, 23(1): 72-80.
[46] Xinias I, Agakidis C, Delaporta T, et al.Prevalence clinical syndromes and outcomes of cow′s milk allergy in children: A four-year follow-up[J].Nutrients, 2025, 17(23):3646.
[47] Mcnally J, Hugh-Jones S, Caton S, et al.The eyes have it: Infant gaze as an indicator of hunger and satiation[J].Appetite, 2019, 133: 353-361.
[48] 中华人民共和国卫生部.儿童营养性疾病管理技术规范(卫办妇社发[2012].49号)[J].中国儿童保健杂志, 2012, 20(11): 3.
[49] 江载芳, 申昆玲, 沈颖.诸福棠实用儿科学[M].9版.北京: 人民卫生出版社, 2022.
[50] 中华人民共和国国家卫生健康委员会.婴幼儿营养喂养评估服务指南(试行)[Z/OL].(2024-11-27) https://www.nhc.gov.cn/fys/c100078/202502/19903ff647694f3a85ed6f e332380b34.shtml2025
[51] World Health Organization. Global manual on surveillance of adverse events following immunization[M]. Geneva: World Health Organization, 2014:18.
PDF(1207 KB)

Accesses

Citation

Detail

Sections
Recommended

/