General framework
The table systematically organises food introduction during the first year of life, aligning the most common foods with the recommended age and relevant restrictions. The starting point is breastfeeding, reinforcing the concept of exclusive breastfeeding until 6 months, with scope for starting complementary feeding between 4–6 months when clinically indicated. After 6 months, breast milk remains an important source of energy, but no longer has an exclusive role, coexisting with foods dense in micronutrients, especially sources of iron, zinc and essential fatty acids.
Fruit and early allergens
Fruit is usually one of the first foods introduced, and it is worth noting that the document includes both the traditional purée approach and the offer of soft pieces. From 6 months, the introduction of potentially allergenic fruits such as strawberry or kiwi is allowed, which is consistent with evidence discouraging delayed introduction of allergens. However, whole nuts remain restricted until preschool age, mainly because of choking risk rather than allergy.
Cereal porridge, iron and gluten
Cereal porridge highlights two aspects that are often overlooked: iron fortification and early introduction of gluten. Gluten may be introduced at any time between 4 and 12 months and should not be delayed, contrary to older practices that associated late introduction with prevention of coeliac disease, an association that is no longer supported.
Vegetables, nitrates and safety
Vegetable purée marks the transition to complete meals, initially as one meal per day and later as lunch plus dinner. The table includes a useful note on nitrates, such as spinach, beetroot, turnip greens and celery, which may be used occasionally but should not be stored for more than 24–48 hours because of the risk of methaemoglobinaemia — a clinically relevant detail that is often not communicated to parents.
Meat, fish and sources of iron
Meat is typically introduced at 6 months, initially focusing on lean white meats and gradually increasing the protein amount. The later introduction of red meat, around 9–10 months, is consistent with the aim of varying haem iron sources without early exposure to higher levels of saturated fat. In parallel, white fish is introduced early, at 6 months, and oily fish a few weeks later, highlighting the relevance of DHA while avoiding large predatory fish because of mercury content.
Legumes as an alternative protein source
Legumes take on an increasing role as a plant-based protein alternative and may replace meat or fish in some meals. The table emphasises texture — well cooked and mashed — which is mainly a respiratory safety concern rather than a nutritional one.
Egg and allergen exposure
Egg is no longer subject to staged restrictions and may be introduced whole, including yolk and white, from the beginning of complementary feeding, without postponing introduction because of allergy risk, in line with the current approach of early allergen exposure.
Dairy products and cow’s milk
Dairy products are addressed in a differentiated way: plain unsweetened yoghurt may be introduced at 6 months, but cow’s milk as the main drink should only be used from 12 months. This recommendation reinforces current guidance because of the lower iron density of cow’s milk and the risk of iron deficiency anaemia.
Family diet and textures
The table ends with the “family diet”, which has two dimensions: composition, avoiding salt, fried foods, sugar and ultra-processed foods, and texture, with age-appropriate pieces and self-feeding. This converges with mixed approaches combining baby-led weaning and traditional spoon-feeding. By 12 months, the child approaches a full family diet, but the document stresses that “no added salt” remains the rule.
Key messages for clinical practice
In summary, a transversal reading of the table highlights three key messages useful in paediatric and family medicine consultations:
- do not delay the introduction of allergens;
- ensure iron-dense sources from the start of complementary feeding;
- gradually integrate the child into the family diet, with adaptations mainly for safety rather than composition.
