Sustainable complementary feeding in low-resource countries: bridging global recommendations and local food systems

Complementary feeding is a critical window for child growth and long-term health. Yet, practices remain suboptimal in many low-resource settings, where undernutrition and food insecurity are prevalent and pose a significant threat to child survival and well-being. This narrative review examines the key barriers to adequate complementary feeding and explores feasible, sustainable strategies to improve its quality, with particular attention to locally available food resources. Major constraints to adherence to global complementary feeding recommendations include structural poverty; fragile agro-food and health systems; weak enabling environments; limited caregiver time, resources, and knowledge; and established socio-cultural norms. In alignment with global commitments to nutrition and climate action, sustainable complementary feeding approaches that prioritize locally produced, nutrient-dense, and safe foods offer a promising pathway to enhance nutrition while strengthening local economies and community resilience. Emerging evidence, including intervention studies, across several low-resource countries indicates that strategic combinations of traditional, affordable food resources, such as indigenous crops, insects, and products from small-scale fisheries, together with appropriate processing techniques, can improve the nutritional adequacy and acceptability of complementary foods. These approaches have demonstrated potential to support optimal growth and overall health outcomes in children aged 6-23 months. Context-sensitive, culturally aligned, and community-centered interventions, integrated with caregiver education and supported by coordinated, multisectoral, and holistic strategies, are more likely to achieve lasting and equitable improvements in child nutrition and food system resilience.