Designing the new recommendations on complementary feeding for children up to 3 years of age

In France, dietary guidelines have been publicised since 2001 as part of the National Nutrition and Health Programme (Programme national nutrition santé, PNNS). New scientific data and recent reports from the French Agency for Food, Environmental and Occupational Health and Safety (l'Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail, ANSES) and the High Council for Public Health (Haut Conseil de santé publique, HCSP) prompted the General Directorate for Health (Direction générale de la santé, DGS) to charge Santé publique France with updating dietary guidelines for all populations. The new recommendations for adults on diet, physical activity and sedentary behaviour were published in February 2019 (Delamaire et al., 2019). In September 2021, Santé publique France published its new recommendations regarding complementary food for children up to 3 years of age, in the form of a multimedia communication campaign. Santé publique France has used a participatory approach to build recommendations that are both clear and achievable for parents, and easy for professionals to use in their routine practice. These recommendations include two complementary components: dietary recommendations - also covering physical activity and sedentary behaviour - and advice for parents on educational strategies around complementary feeding then family meals. At the same time, research was done to establish which formats would be best suited to disseminating these messages. This resulted in the creation of a 36-page brochure and a poster for parents showing a table of foods to introduce during the first 3 years of childhood. Additional resources and content were also recommended in order to offer parents a range of tools adapted to their preferred media (leaflets, videos, website, menus, recipes), which together formed a comprehensive communication campaign. A document summarising the new recommendations has also been drawn up for professionals working in health and early childhood. Santé publique France was supported in this work by a committee that brought together specialists who have direct contact with the populations concerned (healthcare, maternity and children's services, childcare), particularly the least well-off, with epidemiologists and professionals from the fields of health promotion and prevention, information and communication, and research into children's eating behaviours. A number of study phases were carried out in association with parents, including those from modest backgrounds, and with the paediatricians who relay these recommendations, allowing for the choices of wording to be approved or revised throughout the design process. Some of these studies were conducted by the Centre for Taste and Feeding Behaviour (Centre des sciences du goût et de l'alimentation, CSGA) at the French National Institute for Agriculture, Food and Environment (INRAe) as part of the European project Edulia, and others by Santé publique France. Santé publique France also consulted the various bodies involved in the renewal of the recommendations − DGS, ANSES and HCSP - to ensure that the public outreach work was consistent with the scientific opinions of ANSES and the HCSP. These new recommendations from Santé publique France were publicised in a communication campaign launched in autumn 2021.