Solid advice: complementary feeding experiences and use of guidance among disadvantaged parents in two countries

The initiation of complementary feeding (CF) (introducing infants to food/drink other than milk) is recommended close to six months, and not before four months of age. Low socioeconomic status (SES) is a determinant of non-adherence to CF recommendations, but there is an evidence gap around reasons for non-adherence among these parents. This study investigated knowledge, attitudes and practices of disadvantaged families (in terms of SES and social support), and use of guidance for CF, in the Republic of Ireland and Northern Ireland. 

Parents of infants aged 3-14 months were recruited via community groups. Semi-structured focus groups aided by vignettes were used. Data were analysed using an inductive thematic approach. 

Nineteen focus groups took place with parents (n=83). A range of factors influence parents when introducing solids. Sources of guidance extend to family, friends, the internet and commercial resources. Parents experience uncertainty and anxiety during this time, driven by lack of knowledge and conflicting advice. Five major themes were identified: 1. More guidance which is accessible, timely and respectful needed; 2. The challenge of choosing safe, nutritious food; 3. 'Everybody has an opinion' 4. Feelings of inadequacy, embarrassment and guilt; 5. Decisions are ultimately based on individual circumstances. 

CF advice should be culturally appropriate, practical and empowering, emphasising the rationale behind updates to recommendations and consequences of non-adherence. Future training of health professionals for delivery of CF advice and guidance should consider these findings. Compliance with CF recommendations is influenced by health professionals, the wider family and the commercial baby-food sector.