Background: Recommendations from most United States professional and public health organizations in indicate that infants should begin eating complementary foods (CF) at 6 months of age. Despite this recommendation, parents frequently introduce CF to their infants earlier. To our knowledge, no previous studies have assessed maternal awareness of feeding guidelines, and whether this knowledge influences decision making around infant feeding. We hypothesized that the majority of mothers introduce CF before the recommended age or appropriate developmental milestones due to limited awareness of current feeding guidelines.

Methods: This observational cross-sectional study surveyed the maternal factors that influenced the timing of introduction of CF in infants in a sample of mothers who sought counseling at the Atlanta-based non-profit, Peapod Nutrition and Lactation Support.

Results: Fourteen mothers completed the survey on feeding practices, and over half of the mothers indicated that they waited until 6 months to introduce CF to their infants. All of the mothers knew the correct age recommendation for the introduction of CF. Some of the mothers indicated that they used professional organization recommendations to decide when to feed their infants, but some of the other reasons included influence from a pediatrician, developmental readiness, and the desire for their infant to sleep longer or go longer between breastfeeding sessions. Because all mothers were aware of the guidelines, we failed to reject the null

hypothesis that there is no association between early introduction of CF and limited knowledge of the recommendations.

Conclusion: This study found that mothers choose to introduce CF for various reasons beyond public health guidelines. Future studies investigating similar questions would benefit from a larger sample size and a longer duration.