Abstract

Worldwide data suggest a clash between parental complementary feeding practices and recommendations. Understanding the circumstances under which parents form their feeding practices is a crucial step to improve such practices. This paper aimed to systematically review the existing qualitative literature and synthesise the factors that parents take into consideration in relation to complementary feeding. A systematic review was undertaken. Four electronic databases were searched for qualitative studies published after 2001 exploring parental experiences during complementary feeding. A framework that included authors' outcomes of interest was used to extract and synthesise study findings. The Standards for Reporting Qualitative Research were used to critically assess the included studies. Upper-middle- and high-income countries. Parents with a child below the age of 3 years. A total of forty-seven studies met the eligibility criteria and were included in this systematic review. The themes were organised into three main categories: (1) factors related to introduction of complementary foods; (2) factors related to the type of complementary foods and (3) factors related to both timing and type. The selected literature highlights: prevalent baby cues that prompt parents to introduce solid foods; parents' views on the recommended timing of complementary feeding; factors that drive the choice of complementary foods and perceived value in advice received from health professionals and grandmothers. This systematic review indicates factors that can be barriers to complying with the complementary feeding guidelines, and therefore, its findings are pertinent to improving parental feeding practices through intervention studies and through infant feeding education in a primary care setting.

Highlights

  • The selected literature highlights: prevalent baby cues that prompt parents to introduce solid foods; parents’ views on the recommended timing of complementary feeding; factors that drive the choice of complementary foods and perceived value in advice received from health professionals and grandmothers

  • Findings of this paper provide novel insights into parental experiences and attitudes and can be grouped into three overarching categories: [1] themes that relate to the age of introduction of solids foods; [2] themes that relate to the type of first solid foods and [3] themes that relate to both age of introduction and type

  • Themes with important public health implications include prevalent baby-driven cues to introduce solids; parental views on the recommendations for the age of complementary feeding; factors that drive the choice of complementary foods; perceived value in advice received from health professionals and grandmothers and the nature of fathers’ role during complementary feeding

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Summary

Methods

The protocol of this review has been registered in the PROSPERO database (registration ID: CRD42017067091). The studies that satisfied the eligibility criteria were incorporated into the synthesis; no further considerations were included (e.g. data saturation). Information sources and search Four electronic databases were searched for this review: PubMed, EMBASE, Scopus and Web of Science. The papers retrieved from all databases were published in the same reference period (January 2001 – 6 March 2021). The reference lists of all included studies were hand-searched for additional papers that meet the inclusion criteria. In a few cases, where a full text could not be retrieved in English, the authors of these papers were contacted to confirm that a paper in English did not exist

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