Factors underlying parental decisions on the introduction of healthy and unhealthy foods during complementary feeding

Research is still needed to better understand parental decisions regarding the introduction of specific foods during complementary feeding, particularly in Latin America. This descriptive cross-sectional study aimed to contribute to fill this research gap by: i) estimating the age at which healthy and unhealthy foods are introduced in Uruguay, and ii) exploring factors influencing parental decisions related to the introduction of healthy and unhealthy foods. An online survey with 450 parents of children aged between 6 and 36 months was conducted. Participants were shown images of natural foods and ultra-processed products and were asked a series of questions about their decisions regarding the introduction of these foods during complementary feeding. A series of open-ended questions were asked to identify the motives underlying their decisions. Most participants had introduced the evaluated natural foods early in the complementary feeding process. However, delayed introductions, particularly for strawberries, leafy greens, and fish were reported. Although most participants had delayed the introduction of ultra-processed products, they anticipated gradually incorporating these products into their children’s diets. A diverse range of factors that influence parental decisions regarding the introduction of foods during complementary feeding were identified, which were categorized into those related to the child, the child’s social environment, and the broader societal and cultural context. These results highlight the need for comprehensive public policies to promote healthy complementary feeding practices in Uruguay.