Quality, WHO guideline concordance and viewer reception of Turkish-language YouTube videos on complementary feeding: a mixed-methods study

Abstract Background Introducing complementary foods between 6 and 23 months is a critical window, and caregivers increasingly rely on video platforms for guidance. Previous appraisals assessed generic quality rather than concordance with specific recommendations, focused on English-language content, and didn’t examine how viewers receive it. We appraised the quality, reliability, and guideline concordance of Turkish-language YouTube complementary-feeding videos and analyzed viewers’ comments. Methods The 20 most relevant videos for each of three Turkish search terms (60 videos) were assessed with four validated instruments (GQS, VIQI, mDISCERN, and JAMA benchmark criteria) and a guideline coverage score (0–10) based on five strong recommendations from the 2023 WHO guideline. Two raters scored all videos independently and reconciled by consensus (inter-rater reliability ICC 0.79–0.95, except the JAMA benchmark, 0.46); non-parametric tests with Benjamini–Hochberg correction were used. The first 20 comments per video (298 comments from 26 videos) underwent thematic analysis. Results The four quality instruments were moderately-to-strongly intercorrelated (Spearman’s ρ = 0.51–0.77). The key finding was a between-group difference: as a group, complementary-food videos scored highest on quality but lowest on guideline coverage (large effect sizes), despite predominantly physician authorship, while underrepresenting continued breastfeeding, dietary diversity, and avoiding unhealthy foods and drinks. The inverse quality–coverage correlations across all videos (ρ=−0.28 to − 0.42) reflected this between-group separation, not a within-video relationship: they didn’t persist after adjustment for search-term group, and within the complementary-food group they were positive. Thematic analysis identified four themes: responses were appreciative rather than evaluative, with no comment engaging the evidence base; over half expressed persisting uncertainty about practical feeding decisions; a substantial group positioned the channel as a source of clinical guidance; and many disclosed parental burden that the videos were said to relieve. Conclusions Apparent quality, professional authorship, and popularity didn’t track concordance with guidance. In their comments, viewers responded largely to clarity rather than accuracy, and some described relying on the channel as a primary source of feeding guidance. Because complementary feeding is anchored in explicit guidance, concordance can be measured and the omitted messages named, giving clinicians, creators and platforms specific targets for safer online infant-feeding information.