235531 Introducing solids before 6 months: Inaccuracy of maternal recall at 1 year

Wednesday, November 2, 2011: 12:50 PM

Julia Coit, MPH , Division of General Pediatrics, Boston Medical Center, Boston, MA
Magdalena Buczek , The Breastfeeding Center, Boston Medical Center, Boston, MA
Xena Grossman, MS, RD , Division of General Pediatrics, Boston Medical Center, Boston, MA
Lori B. Feldman-Winter, MD, MPH , Department of Pediatrics, The Children's Regional Hospital at Cooper-UMDNJ-RWJMS, Camden, NJ
Anne Merewood, PhD, MPH, IBCLC , Division of General Pediatrics, Boston Medical Center, Boston, MA
Background: The AAP recommends exclusive breastfeeding for 6 months. Early introduction of solids can interfere with breastfeeding, and is associated with adverse health outcomes like obesity. Many studies use maternal recall to determine when infants start solids. Our goal was to determine accuracy of maternal recall regarding starting solids, at 1 year postpartum. Methods: Between 2008-2010 we telephoned mothers of infants enrolled in a cohort study monthly, for 6 months, and asked if they had given their baby any solids in the past month. The first month a mother answered yes was considered the month solids were started. At 1 year, we asked the same mothers when their child was first given solids. Percent agreement and the kappa statistic (k) were used to measure agreement between responses. Results: We obtained data on 148 women. At one year, 8% (12/148) accurately described the month they first gave solids; however, 90% (133/148) reported starting solids later than they were actually started (k = 0.05) (for example, our monthly records indicated solids were started at 2 months, but at 1 year, the mother recalled starting at 6 months). On average, incorrect responders overestimated by 2.3 months (range 1-8 months); 15.5% (23/148) overestimated by 4 or more months. Conclusion: At 1 year postpartum, only 8% of women accurately recalled when solids were started. Similar errors in breastfeeding studies could compromise the validity of reported health outcomes, especially if women consistently report starting solids later than they were actually started.

Learning Areas:
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Describe maternal recall issues over introduction of solid foods to infants in year 1 of life.

Keywords: Breast Feeding, Infant Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am PI on the study. Also, I am an Associate Professor in the Division of General Pediatrics, at the Boston University School of Medicine, and Director of the Breastfeeding Center at Boston Medical Center; as well as the Editor in Chief of the Journal of Human Lactation. I have published articles on breastfeeding, and served as the PI on several early nutrition/lactation/breastfeeding related research studies.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.