This study looked to assess early infant-feeding patterns in a cohort of low-income black mothers in the United States and to examine associations between maternal perception of infant temperament and complementary feeding before 4 months. It was hypothesised that a “fussy” infant temperament may lead parents to use food as a soothing technique.

The researchers used cross-sectional data from the 3-month visit (n = 217) of the Infant Care, Feeding and Risk of Obesity Study to assess relationships between early feeding of solids or juice and 6 dimensions of perceived infant temperament.

A total of 77% of the infants were fed solid foods at 3 months, 25% were fed juice, and 6% were exclusively breastfed. Maternal perception of infant temperament was measured by using 6 subscales from a validated tool - the Infant Behavior Questionnaire-Revised. Two aspects of perceived infant temperament were associated with early feeding of solid foods: distress-to-limitations defined as "When placed on his/her back, how often did the infant fuss or protest?" and activity-level defined as "When put into the bath water, how often did the infant splash or kick?" Maternal characteristics significantly associated with early complementary feeding included breastfeeding, obesity, and depressive symptoms.

The authors concluded that low-income black mothers may represent a priority population for interventions aimed at improving adherence to optimal infant feeding recommendations. That maternal perceptions of several aspects of perceived infant temperament are related to early complementary feeding suggests that this is an important factor to include in future observational research and in the design of interventions.

Wasser H, Bentley M, Borja J (2011). Infants Perceived as "Fussy" Are More Likely to Receive Complementary Foods Before 4 Months. Pediatrics; 127(2): p. 229-237