en Nursing Orginal research <div style="text-align: justify;"><span style="line-height:2;"><span style="font-family:Times New Roman;"><span style="font-size:14px;"><span style="unicode-bidi:embed"><span style="color:#2980b9;"><b>Background</b>:</span> Health literacy (HL) lays the foundation for health-related decisions. Moreover, nutrition during infancy plays a critical role in a child&rsquo;s growth and development. Therefore, it is particularly important to investigate the status of maternal health literacy (MHL) and its relationship with nutritional performance (NP).</span><br> <span style="unicode-bidi:embed"><span style="color:#2980b9;"><b>Objectives:</b></span> This study aims to investigate the association of mothers&rsquo; HL level with their breastfeeding self-efficacy (BSE) and NP. </span><br> <span style="unicode-bidi:embed"><span style="color:#2980b9;"><b>Methods:</b> </span>This cross-sectional study was conducted on 234 mothers recruited from urban integrated healthcare service centers (UIHSCs) and their affiliated healthcare bases using a two-stage cluster sampling method. Data were collected using demographic survey questions, the Health Literacy for Iranian Adults (HELIA), the Breastfeeding Self‑Efficacy Scale‑Short Form (BSES‑SF), and the researcher-made Mother&rsquo;s Complementary Feeding Performance (MCFP) Questionnaire. Descriptive statistics and the correlation coefficient test were used to analyze the data in SPSS 24.</span><br> <span style="unicode-bidi:embed"><span style="color:#2980b9;"><b>Findings:</b> </span>The mean (SD) scores for Health Literacy, Breastfeeding Self-Efficacy, and Nutritional Performance were 71.47 (11.98), 42.65 (8.79), and 20.36 (4.20), respectively, indicating adequate to satisfactory levels. The mothers&#39; HL and its components were significantly related to their BSE and NP (P<0.05).</span><br> <span style="unicode-bidi:embed"><span style="color:#2980b9;"><b>Conclusion:</b> </span>Given the relationship between mothers&rsquo; HL levels and their BSE and NP, the findings of this study highlight the need for greater attention to education across various areas, including mass media, and to the provision of educational courses in UIHSCs.</span></span></span></span></div> Health Literacy, Mothers, Complementary Feeding, Breastfeeding Self-Efficacy 41 49 http://nmcjournal.zums.ac.ir/browse.php?a_code=A-10-335-7&slc_lang=en&sid=1 Nazanin Zahra Esmaili Nazanin.smaeili1374@gmail.com 100319475328460013447 100319475328460013447 No Department of Community Health Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences nasrin jafari varjoshani jafari_ns@yahoo.com 100319475328460013448 100319475328460013448 No Department of Community Health Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences masomeh hasanloo hasanloo_md@zums.ac.ir 100319475328460013449 100319475328460013449 No Department of Operating Room and Anesthesiology, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran mansoureh sepehrinia m.sepehrinea@zums.ac.ir 100319475328460013450 100319475328460013450 Yes Department of Pediatric Nursing, School of Nursing and Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran