“Those who care much, understand much.” Maternal perceptions of children's appetite: Perspectives from urban and rural caregivers of diverse parenting experience in Bangladesh

Abstract

Appetite in children is an important determinant of nutritional intake and growth. The information used by caregivers to understand children's appetite can help inform infant and young child feeding promotion and appetite assessment. We conducted a qualitative study to (a) explore maternal perceptions and responses to children's appetite and (b) to identify how these factors differ by type of caregiver, level of maternal experience, and urban versus rural context. We used purposive sampling to recruit mothers and alternate caregivers into 14 total focus group discussions (six to eight participants in each group; N = 95) in both urban and rural settings in Bangladesh. To understand children's appetite, caregivers monitor children's dietary patterns, emotional signs, and physical and verbal cues. Healthy appetite was observed by willingness to eat diverse foods, finish offered portions, and by acceptance of foods without excessive prompting. Child illness was cited for a cause of low appetite, which was manifested through fussiness, and avoiding commonly consumed foods. Mothers described a limited set of feeding practices (offering diverse foods, playing, and cheering children with videos) to encourage consumption when children lacked appetite. Mothers' stress related to work was noted as a barrier to identifying appetite cues. Urban mothers described a lower access to instrumental social support for child feeding but informational support than mothers in the rural setting. Understanding caregivers' perceptions of children's appetite may inform strategies to improve responsive feeding and tool development to assess changes in appetite as early indicators of change in health or nutrition status among high-risk children.

Pattern of Complementary Feeding Practices among Mothers Attending at a Tertiary Level Hospital in Bangladesh

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Improvement in appetite among stunted children receiving nutritional intervention in Bangladesh: results from a community-based study

“…The primary objective of the study was to see the changes in appetite status of stunted children after receiving nutritional intervention. Prior studies have assessed the use of an appetite score based on food consumption, whereas the present study measured appetite using a previously validated interview-based tool [ 28 , 30 ]. The results of this study suggest that stunted children in Bangladesh receiving a nutrition intervention comprised of FS and PS had measurably increased appetite over a period of 6 months.…”

Unintended consequences of programmatic changes to infant and young child feeding practices in Bangladesh

“…Our qualitative findings indicate that caregiver's perceptions of complementary feeding practices could also vary among different areas and could thus contribute to inconsistent patterns of IYCF practices across programme areas. A study recently conducted in Bangladesh illustrates that complementary feeding practices are related to mothers' perceptions (Naila et al, 2018).…”