Understanding maternal food choice for preschool children across urban–rural settings in Vietnam

Abstract

Improving diet quality of preschool children is challenging in countries undergoing food environment and nutrition transition. However, few studies have sought to understand how mothers in these countries decide what and how to feed their children. This study aims to explore maternal experiences, perspectives and beliefs when making food choice decisions for preschool children in urban, peri-urban and rural areas in northern Vietnam. Two focus group discussions and 24 in-depth interviews were carried out and analysed using thematic analysis. The results showed that mothers across the urban-rural spectrum shared the intention to feed children safe, nutritious food for better health and weight gain while satisfying child food preferences to improve appetite and eating enjoyment. These food choice intentions were embedded within family food traditions, whereby mothers emphasised nutritious food and adopted strict feeding styles during lunch and dinner but were flexible and accommodating of child preferences during breakfast and side meals. These intentions were also embedded within the physical food environment, which provided a mix of healthy and unhealthy food through informal food retailers. Despite these intentions, mothers faced financial constraints and difficulties in managing children's refusal to chew, changes in eating mood and strong eating temperament. These findings support policies to limit the presence of unhealthy food in informal food retail and encourage meal-specific feeding strategies to help children enjoy nutritious food, transition from soft to textured food and become more cooperative during mealtime.

High unhealthy food and beverage consumption is associated with poor diet quality among 12–35-month-olds in Guédiawaye Department, Senegal

“…They are also less likely to be rejected by young children; resource-constrained caregivers may therefore offer hyper-palatable UFB to young children rather than risk wastage of limited resources by offering perishable, more expensive options such as fruit or fortified cereal ( 67 ). Convenience, availability, accessibility, and use of UFB to cope with the stress of food insecurity have also been identified as factors contributing to associations between UFB consumption and food insecurity in various contexts ( 49 , 63 , 65 , 68 ). Evidence-based action to address high UFB consumption in food insecure households is essential given the nutritional vulnerabilities of these young children.…”

Parents' food choice for their preschool‐aged children: A means‐end investigation

“…Another recent study concluded that a combination of parental nutritional knowledge and engagement in parent–child conditioning experiences (e.g., repeated flavour exposures and repeated game‐play) in food and non‐food contexts may be beneficial in improving food choices for preschoolers (Halbeisen & Walther, 2021), highlighting the importance of nutrition education for new parents. Further, access to foods inside and outside the home also influence children's consumption patterns (Chung et al, 2021, Duong et al, 2023; Sirasa et al, 2019), indicating socioecological influences (e.g., socio‐economic status, food marketing and cultural foods) on consumption beyond the parent–child relationship or family unit (Sirasa et al, 2019).…”

“…Initially, these results seem to contrast with recent literature, which typically indicates that greater parental nutritional knowledge predicts healthier child consumption patterns (Sirasa et al, 2019; Wungrath et al, 2022). However, several recent studies have indicated that children's food preferences and food‐related behaviours (e.g., refusals) are a core driving factor in parental offering behaviours and child consumption patterns (Chung et al, 2021; Duong et al, 2023; Sirasa et al, 2020) regardless of parents' nutritional knowledge. Further, a recent qualitative study identified that the foods parents reported their preschooler actually consumed (compared to what was offered) often felt outside of their control (Chung et al, 2021).…”