Nutrition and Clinical Services Division, International Center for Diarrheal Diseases Research, Dhaka, Bangladesh.
Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA.
Matern Child Nutr. 2018 Jan;14(1). doi: 10.1111/mcn.12473. Epub 2017 Jul 21.
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.
儿童的食欲是营养摄入和生长的重要决定因素。照顾者用来了解儿童食欲的信息可以帮助促进婴儿和幼儿喂养，并评估儿童的食欲。我们进行了一项定性研究，（a）探讨母亲对儿童食欲的看法和反应，（b）确定这些因素如何因照顾者类型、母亲经验水平以及城市与农村背景而有所不同。我们使用目的性抽样方法在孟加拉国的城市和农村地区招募了母亲和替代照顾者参加 14 个总焦点小组讨论（每组 6 到 8 名参与者；N=95）。为了了解儿童的食欲，照顾者会监测儿童的饮食模式、情绪迹象以及身体和言语提示。健康的食欲表现为愿意吃各种食物、吃完提供的食物份量，以及在无需过多提示的情况下接受食物。儿童生病被认为是导致食欲不佳的原因，其表现为烦躁不安，以及避免食用常见食物。母亲描述了一系列有限的喂养行为（提供各种食物、玩耍和用视频逗孩子），以在孩子缺乏食欲时鼓励他们进食。母亲们还提到，由于工作压力，她们难以识别食欲提示。城市母亲表示，在获取儿童喂养方面的工具性社会支持方面，她们的机会比农村地区的母亲要少，但在信息支持方面则比后者多。了解照顾者对儿童食欲的看法可能有助于制定策略，以改善响应式喂养，并开发工具来评估食欲变化，作为高风险儿童健康或营养状况变化的早期指标。
