Indulgence and stress around feeding: Initial evidence from a qualitative study of Saudi mothers.

Studies that examine social influences on child eating/weight status, including parental feeding, are particularly lacking among Arab populations. Due to variations in societal norms and perceptions of what embodies a healthy weight status, feeding practices may vary among cultures; Unique patterns of feeding behaviors may exist among parents of Saudi descent. This study aimed to collect and analyze qualitative data in order to detect themes and characterize feeding behaviors among mothers of preschoolers in Saudi Arabia. This study included 21 Saudi mothers of preschool children (mean age 3.97 years) who were following up at a pediatric outpatient clinic for a non-serious acute illness. One-on-one semi structured interviews were audio recorded and evaluated to detect emerging themes. A coding scheme was developed to code maternal perceptions, attitudes, and practices around feeding; A total of 24 codes with established inter-rater reliability were incorporated into the study. Examples of the codes generated: "Maternal Perceptions of Child's Fullness Cues: Child Declaration" and "Maternal Feeding Stress: Maternal Distress/Resentment". Descriptive statistics were conducted to assess sample characteristics, and frequency of each code was calculated. Results showed that the majority of mothers reported using rewards, electronics, and attractive plate presentations to get their children to eat, as well as base their cooking decisions on their child's preferences. None reported the use of threats and punishments in feeding, and they seemed to view feeding as highly stressful. Findings suggest that Saudi mothers may be more prone to follow indulgent feeding practices, which have been previously associated with child obesity This study is a key step in identifying important feeding practices in Saudi Arabia. Results can aid in the development of culturally-sensitive research instruments and effective interventions.