Applying Social Cognitive Theory to Understand Perspectives on Child Feeding Practices of Thai Female Caregivers With Young Children With Stunting

Abstract

Childhood stunting remains a public health challenge in Thailand. While national surveys provide prevalence estimates, there is limited understanding of the multilevel influences shaping child feeding practices. This qualitative study aimed to explore individual, familial, and socioenvironmental determinants of child feeding practices among Thai female caregivers of young children with stunting. In-depth interviews, guided by Social Cognitive Theory, were conducted with 40 female caregivers (primarily mothers) of children under 5 years old with stunting. Participants were purposively selected from nutrition clinics in four hospitals across four regions of Thailand (Chiang Mai, Bangkok, Satun, and Ubon Ratchathani). Trained local dietitians and nutritionists conducted interviews within the clinics. Transcripts were thematically analysed by two independent researchers, triangulated by input from local interviewers. Children's age ranged from 1.0 to 4.9 years old (mean 3.0 ± 1.1 years). Results showed that caregivers understood the importance of healthful feeding but faced barriers such as financial constraints, low self-efficacy, limited food acceptance, and misconceptions about nutrition. Permissive feeding practices were common due to concerns over picky eating. Family dynamics, food access and availability, and limited engagement with government nutrition programmes further shaped child feeding practices. This study highlights the complex interplay of multilevel factors that influence child feeding practices among Thai caregivers of young children with stunting. Addressing these challenges effectively requires a multifaceted approach for caregivers, including nutrition education, behavioural support, and policies to improve food access and affordability.