Understanding Parents' Experiences of Using a Portion Guide for Young Children: A Qualitative Study.

Serving children larger portion sizes is associated with higher energy intake and can contribute to childhood obesity. Parents of young children report being open to receiving portion guidance. However, the perspective of parents who have received a portion guide is not well understood. The current study aimed to (i) understand how parents provided with an age-appropriate portion guide use it to guide feeding behaviour and (ii) assess the value of making age-appropriate portion guidance more widely available. In-depth, semi-structured interviews were conducted with 15 parents of young children (1-4 years) who had received an age-appropriate portion guide. Interviews were analysed using reflexive thematic analysis and four themes were developed: (i) guidance is appreciated but has a limited impact on portion sizes, (ii) portions are usually determined by other factors, (iii) the guide is still useful, just not as intended and (iv) when and how guides are delivered influences acceptability. Parents were receptive to feeding guidance from trusted sources. The portion guide was seen as a useful resource for maintaining balance in children's diets along with limiting less healthy foods, but was not used directly to guide the portions parents served. Several aspects of the guide were seen as impractical and unrealistic, and portions served were mainly determined using parent- and child-led strategies. Results suggest that portion guides might be less useful for parents' portioning practices than previously assumed. However, portion guides are still appreciated by parents and positively influence other aspects of feeding behaviour.