A qualitative exploration of food portion size practices and awareness of food portion size guidance in first-time parents of one- to two-year-olds living in

Participant demographics

Twenty-seven first-time parents of one- to two-year-olds were recruited: 25 mothers and two fathers. Table 2 presents the participant demographics. Most participants were White (n = 18 [67%]) and aged between 31 and 35 years (n = 17 [63%]). Twenty-four (89%) participants had a first degree or higher and 26 (96%) were married or living with a partner. Child age ranged between 13 and 24 months.

Table 2 Participant demographic characteristics (N = 27)

Portioning practices of first-time parents

Parental experience and learning

When first asked, many parents referred to using their “instinct” or just “winging it” when serving portions to their child. However, when probed further, they described learning over time from observing the amount their child ate (and wasted) on a meal-to-meal basis, using this as a reference when serving portions at the next meal. Although this sample of parents had limited feeding experience (being first-time parents of one- to two-year-olds), parents suggested they had gained confidence over time from past feeding experiences, which they now used to decide portions intuitively through “eyeballing” and guessing approximate amounts. This contrasted with experiences during weaning, where parents tended to measure foods more frequently. Although most parents did not know the official portion size recommendations for one- to two-year-olds before being shown the resources, parents felt confident to serve their child appropriate portions across a range of meals and foods, and to allow their child autonomy to dictate how much they ate (within limits and depending on perceived healthiness of the food).

“When we were first getting onto proper food, he was maybe getting too much and then he would leave it because he wasn’t eating it so I think you just get used to how much [food] they get through” (Participant 4-Parent of 19-24-month-old)

“You listen to all the advice and then you realise that actually your own instincts are better.” (Participant 18-Parent of 19-24-month-old)

Physical indicators

First-time parents also used physical indicators to determine portion sizes. Parents were often guided by the size of children’s dishware, believing the amount that fits in a child-specific bowl, plate or Tupperware was a child-appropriate portion size. Similarly with packaged foods specifically marketed for young children (such as Organix™, Ella’s Kitchen™ and Kiddylicious™), parents served the whole packet because they felt this was an age-appropriate portion size.

“I think because I’ve got his little kiddie bowl and the plate, I just put it in that and then I kind of know obviously if it’s a bowl for a kid then I suppose that should be the right portion size.” (Participant 8-Parent of 19-24-month-old)

Parental judgement alongside physical indicators was often used. For example, a whole packet might not be served if the food was perceived to be unhealthy and a full bowl of one single food was sometimes perceived to be too much (e.g. a full bowl of yoghurt). A few parents suggested their child became overwhelmed when presented with a large, full plate of food. In this instance, parents served less on the plate to start, followed by a second serving.

“I’ve just got my idea about what [her] size portion would be for all different types of food. So, with yoghurt it would probably only be about half full.” (Participant 2-Parent of 19-24-month-old)

“Giving her a little bit to look at, think about, sort of process and then eat – that is the best way to do it rather than pile the whole portion in front of her… I think it’s just about, just not being overwhelmed by a big mass of food in front of her” (Participant 7-Parent of 12-18-month-old)

A few parents used their own portion sizes to help determine the portion size for their child and whether to offer additional servings. A portion that was “smaller than” or “less than half” of their adult portion was deemed appropriate.

“With porridge, she has quite a big bowl in the morning… I won’t give her more because if she has any more, it’s bordering on an adult’s portion” (Participant 12-Parent of 19-24-month-old)

Awareness and use of existing portion size guidance for feeding preschool children

Participants were shown the six portion size guidance resources and asked about recognition. Resource five (Start4Life) was the most recognised resource, recognised by seven parents (26%). However, parents referred to this resource as a source of information for weaning to solid foods rather than something used now. Resource one (First Steps Nutrition Trust) was recognised by two parents, Resource three (National Health Service (NHS) Bradford) by two, Resource four (British Nutrition Foundation) by one and Resource six (Bristol City Council) by two. No parents recognised Resource two (Infant & Toddler Forum).

Only four of the 27 (15%) first-time parents had read any of the six portion size guidance resources. Three of these parents had found the resources useful, however one parent said “I’ve read it, but I didn’t really tend to take much notice of it” (Participant 21-Parent of 12–18-month-old). Parents described obtaining feeding advice and guidance more generally (e.g. to obtain information about how to wean, foods to avoid, how to manage certain feeding situations such as when a child is not eating) from a range of sources, including the internet, family and friends, social media, books, health professionals (e.g. health visitors), and community groups (e.g. children’s centres). In addition, the NHS website was often mentioned as a trustworthy information source for official guidance. However, very few parents described using these sources to obtain information about how much to feed their child specifically.

Several parents explained they had read a lot during the weaning stage and so needed less guidance now. For some parents, seeing these resources acted as a “reminder” to continue seeking information during the preschool years. However, the resources were viewed as a “guide” or “reference” to aid decision making and “give you an idea of what’s appropriate” rather than something which should be rigorously followed. Conversely, other parents deemed the resources unnecessary because they were confident in feeding their child the right amount, had an established feeding routine, and were happy being led by their child’s hunger cues rather than the guidance.

“I definitely used to look at things much more around that weaning age… It’s probably not a bad idea to just go and have a little look at typical portion sizes, and just try and keep up to date with her age group a little bit.” (Participant 16-Parent of 12-18-month-old)

“It was the first year where I was really concerned and really worried and I wanted to do it according to the guidance. But now, you say after one year maybe, you will get knowledge. You get experience [of] how much he wants to [eat]” (Participant 25-Parent of 12-18-month-old)

In addition, some parents mentioned time was a barrier due to going back to work, so they no longer had time to read online information. At this stage, parents were more likely to look online for meal inspiration than for specific guidance or advice.

“I’ve sort of got into a routine with it now and got more confident and I guess being back at work I’ve not had as much time to be looking.” (Participant 12-Parent of 19-24-month-old)

“Quick meal ideas, that’s all I ever want really.” (Participant 6-Parent of 19-24-month-old)

Content, structure and accessibility of the portion size guidance resources

Resources two, three, four and six presented individual food portion sizes, while resources one and five presented meal portion sizes (see Table 1). For example, this webpage provides an example of the British Nutrition Foundation resource presenting individual food portion sizes: 5532-booklet-sept21.pdf (nutrition.org.uk) [17] and this webpage provides an example of the NHS Start4Life resource presenting meal portion sizes: Beefy veg curry—Weaning recipes—Start for Life—NHS (www.nhs.uk) [18]. Some parents liked resources which showed portion sizes for specific foods (e.g. portions of pasta or vegetables) and how these foods could make up a balanced diet. Other parents preferred resources which showed actual meals (e.g. curry) because they showed how foods could be combined and offered meal inspiration. Although one Bangladeshi parent felt the resources only recommended “Westernised” meals, which they would not cook at home.

“[it] is really handy knowing what amount of each food group is needed and then like I said, once you see that it sticks with your mind, you get used to cooking it and you then just know how much of what you need to keep giving them” (Participant 8-Parent of 19-24-month-old)

I’d probably look at more websites, pages that have something that can feed the parents as well. It’ll say ‘portion size for two adults and a child’, rather than – I don’t really make individual portions like that now.” (Participant 12-Parent of 19-24-month-old)

“I find a lot of the meals that are there on-line are sort of Westernised if that makes sense. There’s not much for sort of people in our ethnic minority with the sort of ingredients we have in our cupboards.” (Parent of 12-18-month-old/P22)

Only resources two and three presented recommended portion size limits for foods high in fat and sugar; the other resources either did not mention these foods or more generally suggested avoiding them. Most parents thought it was appropriate to include these recommended portion size limits to remind parents which foods should be restricted and by how much. Although many parents were currently restricting these foods from their child’s diet, they acknowledged these foods would probably “creep into their lives at some point” and having guidance was helpful. Conversely, a couple parents felt strongly that resources should not include unhealthy foods because this might “signal that it’s okay to give them” and instead should provide healthy ‘treat’ options.

“It’s useful to know how much of it they have or what you should be aiming for and when they’re reaching for their fifth biscuit, perhaps half a biscuit is enough, so yeah, I like resource two.” (Participant 6-Parent of 19-24-month-old)

Showing parents the resources sparked discussion about the resources’ visual appeal, length, accessibility and usability. Some parents were interested in reading the resources and found them “interesting”, “short [and] sharp”, whereas others were uninspired, finding them “busy” and “not simple”. Parents preferred the short, concise and visual resources. Parents liked the presentation of portion size recommendations in simple concise tables, which could be screenshotted or downloaded to their phones. Parents were more drawn to the resources with bold colours, a visual front cover and images of foods and meals, which could help them to better gauge how big the portion sizes were.

“I think that’s really good to have visually, to kind of work out [portion size], actually, yes, otherwise I think it would be really easy to just give them what you give yourself.” (Participant 10-Parent of 12-18-month-old)

Portions consumed compared to the guidance

During the interviews, many parents compared the portions their child consumed to the recommended portions in the resources. For some parents, the comparison provided reassurance their child was eating enough for their age. For others, parents became anxious their child wasn’t eating enough.

“That little resource thing, I think if I had that in my arsenal, I’d be like, ‘It’s all right! I’m doing all right!’…It actually makes me feel better, so if he ever does not eat it all, then I’m like, ‘Well, he’s having more than he should have anyway, so it’s fine.’” (Participant 17-Parent of 12-18-month-old).

“I think following something like that probably wouldn’t be ideal because not every child would stick to something like that and it’d just end up making me more anxious.” (Participant 22-Parent of 19-24-month-old)

In contrast, parents did not seem particularly concerned if their child was consuming more than recommended. Only a few parents suggested they might “cut down on certain foods” (especially ‘unhealthy’ foods) if their child was consuming more than recommended, to avoid overeating and excessive weight gain.

The notion that “every child is different” seemed to ring true for many parents. Some parents felt the guidance did not reflect this, nor did it reflect the meal-to-meal and day-to-day variation in how much their child ate. Parents wanted to be led by their child’s appetite and hunger and respond to those needs appropriately over the course of the day. One parent suggested guidance resources should reflect that all children eat differently and should instead inform parents about the contexts in which portion sizes may be of concern.

“I’m sure sometimes she has eaten more than a tablespoon of rice or a tablespoon of mashed potato in one sitting. I wouldn’t be worried about that because sometimes like in a day, some of her meals and snacks, she’ll hardly eat anything and she’ll just pick at and then one or two of those meals, or snacks, she’ll seem to eat absolutely tons and I’m sure it’s just making up for the fact that she’s not really eaten anything all day.” (Participant 2-Parent of 19-24-month-old)