A mixed-method approach to assess factors associated with food provision to children during weaning in Singapore

The complementary feeding period is a key transitional phase in which lifelong dietary preferences are developed which shapes disease risk in later life. This study aimed to use cross-sectional data to examine how maternal characteristics are associated with the diet quality of their offspring. Analysis of cross-sectional data in Singaporean mother-child dyads was conducted, alongside individual in-depth interviews to explore mothers’ perceptions and beliefs on food provisioning. Data from 488 Singaporean mother-child dyads (aged 6-24mo), were collected. Food intake (assessed by food frequency questionnaires), anthropometric and questionnaire data were collected during on-site visits. In-depth interviews were carried out in a sub-group of mothers (n = 12) to better understand dietary habits, choices, motives and influences related to their food provisioning. Pearson/Spearman correlation coefficients were used to explore diet quality relationships in the mother-child dyads. Multiple linear regression models were applied to examine the predictors for the diet quality of a child. Diet quality of children was significantly affected by maternal age, education, BMI, breastfeeding practice, and household income. The total diet quality scores in mother-child dyads were correlated (r = 0.176, p < 0.001), contributed primarily by whole grains and fruit (r = 0.330 and r = 0.325 respectively, p < 0.001), and vegetable (r = 0.125, p = 0.006). Breastfeeding was the strongest predictor of a child’s diet quality (β = 0.195; p < 0.001), and mothers valued breastfeeding qualitatively as a means to improve the bonding and well-being of their children. Multiple factors influence diet quality in children during complementary feeding, including breastfeeding, maternal age, BMI status, dietary habit and educational attainment.