Contextual Influences on Child Feeding in Two South Asian Immigrant Groups


  • Alison Karasz Department of Family and Social Medicine, Albert Einstein College of Medicine, 1300 Morris Park Blvd, Bronx NY 10461, USA
  • Margia Shiriti Department of Family and Social Medicine, Albert Einstein College of Medicine, 1300 Morris Park Blvd, Bronx NY 10461, USA
  • Nilifa DeSilva Department of Family and Social Medicine, Albert Einstein College of Medicine, 1300 Morris Park Blvd, Bronx NY 10461, USA
  • Afrida Khurshid Department of Family and Social Medicine, Albert Einstein College of Medicine, 1300 Morris Park Blvd, Bronx NY 10461, USA
  • Karen Bonuck Department of Family and Social Medicine, Albert Einstein College of Medicine, 1300 Morris Park Blvd, Bronx NY 10461, USA
  • Usha Ramachandran Department of Pediatrics, Robert Wood Johnson School of Medicine, 89 French St. New Brunswick, NJ 08901, USA



Health disparities,, contextual features,, South Asians,, immigrant health,, child obesity,, feeding practices.


Child obesity is a major health disparity, with low-income communities bearing a disproportionate burden of disease. Although the powerful influence of socio-economic status on child diet and feeding practices is well established, its local contextual mechanisms are not necessarily well understood. This study used a qualitative comparative design to explore the socio-cultural context of child feeding ethnically similar but economically diverse immigrant families. Seventeen in-depth qualitative interviews conducted with affluent and low-income immigrant mothers from the South Asian subcontinent. We sought to explore potential contextual influences on maternal feeding practices, including: maternal beliefs and values, patterns of help and information seeking, family and household, and impacts of the chrono-system—the role of memory and life transitions. Our findings help to explain mechanisms underlying SES disparities in child obesity in this group, and maybe helpful in designing tailored interventions aimed at reducing these disparities.


Isong I, Dantas L, Gerard M, Kuhlthau K. Oral Health Disparities and Unmet Dental Needs among Preschool Children in Chelsea, MA: Exploring Mechanisms, Defining Solutions. Journal of Oral Hygiene & Health 2014; 2.

Cardel M, Willig AL, Dulin-Keita A, Casazza K, Beasley TM, Fernandez JR. Parental feeding practices and socioeconomic status are associated with child adiposity in a multi-ethnic sample of children. Appetite 2012; 58(1): 347-53.

Bolton KA, Kremer P, Hesketh KD, Laws R, Kuswara K, Campbell KJ. Differences in infant feeding practices between Chinese-born and Australian-born mothers living in Australia: a cross-sectional study. BMC pediatrics 2018; 18(1): 209.

Zhou N, Cheah CS. Ecological risk model of childhood obesity in Chinese immigrant children. Appetite 2015; 90: 99-107.

Wutich A, McCarty C. Social networks and infant feeding in Oaxaca, Mexico. Matern Child Nutr 2008; 4(2): 121-35.

Golden SD, Earp JA. Social ecological approaches to individuals and their contexts: twenty years of health education & behavior health promotion interventions. Health education & behavior: the official publication of the Society for Public Health Education 2012; 39(3): 364-72.

Holman D, Lynch R, Reeves A. How do health behaviour interventions take account of social context? A Literature Trend and Co-Citation Analysis 2018; 22(4): 389-410.

Baum F, Fisher M. Why behavioural health promotion endures despite its failure to reduce health inequities. Sociol Health Illn 2014; 36(2): 213-25.

Davison KK, Birch LL. Childhood overweight: a contextual model and recommendations for future research. Obes Rev 2001; 2(3): 159-71.

Pak-Gorstein S, Haq A, Graham EA. Cultural Influences on Infant Feeding Practices. Pediatrics in Review 2009; 30(3): e11-e21.

Pallan M, Parry J, Cheng KK, Adab P. Development of a childhood obesity prevention programme with a focus on UK South Asian communities. Prev Med 2013; 57(6): 948-54.

Asian, Pacific Islanders Health F. South Asians in the United States 2006. Contract No.: Report.

Godson JH, Williams SA. Oral health and health related behaviours among three-year-old children born to first and second generation Pakistani mothers in Bradford, UK. Community Dental Health 1996; 13(1): 27.

Cowin I, Emmett P, Team AS. Diet in a group of 18-month-old children in South West England, and comparison with the results of a national survey. J Hum Nutr Diet 2007; 20(3): 254-67.

Gu C, Warkentin S, Mais LA, Carnell S. Ethnic differences in parental feeding behaviors in UK parents of preschoolers. Appetite 2017; 113: 398-404.

Olvera N, Power TG. Brief report: parenting styles and obesity in Mexican American children: a longitudinal study. Journal of Pediatric Psychology 2010; 35(3): 243-9.

Engle PL, Pelto GH. Responsive feeding: implications for policy and program implementation. J Nutr 2011; 141(3): 508-11.

Karasz A, Bonuck K. Reducing pediatric caries and obesity risk in South Asian immigrants: randomized controlled trial of common health/risk factor approach. BMC Public Health 2018; 18(1): 680.

Kannan S, Carruth BR, Skinner J. Infant Feeding Practices of Anglo American and Asian Indian American Mothers. Journal of the American College of Nutrition 1999; 18(3): 279-86.

Toh JY, Yip G, Han WM, Fok D, Low YL, Lee YS, et al. Infant Feeding Practices in a Multi-Ethnic Asian Cohort: The GUSTO Study. Nutrients 2016; 8(5).

Momin SR, Chung KR, Olson BH. A qualitative study to understand positive and negative child feeding behaviors of immigrant Asian Indian mothers in the US. Matern Child Health J 2014; 18(7): 1699-710.

Martinson ML, McLanahan S, Brooks-Gunn J. Variation in child body mass index patterns by race/ethnicity and maternal nativity status in the United States and England. Matern Child Health J 2015; 19(2): 373-80.

Bansal N, Ayoola OO, Gemmell I, Vyas A, Koudsi A, Oldroyd J, et al. Effects of early growth on blood pressure of infants of British European and South Asian origin at one year of age: the Manchester children's growth and vascular health study. J Hypertens 2008; 26(3): 412-8.

Karasz A, Singelis TM. Qualitative and Mixed Methods Research in Cross-cultural Psychology: Introduction to the Special Issue. J Cross Cult Psychol 2009; 40(6): 909-16.

Giacomini MK, Cook DJ. Users' guides to the medical literature: XXIII. Qualitative research in health care A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA 2000; 284(0098-7484; 3): 357-62.

AAPD. Guideline on Infant Oral Health Care 2014.

Baughcum AE, Burklow KA, Deeks CM, Powers SW, Whitaker RC. Maternal feeding practices and childhood obesity: a focus group study of low-income mothers. Arch Pediatr Adolesc Med 1998; 152(10): 1010-4.

Buckshee K. Impact of roles of women on health in India. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 1997; 58(0020-7292; 1): 35-42.

Rauf A. Rural women and the family: A study of a Punjabi village in Pakistan 1987; pp. 403-15.

Karasz A. Marriage, Depression and Illness: Sociosomatic Models in a South Asian Immigrant Community. Psychology and Developing Societies 2005; 17(2): 161-80.

Cheah CS, Van Hook J. Chinese and Korean immigrants' early life deprivation: an important factor for child feeding practices and children's body weight in the United States. Soc Sci Med 2012; 74(5): 744-52.

Affleck W, Pelto G. Caregivers' responses to an intervention to improve young child feeding behaviors in rural Bangladesh: a mixed method study of the facilitators and barriers to change. Soc Sci Med 2012; 75(4): 651-8.

Naila N, Nahar B, Lazarus M, Ritter G, Hossain M, Mahfuz M, et al. "Those who care much, understand much." Maternal perceptions of children's appetite: Perspectives from urban and rural caregivers of diverse parenting experience in Bangladesh. Matern Child Nutr 2018; 14(1).

Quazi SAG, Priti K, Umesh K, Nazli K, Shilpa G. Challenges and patterns of complementary feeding for women employment: A qualitative study from rural India. Research in Nutrition and Food Science 2016; 4(1): 48-53.

Faruque AS, Ahmed AM, Ahmed T, Islam MM, Hossain MI, Roy SK, et al. Nutrition: basis for healthy children and mothers in Bangladesh. Journal of Health, Population, and Nutrition 2008; 26(3): 325-39.

Chaturvedi S, Ramji S, Arora NK, Rewal S, Dasgupta R, Deshmukh V, et al. Time-constrained mother and expanding market: emerging model of under-nutrition in India. BMC Public Health 2016; 16: 632.

Chanchani D. Maternal and child nutrition in rural Chhattisgarh: the role of health beliefs and practices. Anthropol Med 2017; 1-17.

Monteiro CA, Conde WL, Popkin BM. The burden of disease from undernutrition and overnutrition in countries undergoing rapid nutrition transition: a view from Brazil. Am J Public Health 2004; 94(3): 433-4.

Monteiro CA, Moura EC, Conde WL, Popkin BM. Socioeconomic status and obesity in adult populations of developing countries: a review. Bull World Health Organ 2004; 82(12): 940-6.

Popkin BM. Nutritional patterns and transitions. Population and Development Review 1993; 19(1): 138-57.

Karasz A, Dempsey K. Health seeking for ambiguous symptoms in two cultural groups: a comparative study. Transcult Psychiatry 2008; 45(3): 415-38.

Brewis A, Gartin M. Biocultural construction of obesogenic ecologies of childhood: parent-feeding versus child-eating strategies. American Journal of Human Biology: the Official Journal of the Human Biology Council 2006; 18(2): 203-13.




How to Cite

Karasz, A. ., Shiriti, M. ., DeSilva, N. ., Khurshid, A. ., Bonuck, K. ., & Ramachandran, U. . (2020). Contextual Influences on Child Feeding in Two South Asian Immigrant Groups. International Journal of Child Health and Nutrition, 9(2), 55–64.



General Articles