Eating behaviours in care-experienced children: A mixed-methods UK comparative cohort study to examine mealtime challenges.

Insufficient food provision and malnutrition are features of neglect and are reasons children are taken into care. Subsequent eating difficulties may have long-term negative physical and mental health impact. Literature from various countries indicates patterns of over- and under-consumption, hoarding and stealing food, and consumption of contaminated or non-food (pica) sources in care-experienced children, but no studies have examined these patterns in the UK. This study recruited parents and carers of care-experienced children (CE, n = 105, Age M = 9.24 years, 62% male), comparing them with birth parents living with their child/ren (NCE, n = 103, Age M = 7.95 years, 43% male) on problematic eating measures. Participants were also asked open-ended questions about challenges and enjoyment of mealtimes. The CE group reported higher levels of problematic eating, dietary concern and food maintenance in their children than the other group, with medium-large effect sizes. Number of Adverse Childhood Events experienced was positively associated with these factors. Through Template Analysis, the CE group identified food consumption, disruptive behaviour, negative communication and food rejection/aversion as challenges. The comparison group reported similar challenges, with lower levels of behavioural extremes. Time together, creating a positive environment and exploring/enjoying new food were identified as enjoyable mealtime aspects in both groups. The CE group placed more emphasis on creating a nurturing and calm atmosphere. This is the first study in the UK to provide a comprehensive picture of eating and mealtime behaviours in care-experienced children. Insights into the specific challenges that parents and carers face in this context can assist intervention development.