An appreciative inquiry into positive healthcare provider appointments by parents help-seeking for their child’s picky eating in Aotearoa New Zealand

Estimates of clinically diagnosed picky eating (Paediatric feeding disorder) (1) prevalence (2) is greater annually than that of autism spectrum disorder in the paediatric population. Therefore, it is unsurprising, that research in this area is increasing, particularly given negative outcomes for those children experiencing feeding issues. However, globally absent is qualitative exploration of parents’ experiences in primary care when help-seeking for their child’s picky eating. Prior research, when touching on the subject, primarily documents lack of support. This study therefore sought to establish via an appreciative inquiry what positive medical experiences look like, and whether affirmative appointments lead to good outcomes. Eleven parents were recruited through well-child centres, education providers and social media advertising. Semi-structured interviews were conducted via videoconference. Wong and Breheny’s (2018) (3) three levels of narrative analysis was employed to explore the data. The key finding was evidence of a clear, three-part structure across the narratives. The three structures were, parental management of picky eating, the positive appointment with the doctor, and the outcomes from that interaction. Within these, four key themes were explored. First, the challenge of defining picky eating. Currently, no one unifying definition for subclinical presentations exists, which impacted on decision making for participants. Second, the effect on participant behaviour of wider social discourses of motherhood and its interaction with public health messages. The participants, all female, felt both censure and/or failure and the need to feed according to guidelines. Discomfort was compounded by being unable to conform to norms. Third, the importance of the relationships between doctor–parent and doctor–child. Finally, that doctors were limited by a range of factors in the care they could provide including lack of in-depth knowledge of picky eating and limited referral paths. The study concluded that positive experiences are characterised by personable, caring doctors but that picky eating was neither well-understood nor resolving it was prioritised. In fact, much of the support focused either on supplementation to cover nutritional and/or calorific gaps or reassurance that picky eating was normal and/or transitive and therefore not cause for concern.