This study was conducted to understand the caregivers’ perceptions of nutritional status among children aged under five years in Nakhon Phanom province of Thailand. Qualitative research methods, such as participant observation, focus group discussion, and in-depth interviews, were used to collect data between February and July 2017. One rural sub- district with a high prevalence of child malnutrition was purposely selected, and a total of 36 caregivers were recruited. Triangulation and reflexivity were applied to reduce bias during data collection and analysis. The study findings indicated that caregivers perceived that good nutritional status in children equated to living and eating well, regardless of body size. However, most caregivers were worried that if their children were underweight, they would be blamed by society for not raising the children properly, be considered as poor, and would lose face. Although they perceived that the body size of children was due to hereditary factors, given a choice, they preferred their children to be fat as it signified good health and well-being. Children’s nutritional status was a reflection of the caregiver’s perceived social image and acceptance of their children in the community. These perceptions can mislead the caregivers to focus more on their social standing rather than on the quality or benefit of childhood nutrition. Although caregivers should be oriented with appropriate health education regarding childhood nutrition and development, more emphasis is needed on developing better parenting skills to structure the child’s eating habits and activity, and reducing social stigma and embarrassment associated with childhood malnutrition.
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