Food Insecurity is Associated with Reduced Exclusive Breast feeding in Western Kenya: Results of a Longitudinal Cohort Study Público

Abstract

Background: Household food insecurity (HHFI) is a global public health issue in both developed and developing countries with implications for maternal and infant health. Since it is advised by the World Health Organization that exclusive breastfeeding (EBF) be continued from birth through the first six months of life, infants may be dependent fully on their mother for nutrition during their first 500 days of life, conception to six months of age.

Objective: The objective of this prospective cohort study is to assess the effects of household food insecurity on infant feeding practices, specifically exclusive breastfeeding during the first four months of life

Methods: A secondary analysis was performed on data from 399 mother-child dyads from Western Kenya as part of the Cohort Study on Vitamin A (COVA) evaluating pregnant women from their first trimester to nine months postpartum in four study visits. Exposures of interest were household food insecurity during each study visit, as well as two measures of HHFI chronicity: antenatal food insecurity (ANFI) and antenatal to postpartum food insecurity (ANPFI). Outcomes of interest were breastfeeding within an hour of birth, EBF during the first week of life, EBF from birth to four months, and EBF in a 24-hour recall at four months postpartum. Multivariate logistic regression was used to assess the associations of these exposures with the four outcomes.

Results: Comparing the chronically food insecure households to those that were never food insecure, women had a 45% lower odds of EBF from birth to four months (aOR: 0.55, 95% CI:0.30-0.99), and had a 61% lower odds of EBF in the previous 24 hours (aOR: 0.39, 95% CI: 0.20-0.76). Compared to never food insecure, acutely food insecure women had 55% lower odds of EBF from birth to 4 months (aOR: 0.45, 95% CI 0.22-0.94) and 60% lower odds of EBF in the previous 24 hours (aOR: 0.40, 95% CI 0.18, 0.87).

Conclusions: Household food insecurity is associated with reduced exclusive breastfeeding in Western Kenya and should be considered when devising methods to improve exclusive breastfeeding initiation and maintenance in developing countries.

Table of Contents

I. Introduction………………………………………………………………………...1

II. Comprehensive Review of the Literature…………………………………....3

III. Methods…………………………………………………………………………...18

IV. Results……………………………………………………………………………...26

V. Discussion……………………………………………………………………….....29

VI. Public Health Implications……………………………………….…………...33

VII. References…………………………………………………………….………….35

VIII. Tables…………………………………………………………………………….47

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Nutrition Health Sciences, Public Health
Palabra Clave	Nutrition Food insecurity Exclusive breastfeeding
Committee Chair / Thesis Advisor	Girard, Amy Webb, Emory University Hartman, Terry, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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