Food Insecurity &
Breastfeeding is there a Link?
Maternal and child undernutrition has been an underlying
theme this semester with breastfeeding being a plausible solution in
marginalized communities.
Household food insecurity is certainly a construct that
impacts undernutrition in women and children in the slum areas of Sub-Saharan
Africa and I questioned the link between household food insecurity and attitudes towards breastfeeding. Little
research has been done with regards to the relationship; however, Webb-Girard
et al. (2010) identified that women who were in food insecure households in
Nakuru, Kenya were more likely to have the perception
that their breastmilk would be insufficient for their child leading to a lower
likelihood of them breastfeeding. Such attitudes stemmed from the presence of
hunger in a mother and the mental stresses of needing to provide adequate
nutrition for their child (Webb-Girard et al., 2012).
Anxiety, depression, and hunger postpartum due to food
insecurity are just some underlying constructs that can be the cause of such
beliefs. Where should the intervention focus on in such a case? Is it treating
the maternal anxiety that will lead to a greater likelihood of breastfeeding
practices or should the band aid solution come from proving information on the
importance of breastfeeding as initially explored? What other social conditions
surrounding food insecurity may cause the low willingness to breastfeed?
This finding, though small in terms of its generalizability,
should be taken into consideration when identifying how to treat food insecurity
within marginalized communities. Treating
mental anxiety and depression associated within these communities may improve breastfeeding
attitudes that translate to behavioral changes and improve child malnourishment.
Other factors that may be associated with achieving a positive mental state is
the role of self-efficacy; being able
to provide for their child may elicit positive emotions leading to the
treatment of anxiety and depression.
What should come first?! Mental illness intervention or breastfeeding
health literacy?
Reference
Webb-Girard, A., Cherobon, A., Mbugua, S., Kamau-Mbuthia, E., Amin,
A., & Sellen, D. W. (2012). Food insecurity is associated with attitudes
towards exclusive breastfeeding among women in urban Kenya. Maternal &
Child Nutrition, 8(2), 199–214.
https://doi.org/10.1111/j.1740-8709.2010.00272.x
Amy,
ReplyDeleteYou are awesome for asking why breastfeeding is low in these areas versus just saying women should breastfeed more. This is exactly like what we were talking about in class – talking with the women and doing the research through interviews is obviously the best direction toward a positive health change. It sounds like this is exactly what they did in this study, and since this seems to be an indirect or root cause to low breastfeeding rates, this is the real problem that should be solved first. Perhaps a program aimed toward increasing food security and treating maternal anxiety will have the indirect effect of increasing breastfeeding and increase attitudes surrounding it? This will of course be different in each area. My vote – in this particular area, mental health should be addressed. And even at that, it sounds like the root cause of the anxiety/depression should be addressed even before that – perhaps toward food insecurity and self-efficacy.
Amy,
ReplyDeleteMental anxiety and stress affects a woman's ability to produce enough milk to nourish their child. When a woman doesn't eat enough or have a lot of anxiety and stress it affects their milk production and in essence, the woman's milk "dries up". I think the first thing is to address the factors that are causing anxiety in the woman, whether it be food insecurity or something else, then we can address the byproducts of those things. So while the mother can still produce milk to feed the child, she may not be giving the child the appropriate nutrition and thus will need to supplement with other options.
Amy, I had never thought of self-efficacy being such an important part of breastfeeding. It makes complete sense if you look at it though. A new mother has so many changes going on in their lives; adding the decision to breastfeed or not is another huge burden. I believe the best strategy to increase the number of women breastfeeding is to address the lack of self-efficacy first. The issue of post-partum depression can sometimes be dealt with or even prevented by a woman breastfeeding. I do not know the statistics on this, but I have seen it as an argument in favor of breastfeeding many times.
ReplyDeleteAmy
ReplyDeleteGreat post as usual
I love linking theory in analizing such critical topics. However; I prefer to deal with the breastfeeding issue with its underlying food insecurity background from an ecological perspective. I agree with Chris that we should look for the cause of the stress, anxiety and depression. In many situations especially in developing countries, there is structural barriers. Targeting mental health and enhancing self efficacy are a must but, in my opinion, if they are not accompained with looking for the root causes for the stress and the barriers of food security, our intervention will not be sustinable.
Amy, I actually was just reading the other day about maternal social support and breastfeeding, and ended up getting into some literature regarding self-efficacy and personality traits in relation to breastfeeding. Check these out:
ReplyDeleteBrown 2013, Maternal trait personality and breastfeeding duration: the importance of confidence and social support
Dennis 1999, Theoretical underpinnings of breastfeeding confidence: a self-efficacy framework
Blyth et al 2002, Effect of maternal confidence on breastfeeding duration: an application of breastfeeding self-efficacy theory.
I can't remember which article it was, but one pointed out that a lot of breastfeeding studies focus on non-modifiable demographic variables (or at least difficult to modify) but that looking at maternal confidence and self-efficacy may be a more effective approach because these could be easier to change for women in both the developing and developed world. However, personality traits such as extraversion and emotional stability were also correlated with longer BF duration, and these may be culturally bound in some circumstances (therefore difficult to change). The factors affecting a woman's ability and decisions around breastfeeding are definitely complex and interrelated, but I think this mental health approach is our best bet until better strides in fighting hunger/poverty/inequality can be made.