Food insecurity associated with behavioral issues in infancy
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Key takeaways:
- A study found a strong association between household food insecurity and signs of behavioral issues in infancy.
- Household food insecurity is linked to many adverse pediatric mental health outcomes.
The presence of household food insecurity or issues accessing food benefits like the Supplemental Nutrition Assistance Program (SNAP) in the first months of life is associated with signs of behavioral issues in infants, a study found.
“I have a deep, professional and personal passion for early childhood. I believe it is a time that we could do so much more to really build strong adults by building strong children,” Chidiogo Anyigbo, MD, MPH, FAAP, an attending physician in the division of general and community pediatrics at Cincinnati Children's Hospital Medical Center and co-author of the study, told Healio.
“I started off my research interests focusing on adverse childhood experiences and how to mitigate adverse childhood experiences,” Anyigbo said. “There's a triangle that shows that adverse childhood experiences lead to behavioral dysregulation early in childhood, and risk-taking behavior in adolescents leads to various negative outcomes related to health and early death in adulthood. There are gaps in the literature, and I'm just really focused on filling [them].”
Anyigbo and colleagues conducted a retrospective cohort analysis of well-child visits for 6-month-old children between March 30, 202,1 and June 30, 2022, at six primary care clinics in one health system.
“We pulled the charts of the kids who had completed a health-related social need screen in the first 4 months of life and who had completed a behavioral screen, which is the Baby Pediatric Symptom Checklist, or BPSC, that assesses some of the fundamental skills that are helpful for assessing infant regulation at 6 months,” Anyigbo explained.
They also assessed if families were having challenges accessing food or public benefits — such as nutrition assistance programs like SNAP or the Special Supplemental Nutrition Program for Women, Infants, and Children — or child care, or transportation.
“We created a count of the number and the type of the health-related social needs, that they were reporting for months and then did a logistic regression analysis.”
Among 1,541 children included in the study, 26.3% had a BPSC screen identified for clinical review, and 21.3% of caregivers reported at least one household health-related social need (HRSN). The most frequently reported HRSNs were food insecurity (11.3%) and issues accessing food benefits (11%).
They also found that households with food insecurity had a statistically significant higher odds of inflexibility (adjusted OR = 1.73; 95% CI, 1.14-2.63), difficulty with routines (aOR = 1.64; 95% CI, 1.05-2.57), and irritability (aOR = 1.86; 95% CI, 1.13-3.08) than was present in children in households without food insecurity.
Children in households with food benefits issues also had statistically significant higher odds of difficulty with routines (aOR = 1.7; 95% CI, 1.1-2.65) and irritability (aOR = 1.7; 95% CI, 1.03-2.82). Children in households with two or more HRSNs had consistently higher odds of having a BPSC screen identified for clinical review (aOR = 2.16; 95% CI, 1.38-3.39) compared with children with no HRSNs.
“One of the biggest surprises was the fact that both food insecurity and accessing benefits were both being identified as unmet needs in the household that were leading to behavioral dysregulation,” Anyigbo said.
She is interested in what other results could come about if the study is replicated in other settings to “try to identify the interventions that can really be meaningful.”
“What happens in infancy and early childhood does not stay in infancy and early childhood,” Anyigbo said. “These are experiences that are impacting the foundation of how a child develops, and we're seeing it manifest in the reports of the unmet needs of the household impacting the family.”
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