Article

Food insecurity is associated with attitudes towards exclusive breastfeeding among women in urban Kenya

Department of Global Health, Rollins School of Public Health at Emory University, Atlanta, Georgia 30322, USA.
Maternal and Child Nutrition (Impact Factor: 2.97). 09/2010; 8(2):199-214. DOI: 10.1111/j.1740-8709.2010.00272.x
Source: PubMed

ABSTRACT This study aimed to document whether food insecurity was associated with beliefs and attitudes towards exclusive breastfeeding (EBF) among urban Kenyan women. We conducted structured interviews with 75 human immunodeficiency virus (HIV)-affected and 75 HIV-status unknown, low-income women who were either pregnant or with a child ≤24 months and residing in Nakuru, Kenya to generate categorical and open-ended responses on knowledge, attitudes and beliefs towards EBF and food insecurity. We facilitated six focus group discussions (FGD) with HIV-affected and HIV-status unknown mothers (n = 50 women) to assess barriers and facilitators to EBF. Of 148 women with complete interview data, 77% were moderately or severely food insecure (FIS). Women in FIS households had significantly greater odds of believing that breast milk would be insufficient for 6 months [odds ratio (OR), 2.6; 95% confidence interval (95% CI), 1.0, 6.8], that women who EBF for 6 months would experience health or social problems (OR, 2.7; 95% CI, 1.0, 7.3), that women need adequate food to support EBF for 6 months (OR, 2.6; 95% CI, 1.0, 6.7) and that they themselves would be unable to follow a counsellor's advice to EBF for 6 months (OR, 3.2; 95% CI, 1.3, 8.3). Qualitative analysis of interview and FGD transcripts indicated that the maternal experience of hunger contributes to perceived milk insufficiency, anxiety about infant hunger and a perception that access to adequate food is necessary for successful breastfeeding. The lived experience of food insecurity among a sample of low-income, commonly FIS, urban Kenyan women reduces their capacity to implement at least one key recommended infant feeding practices, that of EBF for 6 months.

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    • "ecu - rity may lead mothers to perceive that their milk is insufficient to meet the needs of their infants . Previ - ous studies in this region have also observed an asso - ciation between food insecurity and mother ' s perceived capacity to produce sufficient breast milk ( Gewa et al . 2011 ; Kimani - Murage et al . 2011 ; Nor et al . 2011 ; Webb Girard et al . 2012a ) . As smallholder farmers intensify their dairy systems , the intensified systems will require more labour and in this population , women are likely to absorb the additional workload until the household can afford to hire additional labourers ( Mullins et al . 1996 ) . If women perceive a direct relationship between the type of work an"
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    • "ecu - rity may lead mothers to perceive that their milk is insufficient to meet the needs of their infants . Previ - ous studies in this region have also observed an asso - ciation between food insecurity and mother ' s perceived capacity to produce sufficient breast milk ( Gewa et al . 2011 ; Kimani - Murage et al . 2011 ; Nor et al . 2011 ; Webb Girard et al . 2012a ) . As smallholder farmers intensify their dairy systems , the intensified systems will require more labour and in this population , women are likely to absorb the additional workload until the household can afford to hire additional labourers ( Mullins et al . 1996 ) . If women perceive a direct relationship between the type of work an"
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