Association between Household Food Security and Infant Feeding Practices in Urban Informal Settlements in Nairobi County, Kenya

Abstract

Despite various strategies to reduce child malnutrition and death, millions of children under five years of age die every year due to preventable causes. Appropriate infant and young child feeding (IYCF) practices play a major role in the healthy growth and development of children and helps reduce malnutrition and mortality. Studies in the urban informal settlements show widespread inappropriate infant and young child feeding (IYCF) practices and high rates of food insecurity. These together with the unique challenges with regards to child survival in these settings has led to widespread and persistent under-nutrition rates. This study assessed the association between household food security and IYCF practices in two urban informal settlements in Nairobi, Kenya. The study adopted a longitudinal study design that involved a census sample of 1500 children less than 12 months of age and their mothers aged between 14-49 years. A researcher-administered questionnaire was used to collect data on IYCF; household food security; and maternal demographic and socio-economic characteristics. Logistic regression was used to determine the association between food insecurity and IYFC practices. The findings showed high household food insecurity as only 19.5% of the households were food secure. Breastfeeding practices were comparable to the national rates as most of the children (84.2%) had been initiated to breastfeeding within one-hour of birth and were exclusive breastfed (60.4%). However, infant feeding practices were inappropriate as only 41% of the children attained a minimum dietary diversity; 76% attained minimum meal frequency and 27% attained minimum acceptable diet. With the exception of the minimum meal frequency, adjusted logistic regression findings showed that infants living in food secure households were significantly more likely to achieve appropriate infant feeding practices than those in food insecure households: minimum meal frequency (AOR 1.26, p= 0.530); minimum dietary diversity (AOR 1.84, p= 0.046) and minimum acceptable diet (AOR 2.35, p= 0.008). The findings of this study add to the body of knowledge by demonstrating an association between household food security and infant feeding practices in low-income settings. The findings imply that interventions aimed at improving infant feeding practices and ultimately nutritional status should consider a holistic approach to include improving household food security. The findings of this study provides evidenced-based information useful in decision making by programmes whose aim is to improve the nutrition status of children amongst the urban poor.