Objective: To examine the relationships among food insecurity, breastfeeding, and other related feeding practices by race/ethnicity among US infants and toddlers.
Design: National Health and Nutrition Examination Surveys 2009-2014, a nationally representative cross-sectional survey.
Participants: Infants and toddlers aged 0-24 months with complete data on household food security status (n = 2,069).
Main outcome measures: Initiation of breastfeeding (yes or no), duration of breastfeeding, and age of introduction to foods/drinks.
Analysis: Differences in feeding practices by food security status were tested in survey-weighted, stratified multiple regression models.
Results: Breastfeeding initiation rates among non-Hispanic whites, Hispanics, and non-Hispanic blacks were estimated at 80.0%, 77.5%, and 57.4%, respectively (P < .001). A total of 43% of infants and toddlers were introduced to foods/drinks before 4 months. After adjusting for household income, education, and other covariates, food insecurity was not a significant predictor of poor feeding behaviors.
Conclusions and implications: Racial/ethnic disparities existed, with non-Hispanic black infants at the highest risk for never being breastfed, nor to continue through the recommended period of breastfeeding. Food insecurity was not shown to affect breastfeeding and other infant feeding practices directly. Further investigation is needed to understand whether food insecurity, through stress and other sociostructural pathways, mediates poor infant feeding practices.
Keywords: National Health and Nutrition Examination Surveys (NHANES); breastfeeding; food security; infants and toddlers; race/ethnicity.
Copyright © 2020 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.