Infants pay the price when their parents struggle with food insecurity and benefit from red tape

Taking on parental responsibilities to support a newborn is stressful enough when things are going well.

But when parents living in underfunded conditions also have to fight government red tape to stay enrolled in important food benefit programs, the stress measurably affects their babies’ emotional and behavioral health, according to a study published on December 26, 2023 in JAMA Pediatrics.

Given the importance of the first year of life for overall brain development, addressing disruptions in food security is an issue that requires rapid intervention, according to lead author Chidiogo Anyigbo, MD, MPH, a clinician and researcher in the Division of General and Community Pediatrics. at Cincinnati Children’s Hospital.

“A number of studies have associated household food insecurity with poor pediatric mental health outcomes, including depression, externalizing and internalizing behaviors, and hyperactivity,” says Anyigbo. “But these studies have focused almost exclusively on children aged 9 months and older. To our knowledge, this is the first study to document the association between household food insecurity and problems accessing nutrition benefit programs and behavioral problems during the first 6 months. This is important because at this stage of a child’s development, every month counts and early intervention can have lifelong benefits. »

Measurable, predictable and preventable results

The American Academy of Pediatrics offers many recommendations for preventive screening of a child’s physical and mental health. Although pediatricians can use blood tests, scans and other tools to learn many things about an infant’s health, understanding how their environment influences mental health is not a simple task.

This study used two measurement tools commonly administered during primary care pediatric well visits to identify populations of infants at early risk for behavioral problems due to factors such as the impact of food insecurity or programs public services. Overall, the study analyzed data from more than 1,500 infants, 90% of whom lived in families with or eligible for public health insurance (Medicaid).

Researchers started with a screening tool that assesses health-related social needs (HRSN) before 4 months of age. They compared this information to another standard tool called the Baby Pediatric Symptom Checklist (BPSC), which is administered at 6 months of age.

HRSN data reveals a constellation of problems that disadvantaged families may face, including difficulty meeting their basic needs for food, shelter, and safety. But in this study, researchers found a particular correlation between reports of food insecurity and difficulty maintaining benefits, and infants’ behaviors measured in more detail at 6 months of age.

Overall, about 26% of the families studied reported that their babies exhibited unusual levels of behavioral dysfunction, such as rigidity, difficulty with routines and irritability. The more problems reported in the HRSN data, the more problems were subsequently discovered in the BPSC data.

“Specifically, when two or more problems appeared on the HRSN screening test, children were twice as likely to have behavioral problems on their BPSC screening test that were severe enough to require a clinical examination,” says Anyigbo.

Early intervention can help

“We already know that food insecurity can increase emotional distress, increase aggravation, and weaken attachment between parent and child,” says Anyigbo. “Now, with screening tools that can detect these problems at an early age, we have the opportunity to intervene.”

Pediatricians and primary care clinics have near-universal access to infants and are well-positioned to help connect families to community pantries and food banks. They can also help families access parenting support programs, insurance coverage assistance, and programs such as the Supplemental Nutrition Assistance Program (SNAP) and the Supplemental Nutrition Program for Women, Infants, and Children (WIC).

Anyigbo has already begun work on an online platform and QR code project to help more language-diverse families overcome challenges in qualifying for food benefits through the WIC program.

“The idea that these kinds of support systems are necessary is not particularly new,” Anyigbo says. “What is new is the evidence indicating how vital it is for healthy infant behavioral development to immediately address food insecurity. Difficulties accessing public nutrition benefits such as WIC may further compound the deleterious effects of food insecurity on infant behavioral functioning. relevant given continued calls for Congress to act to fully fund the WIC program.