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Abstract ObjectivesInfant feeding plays a critical role in child health and development. Few studies to date have examined the link between household water insecurity and infant feeding, and none in a cross‐cultural context. Therefore, we examined the perceived impact of household water insecurity in four domains: breastfeeding, non‐breastmilk feeding, caregiver capabilities, and infant health. Our research was conducted as part of the Household Water Insecurity Experiences (HWISE) study. MethodsWe interviewed respondents from 19 sites in 16 low‐ and middle‐income countries (N = 3303) about the link between water insecurity and infant feeding. We then thematically analyzed their open‐ended textual responses. In each of the four domains (breastfeeding, non‐breastmilk feeding, caregiver capabilities, infant health), we inductively identified cross‐cultural metathemes. We analyzed the distribution of themes across sites quantitatively and qualitatively. ResultsWater was perceived to directly affect breastfeeding and non‐breastmilk feeding via numerous pathways, including timing and frequency of feeding, unclean foods, and reduced dietary diversity. Water was perceived to indirectly affect infant feeding through caregiver capabilities by increasing time demands, exacerbating disease, undernutrition, and mortality, and requiring greater efficacy of caregivers. Respondents made connections between water challenges and infant health, for example, increased risk of infectious diseases, undernutrition, and mortality. ConclusionsThese findings suggest that water presents many, and sometimes unexpected, challenges to infant feeding. By systematically investigating biocultural pathways by which water impacts infant and young child feeding, it will be possible to understand if, and how, water security can be leveraged to improve child nutrition and health.
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A systematic review of hot weather impacts on infant feeding practices in low-and middle-income countries
BackgroundIncreased rates of exclusive breastfeeding could significantly improve infant survival in low- and middle-income countries. There is a concern that increased hot weather due to climate change may increase rates of supplemental feeding due to infants requiring fluids, or the perception that infants are dehydrated. ObjectiveTo understand how hot weather conditions may impact infant feeding practices by identifying and appraising evidence that exclusively breastfed infants can maintain hydration levels under hot weather conditions, and by examining available literature on infant feeding practices in hot weather. MethodsSystematic review of published studies that met inclusion criteria in MEDLINE, EMBASE, Global Health and Web of Science databases. The quality of included studies was appraised against predetermined criteria and relevant data extracted to produce a narrative synthesis of results. ResultsEighteen studies were identified. There is no evidence among studies of infant hydration that infants under the age of 6months require supplementary food or fluids in hot weather conditions. In some settings, healthcare providers and relatives continue to advise water supplementation in hot weather or during the warm seasons. Cultural practices, socio-economic status, and other locally specific factors also affect infant feeding practices and may be affected by weather and seasonal changes themselves. ConclusionInterventions to discourage water/other fluid supplementation in breastfeeding infants below 6 months are needed, especially in low-middle income countries. Families and healthcare providers should be advised that exclusive breastfeeding (EBF) is recommended even in hot conditions.
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- Award ID(s):
- 2028598
- PAR ID:
- 10477055
- Publisher / Repository:
- Frontiers in Pediatrics
- Date Published:
- Journal Name:
- Frontiers in Pediatrics
- Volume:
- 10
- ISSN:
- 2296-2360
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.3389/fped.2022.930348
