Exploring the Role of Pre-Conception Food Insecurity for Mother-Infant Bonding at Six Months Postpartum

• In Event: Poster Session 06
  In Poster Session: PS 06 Topic - Parenting & Parent-Child Relationships

Abstract

BACKGROUND It is estimated that 10.5% of American households were food insecure in 2019 (Coleman-Jenson, 2020), and rates are expected to have increased in 2020 due to consequences of the COVID-19 global pandemic (Ahn & Norwood, 2020; Leddy et al., 2020). Food insecurity during pregnancy is associated with increased maternal stress and depression (Laraia et al., 2006; Laraia et al., 2015), iron deficiency (Carmichael et al., 2007), increased risk of birth defects (Park & Eicher-Miller, 2014), and poorer health outcomes throughout infancy and early childhood (Cook et al., 2013; Nyaradi et al., 2013; Pai & Bahadur, 2020). Examining the implications of maternal food insecurity in the pre-conception period for maternal and child health and well-being is critical. Maternal-infant bonding is an essential element of infant well-being (Johnson, 2013; Pickler, 2009) and development in infancy and across the lifespan (Feldman, 2007; Grossmann et al., 2008). Because food insecurity is modifiable through programs and policies, pre-conception food insecurity is a potential target for intervention. Thus, the current study fills a gap in the literature by examining the association between pre-conception food insecurity and mother-infant bonding at six months postpartum.

METHODS Data for the current study came from a longitudinal clinic-based cohort study involving 177 pregnant women (ages 16-38) recruited in 2017-2018 from two perinatal urban clinics in a South-Central U.S. state. The participating clinics serve a racially-diverse and socioeconomically-disadvantaged patient population. The sample for the current study was restricted to the 116 participants who responded to the first six survey waves (first trimester of pregnancy through six months postpartum). Food insecurity was measured at the first assessment using the USDA 6-item short form (USDA, 2012), and maternal depressive symptoms were assessed in the third trimester using the 20-itme CES-D scale (Radloff, 1977). Postpartum bonding (Brockington et al., 2006) was measured at the six-month postpartum assessment. Demographic variables were measured at the first assessment.

RESULTS Approximately half of participants (50.4%) reported at least some food insecurity, and 10.9% responded affirmatively to at least five of the six items (see Table 1 for affirmative responses to each item). Multivariate OLS regression analyses were conducted to examine the association between pre-conception food insecurity in the 12 months prior to participants’ first prenatal visit and self-reported postpartum bonding approximately six months after giving birth (see Table 2). We found that even after controlling for self-reported depressive symptoms and demographic control variables, pre-conception food insecurity was associated with lower self-reported mother-infant bonding at six months postpartum (B = -1.30; p<.05). Maternal depressive symptomatology was also associated with lower postpartum bonding (B = -.25; p<.05), but it did not mediate the impact of food insecurity.

CONCLUSION Results suggest that food insecurity prior to conception has potentially long-lasting implications for postpartum maternal-infant bonding. These findings highlight the need for effective food security programs and policies for women during the pre-conception period due to the critical importance of early mother-infant bonding.

Authors

• Hannah Rebecca James, Oklahoma State University - Tulsa
  Presenting Author

• Jens E Jespersen, Oklahoma State University - Center for Health Sciences
  Non-Presenting Author

• Karina M. Shreffler, University of Oklahoma Health Sciences Center
  Non-Presenting Author