"If there is no water, we cannot feed our children": The far‐reaching consequences of water insecurity on infant feeding practices and infant health across 16 low‐ and middle‐income countries. Issue 1 (23rd December 2019)

• Record Type: Journal Article
• Authors: Schuster, Roseanne C.; Butler, Margaret S.; Wutich, Amber; Miller, Joshua D.; Young, Sera L.
• Other Names: Ahmed Jam Farooq investigator.; Adams Ellis investigator.; Balogun Mobolanle investigator.; Boivin Michael J. investigator.; Brewis Alexandra investigator.; Chapman Kelly investigator.; Collins Shalean M. investigator.; Eini‐Zinab Hassan investigator.; Escobar‐Vargar Jorge investigator.; Figueroa Luisa investigator.; Freeman Matthew investigator.; Gershim Asiki investigator.; Ghattas Hala investigator.; Hagaman Ashley investigator.; Jamaluddine Zeina investigator.; Jepson Wendy investigator.; Maes Kenneth investigator.; Maupin Jonathan investigator.; Melgar‐Quiñonez Hugo investigator.; Niesluchowski Monet investigator.; Omidvar Nasrin investigator.; Owuor Patrick Mbullo investigator.; Pearson Amber L. investigator.; Rosinger Asher Y. investigator.; Sanchez‐Rodríguez E. Cuauhtemoc investigator.; Santoso Marianne (Vicky) investigator.; Stoler Justin investigator.; Sullivan Andrea investigator.; Triviño Nataly investigator.; Tshala‐Katumbay Desire investigator.; Tesfaye Yihenew investigator.; Trowell Alex investigator.; Tutu Raymond investigator.; Workman Cassandra investigator.; Rosinger Asher Y. guestEditor.; Brewis Alexandra guestEditor.;
• Is Part Of: American journal of human biology. Volume 32:Issue 1(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-12-23
• Subjects: Human biology -- Periodicals; Physical anthropology -- Periodicals; Biologie humaine -- Périodiques; Anthropologie physique -- Périodiques; 612
• DOI: 10.1002/ajhb.23357
• Languages: English
• ISSNs: 1042-0533

Abstract

Abstract: Objectives: Infant 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. Methods: We 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. Results: Water 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. Conclusions: These 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.