Total Breastfeeding Duration and Household Food Insecurity in Healthy Urban Children

Acad Pediatr. Nov-Dec 2019;19(8):884-890. doi: 10.1016/j.acap.2019.02.009. Epub 2019 Mar 1.


Objective: Health care policy positions breastfeeding as an important part of the solution to household food insecurity; however, there are critical gaps in our knowledge of the relationship between breastfeeding duration (exposure variable) and household food insecurity (outcome variable). Our objective was to examine this relationship.

Methods: A cross-sectional study was conducted from 2008 to 2016 of healthy urban children (N = 3838) who were 0 to 3 years old and recruited from The Applied Research Group for Kids (TARGet Kids!), a practice-based research network in Toronto, Canada. Total breastfeeding duration was collected from parent-reported questionnaires. Household food insecurity was measured using 1-item and 2-item food insecurity screens. Multivariable regression analysis was performed adjusting for prespecified covariates.

Results: The median total breastfeeding duration was 10.5 months (interquartile range, 6.0-14.0), and 14.7% of households were food insecure. After adjusting for child characteristics (age, sex), maternal characteristics (age, ethnicity, education, employment), and family characteristics (number of children, single parent family, neighborhood equity score), there was no significant association between total breastfeeding duration and household food insecurity (odds ratio, 0.99; 95% confidence interval, 0.98-1.01). Although low-income families had an increased odds of being household food insecure (P ≤ .001), we found no significant association between total breastfeeding duration and household food insecurity at varying income levels.

Conclusions: We found no association between breastfeeding duration and household food insecurity, regardless of family income. Although breastfeeding is associated with improved child health outcomes and considered to be part of the solution to household food insecurity, interventions focused on social determinants may provide more promising targets for the prevention of household food insecurity.

Keywords: breastfeeding; child health; food insecurity; nutrition.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Breast Feeding / statistics & numerical data*
  • Child, Preschool
  • Cross-Sectional Studies
  • Family Characteristics
  • Female
  • Food Supply / statistics & numerical data*
  • Health Policy
  • Humans
  • Income / statistics & numerical data*
  • Infant
  • Infant, Newborn
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Ontario
  • Time Factors
  • Urban Population / statistics & numerical data