Household food insecurity is prevalent in a cohort of postpartum women who registered in the Canada Prenatal Nutrition Program in Toronto

Abstract

Objective: To assess the prevalence, severity and socio-demographic predictors of household food insecurity among vulnerable women accessing the Canada Prenatal Nutrition Program (CPNP), and to examine associations between household food insecurity and breastfeeding practices to six months. Design: Cohort investigation pooling data from two studies which administered the 18-item Household Food Security Survey Module at six months postpartum and collected prospective infant feeding data at two weeks and two, four and six months. Household food insecurity was classified as none, marginal, moderate or severe. Logistic regression analyses were performed to assess predictors of household food insecurity and associations between household food security (any and severity) and continued and exclusive breastfeeding. Setting: Three Toronto sites of the CPNP, a federal initiative targeting socially and/or economically vulnerable women. Participants: 316 birth mothers registered prenatally in the CPNP from 2017-2020 Results: Household food insecurity at six months postpartum was highly prevalent (44%), including 11% in the severe category. Risk of household food insecurity varied by CPNP site (p<0.001) and was higher among multiparous participants (OR 2.08; 95% CI 1.28-3.39). There was no association between prevalence or severity of food insecurity and continued or exclusive breastfeeding to six months postpartum in the adjusted analyses. Conclusions: Household food insecurity affected nearly half of this cohort of women accessing the CPNP. Further research is needed on household food insecurity across the national CPNP and other similar programmes, with consideration of the implications for programme design, service delivery and policy responses.

Household food insecurity is negatively associated with achievement of prenatal intentions to feed only breast milk in the first six months postpartum

“…As such, a portion of the prenatal period would be captured in most participants’ food insecurity responses. Additionally, a recent Canadian study that collected HFI in the pre and postnatal period found that the HFI status of 80% of participants remained the same over both time periods ( 51 ). Second, although the survey was pre-tested to ensure questions were understandable and acceptable, the survey was self-administered, therefore, participants could not ask for clarity or more detail on survey questions.…”