by Cincinnati Children's Hospital Medical Center

Credit: Unsplash/CC0 Public Domain

Taking on the parenting duties to support a newborn child is stressful enough when everything goes well.

But when parents living in under-resourced conditions also must battle government red tape to stay enrolled in important food benefit programs, the stress measurably affects their babies' emotional and behavioral health, according to research published Dec. 26, 2023, in JAMA Pediatrics.

Given the importance of the first year of life to overall brain development, addressing disruptions to food security is a problem that requires rapid intervention, according to lead author Chidiogo Anyigbo, MD, MPH, a clinician and researcher with the Division of General and Community Pediatrics at Cincinnati Children's.

"A number of studies have associated household food insecurity with poor pediatric mental health outcomes including depression, externalizing and internalizing behaviors, and hyperactivity," Anyigbo says. "But those studies have focused almost exclusively on children aged 9 months and older. To our knowledge this is the first study to document the association between household food insecurity and problems accessing nutrition benefits programs and behavioral challenges during the first 6 months. This finding is important because at this stage of child development, every month matters, and early intervention can have lifelong benefits."

Measurable, predictable, avoidable outcomes

The American Academy of Pediatrics provides many recommendations for preventative screening for a child's physical and mental health. While pediatricians can use blood tests, scanners and other tools to learn many things about an infant's health, understanding how their environments influence mental health is no simple task.

This study used two measurement tools routinely administered during primary care pediatric well visits to identify populations of infants at early risk of behavioral challenges due to factors such as impact of food insecurity or public benefits programs. Overall, the study analyzed data from more than 1,500 infants, 90% of whom lived with families receiving or qualified to receive public health insurance (Medicaid).

The researchers started with a screening tool that assesses health-related social needs (HRSNs) before the age of 4 months. They compared that information to another standard tool called the Baby Pediatric Symptom Checklist (BPSC), which is given at age 6 months.

The HRSN data reveals a constellation of problems that under-resourced families can face, including challenges meeting basic needs for food, housing, and safety. But in this study, researchers found a particular correlation between reports of food insecurity and difficulties maintaining benefits, and infant behaviors measured in more detail at age 6 months.

Overall, about 26% of the families studied reported babies exhibiting unusual amounts of behavioral dysfunction such as inflexibility, difficulty with routines, and irritability. The more problems reported in the HRSN data, the more problems were found later in the BPSC data.

"Specifically, when two or more problems appeared on the HRSN screening, children were twice as likely to exhibit behavior concerns on their BPSC screening test that were serious enough to prompt clinical review," Anyigbo says.

More information: Chidiogo Anyigbo et al, Household Health-Related Social Needs in Newborns and Infant Behavioral Functioning at 6 Months, JAMA Pediatrics (2023). DOI: 10.1001/jamapediatrics.2023.5721

Journal information: JAMA Pediatrics 

Provided by Cincinnati Children's Hospital Medical Center