Maternal nutritional correlates of caregiving behavior in Embu, Kenya

In recent years increasing attention has been paid to caregiving behaviors as a determinant of optimal child nutrition and health. A potential determinant of caregiving behavior, as articulated in the Extended Model of Care (Engle et al., 1992) and for which there is little research, is the health and nutritional status of the caregiver. This study examined the association between maternal nutritional factors and maternal caregiving behaviors in a marginally malnourished rural Kenyan population using data from the Kenya Nutrition Collaborative Research Support Program. Additionally, the association between the time allocation pattern of the rural Kenyan women and their nutritional status and food intake was investigated. The time allocation data was collected from 169 households over the course of a year using the random spot observation technique.; Maternal infant interaction was also observed at 2, 4, and 6 months of infant age in 124 mother infant pairs using direct observation with a time sampling technique. Detailed food intake data was collected through direct observation and weighment on a bimonthly basis. The analysis revealed that anemic women spent less time holding their infant and caring for their infant than non-anemic women. Women who gained weight post partum or lost less weight post partum spent more time looking at their infant than women who lost more weight post partum. Women with higher BMIs and more positive post partum weight change also spent more time breastfeeding their infant. Household socioeconomic status influenced the pattern of maternal caregiving behaviors, women from higher household SES tended to spend less time on caregiving to their infant than women from lower household SES. Additionally, the analysis illustrated the heavy workloads of the Embu women across reproductive states. It also revealed a positive association between participation in cash labor and animal product intake for non-pregnant non-lactating women and pregnant women, an association that reversed for lactating women. Finally, anemic pregnant women were found to spend less time on food production than non-anemic pregnant women. In sum, this study provides supporting evidence for an association between maternal nutritional factors and caregiving behaviors in an undernourished population.