Maternal Employment and Child Malnutrition in Ecuador.

BACKGROUND: This paper estimates the causal impact of maternal employment on childhood malnutrition status in Ecuador to understand the trade-off between the time mothers devote to work and the time they dedicate to child-caring activities. METHODS: We use the instrumental variables (IV) approach and exogenous cantonal variation in maternal labor market conditions to account for the potential endogeneity of mothers' employment. The analysis employs the Ecuadorian National Health and Nutrition Survey 2018 and the Living Conditions Survey 2014. RESULTS: The IV estimations indicate that maternal employment increases the probability of having stunted children by between 4.2 and 18.1 percent, while no significant effect is found in the case of children suffering from wasting, being underweight, or being overweight. The effect of maternal employment on stunting is stronger among mothers with high education and living in high-income households. Inconclusive effects of mothers' overweight status are reported. The results are robust to several robustness checks. CONCLUSIONS: Overall, our findings suggest that the additional income that a working mother may obtain (the income effect) does not offset the loss of time available for direct childcare (the time constraint) in terms of child health status, and this effect is even more apparent for more affluent and more educated mothers. Government interventions, including effective conditional cash transfers and/or in-kind family policies, intended to reduce the cost of raising children among vulnerable families appear to be aligned with our findings.

Association Between Maternal Work and Exclusive Breastfeeding in Countries of Latin America and Caribbean.

OBJECTIVE: The aim of this study was to estimate the association between individual and contextual characteristics related to maternal work and exclusive breastfeeding (EBF) in Latin America and the Caribbean. METHODS: A cross-sectional study, conducted with data from the Demographic and Health Survey of Bolivia (2008), Brazil (2006), Colombia (2010), the Dominican Republic (2007), Guatemala (2015), Haiti (2017), Honduras (2011) and Peru (2011). The sample included infants who were under 6 months of age and their mothers. The outcome was EBF (yes/no), individual predictors were maternal employment status (employed/not employed), type of occupation, and type of employment (formal/informal), and contextual predictors were gross domestic product, maternity leave, and percentage of women in the labor force. The association between maternal employment status and EBF was performed using multilevel Poisson analysis adjusted for maternal education level, presence of partner, place of residence, maternal age, type of childbirth, primiparity, wealth index and breastfeeding in the first hour of life. RESULTS: The prevalence of EBF was 58.0% in Bolivia, 41.1% in Brazil, 39.2% in Colombia, 7.6% in the Dominican Republic, 50.8% in Guatemala, 39.7% in Haiti, 31.1% in Honduras, and 68.1% in Peru. The percentage of employed women ranged from 19.1% in the Dominican Republic to 46.1% in Bolivia. Maternal employment was negatively associated with EBF (Prevalence Ratio [PR] = 0.77; 95% CI 0.73, 0.82), while the highest percentage of women in the labor force of the country was positively associated with EBF (PR = 1.03; 95% CI 1.01, 1.06), with an increase in the PR value after the inclusion of gross domestic product in the model. CONCLUSIONS: The prevalence of EBF was lower in infants whose mothers were employed. However, the prevalence of EBF was higher in countries with a larger percentage of women in the labor force.

The Association Between Maternal Employment and Breastfeeding Duration With Household Income in Mexico.

BACKGROUND: Breastfeeding offers the best nutrition during the first months of life. Scholars have identified a dose-response association between breastfeeding duration and reduced risk for child morbidity and mortality. In upper-middle-income countries, including Mexico, maternal employment has been negatively associated with breastfeeding duration. Despite increasing numbers of women entering the workforce and disproportionately participating in the informal sector, where they are un-entitled to paid maternity leave, little is known about how these factors may affect breastfeeding practices. RESEARCH AIM: To determine whether household income moderated the association between maternal employment status (defined as unemployed, formal, and informal full- and part-time employed) and any breastfeeding for ≥ 6 months. METHODS: We conducted a cross-sectional study using retrospective secondary data from the 2018-2019 Mexican Health and Nutrition Survey. The analytic sample included data about 2,156 children aged 6-36 months. We computed logistic regression models stratified by household income. RESULTS: The association between maternal employment and breastfeeding duration varied by household income. Compared to unemployed women, among lower-income households, children were less likely to be breastfed for ≥ 6 months when the participants was part-time informally employed (AOR = 0.30, 95% CI [0.13, 0.69]). Among higher-income households, children were less likely to be breastfed for ≥ 6 months when the participants was full-time formally employed (AOR = 0.52, 95% CI [0.30, 0.88]). CONCLUSIONS: To increase breastfeeding duration, stakeholders need to continue strengthening and enforcing policies among formally employed women, and strategies are urgently needed to support women in the informal sector, particularly those in lower-income households.

An Ecological Approach to Obesity in Mexican American Children.

INTRODUCTION: The objective of this study was to explore the risk factors that contribute to obesity in Mexican American children compared with Mexican American normal weight children. No hypotheses were tested in the study. When risk factors are known, nurses can use evidence to reduce risky behavior. METHOD: A cross-sectional descriptive design was used, comparing two groups of children to discern the risk factors for obesity. The setting is a county in South Texas along the border with Mexico. The sample consisted of 55 Mexican American dyads (mother-child). The following measures, based on the Ecological Model of Growth, were used to collect data: anthropometrics, dietary data of children, home environment, perceived stress of mother, and maternal acculturation. Independent sample t tests, chi-square tests, Fisher exact tests, and a hierarchical logistic regression analysis were used to analyze the data. RESULTS: The findings show children's age and maternal body mass index (BMI) are positively correlated with childhood obesity, as measured by BMI percentile by age/sex. There were significant differences in the host and agent factors of prolonged bottle feeding, amount of outdoor play, and fruit drinks between normal weight and obese children. DISCUSSION: Engagement and involvement of other family members in outdoor activities, nutrition/feeding, and child care may mitigate the negative effects of host and agent factors on child body size.

Maternal employment and Mexican school-age children overweight in 2012: the importance of households features. / Empleo materno y exceso de peso en escolares mexicanos en 2012: la importancia de las características del hogar

Background: International evidence regarding the relationship between maternal employment and school-age children overweight and obesity shows divergent results. In Mexico, this relationship has not been confirmed by national data sets analysis. Consequently, the objective of this article was to evaluate the role of the mothers' participation in labor force related to excess body weight in Mexican school-age children (aged 5-11 years). Method: A cross-sectional study was conducted on a sample of 17,418 individuals from the National Health and Nutrition Survey 2012, applying binomial logistic regression models. Results: After controlling for individual, maternal and contextual features, the mothers' participation in labor force was associated with children body composition. However, when the household features (living arrangements, household ethnicity, size, food security and socioeconomic status) were incorporated, maternal employment was no longer statically significant. Conclusions: Household features are crucial factors for understanding the overweight and obesity prevalence levels in Mexican school-age children, despite the mother having a paid job.

Introducción: La evidencia respecto a la relación entre la participación laboral de las madres y el sobrepeso y la obesidad de los niños en edad escolar presenta resultados divergentes en todo el mundo. En México, dicha relación no ha sido analizada con datos representativos nacionales. Por lo anterior, el objetivo de este artículo fue evaluar el papel de la participación laboral materna extradoméstica en el peso elevado de la población mexicana en edad escolar (5 a 11 años). Métodos: Se realizó un estudio transversal a partir de una muestra de 17,418 individuos provenientes de la Encuesta Nacional de Salud y Nutrición 2012, utilizando modelos de regresión logística binomial. Resultados: En el modelo en el que se controló por características individuales de la madre y de contexto se encontró una relación entre la participación materna en el mercado laboral y la composición corporal de los escolares. Sin embargo, al incorporar las características del hogar (arreglos residenciales, etnicidad, tamaño, seguridad alimentaria y nivel socioeconómico) al modelo estadístico, el empleo materno dejó de ser estadísticamente significativo. Dicho modelo fue el que presentó mayor bondad de ajuste. Conclusiones: Las características del hogar, más allá de que la madre trabaje, son aspectos cruciales para entender las tasas de prevalencia de obesidad y sobrepeso en los escolares mexicanos.

Empleo materno y exceso de peso en escolares mexicanos en 2012: la importancia de las características del hogar / Maternal employment and Mexican school-age children overweight in 2012: the importance of households features

Resumen Introducción: La evidencia respecto a la relación entre la participación laboral de las madres y el sobrepeso y la obesidad de los niños en edad escolar presenta resultados divergentes en todo el mundo. En México, dicha relación no ha sido analizada con datos representativos nacionales. Por lo anterior, el objetivo de este artículo fue evaluar el papel de la participación laboral materna extradoméstica en el peso elevado de la población mexicana en edad escolar (5 a 11 años). Métodos: Se realizó un estudio transversal a partir de una muestra de 17,418 individuos provenientes de la Encuesta Nacional de Salud y Nutrición 2012, utilizando modelos de regresión logística binomial. Resultados: En el modelo en el que se controló por características individuales de la madre y de contexto se encontró una relación entre la participación materna en el mercado laboral y la composición corporal de los escolares. Sin embargo, al incorporar las características del hogar (arreglos residenciales, etnicidad, tamaño, seguridad alimentaria y nivel socioeconómico) al modelo estadístico, el empleo materno dejó de ser estadísticamente significativo. Dicho modelo fue el que presentó mayor bondad de ajuste. Conclusiones: Las características del hogar, más allá de que la madre trabaje, son aspectos cruciales para entender las tasas de prevalencia de obesidad y sobrepeso en los escolares mexicanos.

Abstract Background: International evidence regarding the relationship between maternal employment and school-age children overweight and obesity shows divergent results. In Mexico, this relationship has not been confirmed by national data sets analysis. Consequently, the objective of this article was to evaluate the role of the mothers' participation in labor force related to excess body weight in Mexican school-age children (aged 5-11 years). Methods: A cross-sectional study was conducted on a sample of 17,418 individuals from the National Health and Nutrition Survey 2012, applying binomial logistic regression models. Results: After controlling for individual, maternal and contextual features, the mothers' participation in labor force was associated with children body composition. However, when the household features (living arrangements, household ethnicity, size, food security and socioeconomic status) were incorporated, maternal employment was no longer statically significant. Conclusions: Household features are crucial factors for understanding the overweight and obesity prevalence levels in Mexican school-age children, despite the mother having a paid job.

Pathways of the association between maternal employment and weight status among women and children: Qualitative findings from Guatemala.

The double burden of malnutrition, defined by the coexistence of undernutrition and overweight, is well documented in low- and middle-income countries. However, the mechanisms by which employment may be related to maternal and child weight status in low- and middle-income countries are not well understood. We conducted in-depth interviews among 20 mothers who participated in Project MIEL, a contemporary trial which evaluated the effects of an integrated micronutrient supplement and parenting intervention in rural Guatemala. We utilized semi-structured interviews to explore the pathways by which maternal employment might influence bodyweight. Interviews were structured to explore the factors that mothers considered when deciding whether or not to participate in the labor force and how mothers perceived the influence of employment on determinants of their own bodyweight and that of their children. Themes were used to develop a conceptual framework. Mothers described four pathways through which employment could lead to changes in weight status: changes in food purchasing; improved household well-being; changes in time allocation; and psychological effects. Mothers described purchasing increased quantities and more varied types of food, as well as the purchase of energy-dense foods. Less time to devote to food preparation resulted in mothers preparing quicker meals and relying on substitute childcare. Mothers also expressed feelings of worry and neglect in relation to being employed, and perceived that these feelings would affect weight. A better understanding of these mechanisms is important for developing policies and programs to support women in the workplace and also reducing maternal and child overweight in Guatemala.

Aleitamento materno exclusivo: análise desta prática na região sul do Brasil / Exclusive breastfeeding: analysis of practice in southern Brazil

Introdução: O ato do aleitamento materno representa a forma natural de alimentar uma criança nos primeiros meses de vida, sendo inquestionável o relevante papel que esta prática desempenha no crescimento e no desenvolvimento infantil. Os objetivos deste estudo foram: Estudar o tempo do aleitamento materno exclusivo em duas regiões do Rio Grande do Sul RS, estudar a associação entre o aleitamento materno e a escolaridade materna, trabalho materno e renda familiar. Metodologia: Estudo observacional, transversal e descritivo realizado em cinco idades do Rio Grande do Sul (Porto Alegre, Canoas, São Leopoldo, Caxias do Sul e Flores da Cunha). Para análise dos dados, com relação ao aleitamento materno exclusivo até os 6 meses, a amostra foi dividida em 2 grupos com 100 crianças, além da análise geral dessa variável. Esta divisão levou em consideração a localização de residência das mesmas. Resultados: Separando a amostra por regiões, verificou-se que na região serrana 60% das crianças receberam leite materno exclusivamente até os 6 meses de idade. Na região metropolitana, constatou-se que 30% receberam leite materno exclusivo até os 6 meses de idade. Conclusão: Constatamos que o aleitamento materno exclusivo até os 6 meses foi o dobro na região da serra riograndense, em comparação com a região metropolitana.

Introduction: Breastfeeding is the natural way of feeding a child in the first months of life, and the relevant role played by this practice in child growth and development is undisputed. The aims of this study were to study the length of exclusive breastfeeding in two regions of Rio Grande do Sul (RS), and to assess the association of maternal breastfeeding with mother schooling, maternal employment, and family income. Methods: Observational, cross-sectional descriptive study performed in 5 cities of RS (Porto Alegre, Canoas, São Leopoldo, Caxias do Sul and Flores da Cunha). For data analysis, regarding exclusive maternal breastfeeding until 6 months, the sample was divided in two groups with 100 children, besides the general analysis of this variable. Results: By analyzing the sample by region, we found that 60% of the infants in the countryside (Caxias do Sul and Flores da Cunha) were exclusively breastfed until 6 months of age. In the metropolitan region (Porto Alegre, Canoas, São Leopoldo), this proportion was 30%. Conclusion: We found that exclusive breastfeeding until 6 months of age in the “Região Serrana” was twice as common as in the metropolitan region