The neglected ‘m’ in MCH programmes – why mental health of mothers is important for child nutrition

Abstract

Summary In most societies, mothers are the primary providers of nutrition and care to young children. This is a demanding task, and poor physical or mental health in mothers might be expected to have adverse consequences on their children’s health, nutrition and psychological well‐being. Child nutrition programmes do not adequately address maternal mental health. In this article, we consider the evidence from less developed countries on whether maternal mental health influences child growth, with respect to evidence from both observational studies and from clinical trials. We estimate how much of the burden of undernutrition might be averted in one setting, and propose that promoting maternal mental health and treating maternal mental illness offer important new opportunities to tackle the twin scourges of maternal ill‐health and child undernutrition.

Maternal mental health is associated with child undernutrition and illness in Bangladesh, Vietnam and Ethiopia

“…through poverty reduction, social protection, women's empowerment programmes) may be necessary to help improve maternal mental well-being. In the context of behaviour change interventions which aim at reducing undernutrition and death in children by improving IYCF practices, CMD might be an important factor that prevents mothers either from participating in the programme or from adopting recommended practices (6,41) . Further, programme interventions focused on the creation of women's groups and health committees to discuss maternal and child health problems and formulate approaches to deal with them based on methods learned within these group settings have also shown to be successful in improving maternal mental health and breast-feeding practices, indicating that CMD, common mental disorders.…”

“…Maternal behaviours and practices are important elements for translating resources for care, such as household food security and health-care resources, into child well-being (3,4) . Impaired mental health reduces a mother's ability to take adequate care of her child, which in turn can have negative effects on the child's growth and development (5)(6)(7) . Alternatively, the presence of a sick or poorly growing child could undermine a mother's well-being, thereby increasing her vulnerability to depressive symptoms due to the worry and stress of the additional effort required to take care of her child and the pressure of disappointment or even overt criticism expressed by family members or others (5) .…”

Poverty and postnatal depression: a systematic mapping of the evidence from low and lower middle income countries

“…The postpartum period is characterised by increased physical and emotional demands on women, and PND affects the mother, infant and close others. PND can impact negatively on a wide range of outcomes including: maternal deaths due to suicide (Almond, 2009); the mother-infant relationship (Milgrom et al, 2006); child psychological development (Murray et al, 2000); and infant nutrition (Rahman et al, 2008) and growth (Stewart, 2007b).…”

Effect of an early perinatal depression intervention on long-term child development outcomes: follow-up of the Thinking Healthy Programme randomised controlled trial

“…Given that 10--35% of children worldwide are exposed to perinatal depression in their first year of life, understanding the potential for interventions to help alleviate this risk is a global public health priority. 7,8 Interventions to improve outcomes among children of depressed mothers in high income countries have shown some promising results in the short term, typically within 1--18 months of the intervention. 9,10 Among the few studies that have followed children for a longer period, such as five years post--intervention, the main finding is that the initial positive effects do not persist.…”