Maternal employment in low- and middle-income countries is associated with improved infant and young child feeding

Abstract

Women's employment improves household income, and can increase resources available for food expenditure. However, employed women face time constraints that may influence caregiving and infant and young child feeding (IYCF) practices. As economic and social trends shift to include more women in the labor force in low- and middle-income countries (LMICs), a current understanding of the association between maternal employment and IYCF is needed. We investigated the association between maternal employment and IYCF. Using cross-sectional samples from 50 Demographic and Health Surveys, we investigated the association between maternal employment and 3 indicators of IYCF: exclusive breastfeeding (EBF) among children aged <6 mo (n=47,340) and minimum diet diversity (MDD) and minimum meal frequency (MMF) (n=137,208) among children aged 6-23 mo. Mothers were categorized as formally employed, informally employed, or nonemployed. We used meta-analysis to pool associations across all countries and by region. According to pooled estimates, neither formal [pooled odds ratio (POR)=0.91; 95% CI: 0.81, 1.03] nor informal employment (POR=1.05; 95% CI: 0.95, 1.16), compared to nonemployment, was associated with EBF. Children of both formally and informally employed women, compared to children of nonemployed women, had higher odds of meeting MDD (formal POR=1.47; 95% CI: 1.35, 1.60; informal POR=1.11; 95% CI: 1.03, 1.20) and MMF (formal POR=1.18; 95% CI: 1.10, 1.26; informal POR=1.15; 95% CI: 1.06, 1.24). Sensitivity analyses indicated that compared to nonemployed mothers, the odds of continued breastfeeding at 1 y were lower among formally employed mothers (POR=0.82; 95% CI: 0.73, 0.98) and higher among informally employed mothers (POR=1.19; 95% CI: 1.01, 1.40). Efforts to promote formalized employment among mothers may be an effective method for improving diet diversity and feeding frequency in LMICs. Formally employed mothers may benefit from support for breastfeeding to enable continued breastfeeding through infancy. This trial was registered at clinicaltrials.gov as NCT03209999.