Despite receiving supplemental food benefits, some families cannot afford enough infant formula and resort to formula "stretching," according to a study.
This practice, which involves watering down formula to feed a baby, was prevalent at two urban pediatric clinics in Cincinnati, according to researchers with Cincinnati Children's Hospital Medical Center.
The researchers found that families receiving public assistance remain at high risk of food insecurity, defined as the inability to afford enough food to meet basic nutritional needs. About 30% of families in the clinics reported food insecurity. That rate is roughly twice the national average.
"We were surprised to find one in three families worried about putting food on the table," Andrew Beck, MD, MPH, a general pediatrician and an author of the study, said in a news release. "Food insecurity tends to be an invisible problem, forcing families to make difficult choices between nutrition and other essential needs."
Two-thirds of the families in the federal Special Supplemental Nutrition Program for Women, Infants and Children (WIC), which provides nutrition basics for low-income women with children, reported running out of WIC-supplied formula toward the end of most months.
Among those food-insecure families, 27% reported watering down formula or reducing feedings, a practice that can have serious consequences for babies' developing brains and lead to cognitive, behavioral and psychological issues.
In 2009, WIC decreased the amount of formula provided to infants older than 6 months.
"We're seeing the effects of those changes in our urban clinics, highlighting that WIC is truly a supplemental program," Mary Carol Burkhardt, MD, lead author of the study, said in the news release. "I would venture to say that cities with similar demographics and poverty levels are seeing some of the same behaviors in our study."
The study was conducted at two urban health centers in Cincinnati: The Pediatric Primary Care Center (PPCC) and the Hopple Street Health Center. The centers see roughly 45,000 patient visits per year from underserved neighborhoods.
The study is scheduled for publication in Clinical Pediatrics. To access the online version via subscription or purchase, visit http://bit.ly/x5m39j.
This practice, which involves watering down formula to feed a baby, was prevalent at two urban pediatric clinics in Cincinnati, according to researchers with Cincinnati Children's Hospital Medical Center.
The researchers found that families receiving public assistance remain at high risk of food insecurity, defined as the inability to afford enough food to meet basic nutritional needs. About 30% of families in the clinics reported food insecurity. That rate is roughly twice the national average.
"We were surprised to find one in three families worried about putting food on the table," Andrew Beck, MD, MPH, a general pediatrician and an author of the study, said in a news release. "Food insecurity tends to be an invisible problem, forcing families to make difficult choices between nutrition and other essential needs."
Two-thirds of the families in the federal Special Supplemental Nutrition Program for Women, Infants and Children (WIC), which provides nutrition basics for low-income women with children, reported running out of WIC-supplied formula toward the end of most months.
Among those food-insecure families, 27% reported watering down formula or reducing feedings, a practice that can have serious consequences for babies' developing brains and lead to cognitive, behavioral and psychological issues.
In 2009, WIC decreased the amount of formula provided to infants older than 6 months.
"We're seeing the effects of those changes in our urban clinics, highlighting that WIC is truly a supplemental program," Mary Carol Burkhardt, MD, lead author of the study, said in the news release. "I would venture to say that cities with similar demographics and poverty levels are seeing some of the same behaviors in our study."
The study was conducted at two urban health centers in Cincinnati: The Pediatric Primary Care Center (PPCC) and the Hopple Street Health Center. The centers see roughly 45,000 patient visits per year from underserved neighborhoods.
The study is scheduled for publication in Clinical Pediatrics. To access the online version via subscription or purchase, visit http://bit.ly/x5m39j.
Better Screening
Motivated by these findings, the research team launched a separate quality improvement project to help doctors better identify families with hunger issues.
Preliminary research suggested that roughly 30% of clinic households were food insecure. But, during face-to-face, routine health screenings, pediatric residents were identifying just 2% of families with the problem.
"Families are sometimes reluctant to report food insecurity because of the stigma," said study coauthor Robert Kahn, MD. "We made a number of improvements, including training our pediatric residents to ask about hunger issues in a more sensitive manner."
The doctors' identification of food-insecure families climbed to 11% following training, according to the study.
The two studies also sparked the creation of a collaborative effort in which the PPCC teamed with the Freestore Foodbank to provide formula and education for families facing hunger issues. Since it began in March, the program has distributed infant formula to hundreds of families in need.
The discussion of the quality improvement project appeared in the Jan. 16 issue of Pediatrics. It is available via subscription or purchase at http://bit.ly/zaHTLK.
Motivated by these findings, the research team launched a separate quality improvement project to help doctors better identify families with hunger issues.
Preliminary research suggested that roughly 30% of clinic households were food insecure. But, during face-to-face, routine health screenings, pediatric residents were identifying just 2% of families with the problem.
"Families are sometimes reluctant to report food insecurity because of the stigma," said study coauthor Robert Kahn, MD. "We made a number of improvements, including training our pediatric residents to ask about hunger issues in a more sensitive manner."
The doctors' identification of food-insecure families climbed to 11% following training, according to the study.
The two studies also sparked the creation of a collaborative effort in which the PPCC teamed with the Freestore Foodbank to provide formula and education for families facing hunger issues. Since it began in March, the program has distributed infant formula to hundreds of families in need.
The discussion of the quality improvement project appeared in the Jan. 16 issue of Pediatrics. It is available via subscription or purchase at http://bit.ly/zaHTLK.
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