1. ¹Centre of International Child Health, Institute of Child Health, University College London, London, UK
2. ²Epidemiology Research Unit, Tropical Medicine Research Institute, University of the West Indies, Jamaica

Correspondence: H Baker-Henningham, Centre of International Child Health, Institute of Child Health, University College London, 30 Guilford Street, London WCIN 1EH, UK.

Contributors: HB-H contributed to the study conception and design, collection and assembly of results, analysis of the data and drafting the paper. CP contributed to the study conception and design, initiated and directed the study and responsible for recruitment of participants and sample selection. SW contributed to the study conception and design, analysis of the data and revision of the paper. SG-M contributed to study conception and design, data analysis and drafting of the paper.

Received 19 March 2002; Revised 14 July 2002; Accepted 24 July 2002.

Abstract

Objective: To compare mothers of undernourished children with mothers of adequately nourished children on maternal depression, parenting self-esteem, social support and exposure to stressors and to determine if these variables are independently related to undernutrition and stimulation provided in the home after controlling for socio-economic status.

Design: A case control study.

Setting: Children and their mothers were recruited from 18 government health centres in the Kingston, St Andrew and St Catherine parishes of Jamaica.

Subjects: One hundred and thirty-nine mothers of undernourished children (WAZ-1.5z scores) aged 9 – 30 months and 71 mothers of adequately nourished children (WAZ > -1z scores) matched for sex and age group were enrolled into the study.

Results: Mothers of undernourished children came from poorer homes but had similar social support to mothers of adequately nourished children. They were more depressed, had lower levels of parenting self-esteem (both P<0.01), reported higher levels of economic stress (P<0.001) and provided a less stimulating home environment (P<0.05). However, after controlling for social background variables there was no independent relationship between either psychosocial function or home stimulation and nutritional status. Undernutrition was found to be mainly explained by economic factors. The mothers' self-esteem was independently associated with the level of stimulation provided to the child.

Conclusions: When caring for undernourished children attention should be paid to the psychosocial status of the mother as well as the physical condition of the child.

Sponsorship: Thrasher Research Fund; Campus Research and Publication Fund, UWI, Jamaica