Caregiver Nutrition and Nurturing Care: A Scoping Review.

Abstract

Research on early childhood development has focused on child health, nutrition and stimulation. However, less attention has been given to the role of caregiver nutrition in shaping caregiving behaviours. Suboptimal caregiver nutrition may impair the ability to provide responsive and nurturing care. This scoping review aimed to summarise the existing evidence on the link between caregiver nutrition and nurturing care, specifically responsive caregiving and early learning opportunities. Database (Medline) and citation searches yielded 23 articles meeting inclusion criteria (n = 17 observational; n = 6 randomised controlled trials [RCTs]). The majority (n = 15) were conducted in low- and middle-income countries. Observational studies measured caregiver anthropometry (n = 8), dietary intakes/diversity/quality (n = 6), anaemia (n = 6) and vitamin B6 status (n = 1). RCTs supplemented pregnant and/or postpartum women with iron (n = 2), multiple micronutrients (n = 2), fish oil (n = 1) and food-based snacks (n = 1). Most articles (n = 18) measured caregiving through live or videotaped observations of caregiver-child interactions; the remaining used caregiver self-reported measures of stimulation or caregiver-child bonding/relationship. Overall, suboptimal diets, food insecurity, caregiver under- and overnutrition, anaemia and low vitamin B6 status were associated with less responsive caregiving and fewer opportunities for early learning. Providing anaemic or food-insecure caregivers with iron or food-based supplements positively altered caregiver-child interactions. Supplementation trials that did not specifically target undernourished caregivers found no effects on caregiving behaviours. More research specifically targeting undernourished caregivers is needed to understand how nutritional interventions might benefit caregiving. Interventions aimed at enhancing nurturing care should consider both caregiver and child nutrition as potential targets to improve outcomes for both children and their caregivers.