Food insecurity reaches seven in ten lactating mothers in northwest Ethiopia
Food insecurity affected 70.9% of lactating mothers in Ankesha Guagusa Woreda, a striking prevalence that places maternal nutrition at the center of postnatal care in this rural part of northwest Ethiopia. The community-based cross-sectional study captured a period when lactation increases both calorie demand and micronutrient need, yet household access to adequate food remained constrained for most participants. In practical terms, the finding means many mothers were trying to sustain breastfeeding while living with a diet that could not reliably meet the biological cost of milk production.
Lactation is not a marginal nutritional state. It increases energy requirements, raises the need for protein and micronutrients, and makes inconsistent food access more likely to translate into maternal depletion, fatigue, and reduced dietary quality. The study framed food insecurity as limited or uncertain access to nutritious, adequate, and safe food, and used an eight-item Food Insecurity Experience Scale to measure maternal experience. With a final sample size of 464 and analysis performed through bivariable and multivariable logistic regression, the data point to a burden that is both common and patterned by social and clinical risk.
Rural residence and illness clustered with higher risk
Residence mattered. Mothers living in rural areas had nearly twice the odds of food insecurity compared with their non-rural counterparts (AOR = 1.97; 95% CI 1.2, 3.2). In a setting like Ankesha Guagusa Woreda, rural households often face longer distances to markets, more seasonal price pressure, and a thinner margin for dietary substitution when staple foods become scarce. Those constraints are not abstract; they shape what ends up on the plate and how often a family can buy food in socially acceptable ways.
Illness also carried weight. Mothers who reported an illness had higher odds of food insecurity (AOR = 1.72; 95% CI 1.11, 2.68). Clinical burden can erode food security through several pathways at once: reduced capacity to work, higher direct household spending on care, and poorer appetite or dietary tolerance. For lactating women, sickness adds another layer because the body is already supplying nutrients to an infant. A single illness episode can therefore push an already stretched household into a sharper nutritional deficit.
The dietary signal around vitamin A-rich foods was equally clear. Mothers who did not consume vitamin A-rich vegetables, roots, or tubers had higher odds of food insecurity (AOR = 1.99; 95% CI 1.06, 3.73). This association likely reflects more than one nutrient gap. When families cannot access diverse plant foods, the problem usually extends beyond a single vitamin to a broader pattern of diet monotony, lower food quality, and reduced resilience against seasonal shortages.
Meal frequency and dairy intake tracked with lower odds
Two protective factors stood out. Mothers who ate more than three meals per day had substantially lower odds of food insecurity (AOR = 0.34; 95% CI 0.14, 0.76). Frequent meals often serve as a marker of steadier food access, but they may also reflect household routines that allow better distribution of limited supplies across the day. For a breastfeeding mother, that pattern is clinically relevant because repeated intake supports maternal energy balance and may reduce the risk of skipping meals during household shortages.
Consumption of milk and milk products was also inversely associated with food insecurity (AOR = 0.5; 95% CI 0.3, 0.9). Dairy foods provide concentrated energy, high-quality protein, calcium, and other micronutrients that are especially useful during lactation. Their presence in the diet can signal both purchasing power and access to local supply chains, especially in communities where dairy availability depends on household assets, livestock, or cooperatives. A mother who can regularly consume milk is often living in a household with a little more flexibility when food prices tighten.
The contrast between these protective factors and the rural burden is sharp. A mother who lives far from markets, falls ill, and cannot regularly consume nutrient-dense foods is exposed to multiple layers of nutritional instability at the same time. For breastfeeding, that instability matters because maternal diet influences whether the household can sustain the biologic and social work of lactation without collapse into chronic undernutrition.
Why this matters for postnatal care and community nutrition
The findings point toward interventions that fit the local pattern of risk rather than generic food aid alone. Health extension workers can screen for maternal illness during postnatal visits, because illness and food insecurity appear to travel together. Remote rural kebeles deserve special attention during lean cycles, when household food stores are low and market access becomes most fragile. Those are the moments when food access failures become most visible and most dangerous.
Community-based dairy cooperatives could strengthen local access to milk and milk products while also buffering seasonal variability in supply. Home gardens focused on vitamin A-rich vegetables, roots, and tubers may offer a second route to dietary improvement, especially where market dependence is high and cash income is unpredictable. Both strategies are grounded in the study’s observed associations: better access to dairy and vitamin A-rich foods tracked with lower odds of food insecurity.
There is also a broader maternal health lesson here. Food insecurity during lactation is not just a household economics issue; it is a maternal nutrition problem with consequences for recovery after delivery, breastfeeding sustainability, and day-to-day functioning. When a woman is forced to ration meals during the period of highest nutritional demand, the cost is borne by both mother and child.
Local prevalence, local action
The study’s value lies in its specificity. It does not simply confirm that food insecurity exists; it maps where and among whom it is most likely to persist in a highland, community-based setting. The prevalence of 70.9% is high enough to demand routine attention in maternal services, and the associated factors are concrete enough to support field-level response. Rural residence, illness, lower meal frequency, lack of vitamin A-rich foods, and lower dairy intake form a recognizable risk cluster.
The data were collected between July 1 and August 30, 2025, and analyzed from a final sample of 464 lactating mothers. Ethical approval, written consent, and confidentiality procedures were in place, including parental or guardian consent for participants under 18 years. Those safeguards matter, but they do not soften the central finding: in this Ethiopian woreda, food insecurity is common among lactating mothers and tightly linked to access, illness, and diet quality.
The study leaves one immediate clinical question open: how quickly can local maternal services translate these risk markers into practical screening and nutrition support before another lactation cycle begins under the same constraints?