3547487
The effect of maternal common mental disorders on infant undernutrition in Butajira, Ethiopia: The P-MaMiE study
BackgroundAlthough maternal common mental disorder (CMD) appears to be a risk factor for infant undernutrition in South Asian countries, the position in sub-Saharan Africa (SSA) is unclearMethodsA population-based cohort of 1065 women, in the third trimester of pregnancy, was identified from the demographic surveillance site (DSS) in Butajira, to investigate the effect of maternal CMD on infant undernutrition in a predominantly rural Ethiopian population. Participants were interviewed at recruitment and at two months post-partum. Maternal CMD was measured using the locally validated Self-Reported Questionnaire (score of ≥ six indicating high levels of CMD). Infant anthropometry was recorded at six and twelve months of age.ResultThe prevalence of CMD was 12% during pregnancy and 5% at the two month postnatal time-point. In bivariate analysis antenatal CMD which had resolved after delivery predicted underweight at twelve months (OR = 1.71; 95% CI: 1.05, 2.50). There were no other statistically significant differences in the prevalence of underweight or stunted infants in mothers with high levels of CMD compared to those with low levels. The associations between CMD and infant nutritional status were not significant after adjusting for pre-specified potential confounders.ConclusionOur negative finding adds to the inconsistent picture emerging from SSA. The association between CMD and infant undernutrition might be modified by study methodology as well as degree of shared parenting among family members, making it difficult to extrapolate across low- and middle-income countries.
131470190
Repositioning nutrition as central to development: a strategy for large-scale action
2003 Author: DeJong, Joycelyn Classification no: Prevention Collection: Open Shelves Accession no: PR BS/581 Type of material: Book Publication details: London: ITDG Publishing Physical description: xvi, 176p.: ill.
3910132
Maternal and child undernutrition: global and regional exposures and health consequences
Maternal and child undernutrition is highly prevalent in low-income and middle-income countries, resulting in substantial increases in mortality and overall disease burden. In this paper, we present new analyses to estimate the effects of the risks related to measures of undernutrition, as well as to suboptimum breastfeeding practices on mortality and disease. We estimated that stunting, severe wasting, and intrauterine growth restriction together were responsible for 2·2 million deaths and 21% of disability-adjusted life-years (DALYs) for children younger than 5 years. Deficiencies of vitamin A and zinc were estimated to be responsible for 0·6 million and 0·4 million deaths, respectively, and a combined 9% of global childhood DALYs. Iron and iodine deficiencies resulted in few child deaths, and combined were responsible for about 0·2% of global childhood DALYs. Iron deficiency as a risk factor for maternal mortality added 115 000 deaths and 0·4% of global total DALYs. Suboptimum breastfeeding was estimated to be responsible for 1·4 million child deaths and 44 million DALYs (10% of DALYs in children younger than 5 years). In an analysis that accounted for co-exposure of these nutrition-related factors, they were together responsible for about 35% of child deaths and 11% of the total global disease burden. The high mortality and disease burden resulting from these nutrition-related factors make a compelling case for the urgent implementation of interventions to reduce their occurrence or ameliorate their consequences.
155017005
Urbanization and caregiving: a framework for analysis and examples from southern and eastern Africa
This paper considers the role of caregiving on children's health and development with a special focus on identifying the constraints on effective caregiving in urban areas, and the potential solutions. It uses the extended UNICEF framework for nutrition which suggests that there are six major types of care behaviour: feeding and breast-feeding, food preparation and handling, hygiene behaviour, psycho-social care, care for women and home health practices. To ensure adequate care for the child, the caregiver needs adequate knowledge and education, physical and mental health, autonomy in decision-making, time, and social support from the family and community. This paper describes each of these resources and constraints, and two of the behaviour types (breast-feeding and health care utilization) in the urban areas of eight countries in eastern and southern Africa. It also presents a matrix highlighting critical constraints on caregiving behaviours in urban areas, and potential solutions, and identifies areas where further research is needed.
1771871
Maternal depression and low maternal intelligence as risk factors for malnutrition in children: a community based case-control study from South India
Aims: To determine whether current and postpartum maternal depression and low maternal intelligence are risk factors for malnutrition in children. Methods: In rural South India 72 children with malnutrition were identified from a central register; 72 controls were matched for age, gender, and residence. Results: Major depression in the postpartum period (OR 5.0, 95% CI 1.0 to 24.0), current major depression (OR 3.2, 95% CI 1.1 to 9.5), and low maternal intelligence (OR 3.8, 95% CI 1.3 to 11.1) were associated with malnutrition in the child. Low birth weight (OR 2.9, 95% CI 1.2 to 6.8) was also significantly associated with infant malnutrition. Conditional logistic regression adjusting for all other determinants yielded the following results: major depression during the postpartum period (OR 7.8; 95% CI 1.6 to 38.51), current major depression (OR 3.1; 95% CI 0.9 to 9.7), low maternal intelligence (OR 4.6; 95% CI 1.5 to 14.1), and low birth weight (OR 2.7; 95% CI 2.5 to 6.8). The interactions between current maternal depression and low birth weight and between postpartum depression and low maternal intelligence were statistically significant. The level of maternal intelligence was associated with nutritional status. The severity of malnutrition was also significantly associated with major depression during the postpartum period and low maternal intelligence. Conclusion: There is evidence for an association between postpartum maternal depression, low maternal intelligence, and low birth weight with malnutrition in children aged 6–12 months.
1128137
Mental health of the mothers of malnourished children.
BACKGROUND
The objective of this study is to measure the association between protein-energy malnutrition (PEM) in children and their mothers' mental health, in a low income area in the city of Embú, São Paulo, Brazil.


METHODS
A case-control study was performed. Cases were 60 moderately and severely malnourished children (Gomez criteria) selected from two primary health care units. Controls consisted of 45 eutrophic children attending the same units. The main outcome measure was for the mothers to present a mental health score > 6 according with the 'Adult Psychiatric Morbidity Questionnaire' (QMPA), a psychiatric screening instrument.


RESULTS
Of mothers of children with PEM, 63% and 38% of mothers in the control group were QMPA positive: odds ratio (OR) = 2.8 (95% confidence interval [CI]: 1.2-6.9). Of PEM children, 27% had low birthweight (LBW = < 2500 g) and 6% of the control group had LBW. Interactions were found between: mothers' mental health and number of children (with > or = 4 children: OR = 20.0 [95% CI: 2.1-274.2], with < or = 3 children: OR = 1.6 [95% CI: 0.6-4.5), as well as mothers' mental health and maternal age (in women > 30: OR = 12.5 [95% CI: 2.0-93.4], in women < or = 30: OR = 1.5 [95% CI: 0.5-4.4].


CONCLUSIONS
Mothers of children with PEM showed a higher rate of mental disturbances than mothers of eutrophic children. Unlike LBW, maternal age and number of children interact with mothers' mental health, increasing the association. Management of poor mental health may lead to mothers being better caretakers of their children and this may have a positive impact on PEM.
15501731
Postnatal depression and infant growth and development in low income countries: a cohort study from Goa, India
Background: Postnatal depression is a recognised cause of delayed cognitive development in infants in developed countries. Being underweight is common in South Asia. Aims: To determine whether postnatal depression contributes to poor growth and development outcomes in Goa, India. Methods: Cohort study for growth outcomes with nested case-control study for developmental outcomes. A total of 171 babies were weighed and measured at 6–8 weeks following birth. The following measures were used: Edinburgh Postnatal Depression Scale for maternal mood, and sociodemographic and infant health variables. Outcome measures were: weight (<5th centile), length (<5th centile), and Developmental Assessment Scale for Indian Infants scores at six months. Results: Postnatal depression was a strong, and independent, predictor of low weight and length and was significantly associated with adverse mental development quotient scores. Conclusions: This study provides evidence for the first time that postnatal depression, a potentially treatable disorder, is a cause of poor growth and development in South Asia.
27277734
Maternal depressive symptoms and infant growth in rural Bangladesh.
BACKGROUND
Depressive disorders are a major source of disability among low-income mothers in developing countries.


OBJECTIVES
The objectives were to examine the association of maternal depressive symptoms and infant growth among infants in rural Bangladesh and to examine how the relation is affected by infant irritability and caregiving practices.


DESIGN
Infant growth was measured among 221 infants at 6 and 12 mo. Mothers reported their depressive symptoms and perceptions of their infant's temperament, and a home observation of caregiving was conducted.


RESULTS
At 6 mo, 18% of infants were stunted (length-for-age < -2 z scores). At 12 mo, 36.9% of infants were stunted; infants of mothers with depressive symptoms had a 2.17 higher odds of being stunted (95% CI: 1.24, 3.81; P = 0.007) than did infants of mothers with few symptoms (45.3% compared with 27.6%). In a multivariate regression analysis, maternal depressive symptoms were associated with 12-mo length-for-age, adjusted for 6-mo length-for-age, maternal education, infant sex, birth order, receipt of iron and zinc, months breastfed, maternal perception of infant temperament, and caregiving observations. Maternal depressive symptoms were not related to 12-mo weight-for-length. The relation between depressive symptoms and infant growth was not moderated by maternal perceptions of infant temperament, but was partially mediated by caregiving.


CONCLUSIONS
The finding that infants of mothers with depressive symptoms in Bangladesh experience poor linear growth may extend to other low-income countries with high rates of food insecurity. Interventions to promote growth in infants should include prevention or treatment of maternal depressive disorders and strategies to ensure adequate food security.
25650963
Impact of postnatal depression on infants' growth in Nigeria.
BACKGROUND
The contribution of maternal postnatal depression to infant growth and under-nutrition in Africa has not been well studied. This study aims to examine the impact of postnatal depression (PND) on infants' physical growth in the first 9 months of life in Nigeria.


METHODS
A longitudinal case controlled study in which 242 women (consisting of 120 depressed and 122 matched non-depressed postpartum women) had their infants' weight and length measured at the 6th week, 3rd month, 6th month and 9th month after delivery. Discontinuation with breastfeeding and illnesses like diarrhoea, persistent vomiting, fever and cough were also recorded at these periods.


RESULTS
Infants of depressed mothers had statistically significant poorer growth than infants of non-depressed mothers at the 3rd month (weight OR 3.41, 95% CI 1.30-8.52; length OR 3.28, 95% CI 1.03-10.47) and the 6th month postpartum (weight OR 4.21, 95% CI 1.36-13.20; length OR 3.34, 95% CI 1.18-9.52). Depressed mothers were more likely to stop breastfeeding earlier and their infants more likely to have episodes of diarrhoea and other infectious illnesses.


LIMITATIONS
Psychiatric interview was conducted only once (at 6 weeks postpartum), our sample size was moderate and we did not account for mothers who had been depressed in pregnancy.


CONCLUSION
Prevention of postnatal depression and close monitoring of the growth of infants of depressed mothers should be integrated into maternal and child health policies in this region.
11587020
Maternal mental health and child nutritional status in four developing countries
Objective: To test the hypothesis that maternal common mental disorders (CMD) are associated with poorer child nutritional status in four developing countries (Ethiopia, India, Vietnam, and Peru). Design: Community based cross sectional survey in 20 sites in each of the four countries. Maternal CMD measured by the self reporting questionnaire 20 items (SRQ20). Potential confounding factors include: household poverty, household composition, maternal characteristics such as age and education, child characteristics such as birth weight, age, and sex. Possible mediating factors included the child’s physical health and breast feeding status. Setting: Urban and rural, poor and middle income areas in each country. Participants: 2000 mothers and their children aged 6–18 months in each country. Main outcome measures: Child stunting and underweight measured using standard anthropometric techniques. Results: Levels of maternal CMD and child malnutrition are high in each study setting. After adjusting for confounding factors, the odds ratios (OR) for the association of maternal CMD with child stunting are: India 1.4 (95%CI 1.2 to 1.6), Peru 1.1 (0.9 to 1.4), Vietnam 1.3 (0.9 to 1.7), and Ethiopia 0.9 (0.7 to 1.2). For child underweight, the confounder adjusted ORs are: India 1.1 (0.9 to 1.4), Peru 0.9 (0.6 to 1.2), Vietnam 1.4 (1.1 to 1.8), and Ethiopia 1.1 (0.9 to 1.4). No clear evidence for effect modification by the child’s age or sex was found. Possible mediating factors for the effect of maternal CMD on child malnutrition did not provide strong suggestions for potential mechanisms. Conclusions: There was a relation between high maternal CMD and poor child nutritional status in India and Vietnam. However, the findings from Peru and Ethiopia do not provide clear evidence for a similar association being present in non-Asian countries. Regardless of the direction of the relation, child nutrition programmes in Asia should consider incorporating promotion of maternal mental health.
23945037
Maternal depressive symptoms, parenting self-efficacy, and child growth.
OBJECTIVES
We assessed whether maternal depressive symptoms and parenting self-efficacy were associated with child growth delay.


METHODS
We collected data from a random sample of 595 low-income mothers and their children aged 6 to 24 months in Teresina, Piauí, Brazil, including information on sociodemographic characteristics, mothers' depressive symptoms and parenting self-efficacy, and children's anthropometric characteristics. We used adjusted logistic regression models in our analyses.


RESULTS
Depressive symptoms among mothers were associated with 1.8 times higher odds (95% confidence interval [CI] = 1.1, 2.9) of short stature among children. Parenting self-efficacy was not associated with short stature, nor did it mediate or modify the relationship between depressive symptoms and short stature. Maternal depressive symptoms and self-efficacy were not related to child underweight.


CONCLUSIONS
Our results showed that among low-income Brazilian families maternal depressive symptoms, but not self-efficacy, were associated with short stature in children aged 6 to 24 months after adjustment for known predictors of growth.
35983843
Post-partum depression and the mother-infant relationship in a South African peri-urban settlement.
BACKGROUND
Post-partum depression in the developing world has received little research attention, and its association with disturbances in the mother-infant relationship is unknown.


AIMS
To determine the prevalence of post-partum depression and associated disturbances in the mother-infant relationship in Khayelitsha, a South African peri-urban settlement.


METHOD
The mental state of 147 women who had delivered two months previously was assessed, and the quality of their engagement with their infants was determined.


RESULTS
The point prevalence of DSM-IV major depression was found to be 34.7%. Maternal depression was associated with poor emotional and practical support from the partner. It was also associated with insensitive engagement with the infants.


CONCLUSIONS
The rate of post-partum depression in Khayelitsha was around three times that found in British post-partum samples, and these depressions were strongly associated with disturbances in the mother-infant relationship.
33387796
The mother-infant relationship and infant attachment in a South African peri-urban settlement.
A sample of 147 mother-infant dyads was recruited from a peri-urban settlement outside Cape Town and seen at 2- and 18-months postpartum. At 18 months, 61.9% of the infants were rated as securely attached (B); 4.1% as avoidant (A); 8.2% as resistant (C); and 25.8% disorganized (D). Postpartum depression at 2 months, and indices of poor parenting at both 2 and 18 months, were associated with insecure infant attachment. The critical 2-month predictor variables for insecure infant attachment were maternal intrusiveness and maternal remoteness, and early maternal depression. When concurrent maternal sensitivity was considered, the quality of the early mother-infant relationship remained important, but maternal depression was no longer predictive. Cross-cultural differences and consistencies in the development of attachment are discussed.
1265827
Effect of maternal mental health on infant growth in low income countries: new evidence from South Asia
Impaired infant growth, a major problem in South Asia, may require interventions to improve maternal mental health in addition to current interventions targeting infant nutrition 

Unicef estimates that over 220 million children aged less than 5 years in the developing world have significantly impaired growth.1 The South Asian region is perhaps worst affected, being home to more than half of all the underweight children in the world.2 This article considers the relevance of new evidence on the epidemiology and impact of postnatal depression in South Asia on poor infant growth in low income countries. This evidence shows, for the first time, that a common and potentially treatable mental health problem in mothers is one of the causes of infant failure to thrive. We use this evidence to present a case that child focused interventions, largely aiming to provide supplementary nutrition, may need to be combined with mother focused interventions that target maternal mental health.

Postnatal depression is depressive disorder occurring in the postnatal period and is typically diagnosed about 4-12 weeks after childbirth (see box).

Several recent studies from South Asia have documented substantial rates of postnatal depression.3–6 Patel et al's cohort study of women attending a district hospital antenatal clinic in Goa, India, reported a prevalence of 23%.4 Chandran et al's community cohort study from Tamil Nadu, India, documented prevalence and incidence of 19.8% and 11%, respectively.3 Rahman et al's community cohort study from Pakistan reported a prevalence of 28%.6 These studies also showed that depressed mothers had significantly higher levels of disability, and that more than half remained ill for at least six months.

Consistent risk factors for postnatal depression were antenatal psychiatric morbidity, economic deprivation, low education, and marital disharmony. Education, support from extended family members, and employment were …
10239434
Association between antenatal depression and low birthweight in a developing country
Objective:  There is a high prevalence of depression in south Asian women. We aimed to examine the association between antenatal depression and low birthweight (LBW) in infants in a rural community in Rawalpindi, Pakistan.
948424
Maternal psychological morbidity and low birth weight in India
Summary Depression following childbirth is associated with poor child growth in developing countries. We describe the association between psychological morbidity during pregnancy and low birth weight (<2.5 kg). A cohort of 270 mothers was recruited from a district hospital in Goa, India; all mothers were interviewed with a screening questionnaire for psychological morbidity. Babies of 250 mothers were reviewed at birth to measure their weight. Excluding 5 premature babies, we found that maternal psychological morbidity was independently associated with low birth weight (odds ratio 1.44, 95% CI 1.00–2.07). We conclude that maternal psychological morbidity has an adverse impact on foetal growth.
16614613
The impact of maternal experience of violence and common mental disorders on neonatal outcomes: a survey of adolescent mothers in Sao Paulo, Brazil
BackgroundBoth violence and depression during pregnancy have been linked to adverse neonatal outcomes, particularly low birth weight. The aim of this study was to investigate the independent and interactive effects of these maternal exposures upon neonatal outcomes among pregnant adolescents in a disadvantaged population from Sao Paulo, Brazil.Methods930 consecutive pregnant teenagers, admitted for delivery were recruited. Violence was assessed using the Californian Perinatal Assessment. Mental illness was measured using the Composite International Diagnostic Interview (CIDI). Apgar scores of newborns were estimated and their weight measured.Results21.9% of mothers reported lifetime violence (2% during pregnancy) and 24.3% had a common mental disorder in the past 12 months. The exposures were correlated and each was associated with low education. Lifetime violence was strongly associated with Common Mental Disorders. Violence during pregnancy (PR = 2.59(1.05–6.40) and threat of physical violence (PR = 1.86(1.03–3.35) and any common mental disorders (PR = 2.09 (1.21–3.63) (as well as depression, anxiety and PTSD separately) were independently associated with low birth weight.ConclusionEfforts to improve neonatal outcomes in low income countries may be neglecting two important independent, but correlated risk factors: maternal experience of violence and common mental disorder.
58223547
Maternal depression increases infant risk of diarrhoeal illness: a cohort study
Maternal depression increases infant risk of diarrhoeal illness: a cohort study . Rahman A., Bunn J., Lovel H. & Creed F. ( 2007 ) Archives of Disease in Childhood , 92 , 24 – 28 . 
 
 
 
Aims  To examine the associations between post-natal depression in mothers and diarrhoeal illness in their infants in the first year of life in a low-income country. 
 
 
 
Methods  Using a prospective cohort design, 265 infants (n = 130 of mothers having a depressive episode according to the International Classification of Diseases, 10th revision, at 3 months post-natal and n = 135 of psychologically well mothers), living in rural Rawalpindi, Pakistan, were followed up for 1 year. Frequency of diarrhoeal episodes was measured fortnightly by health workers using a standard questionnaire. 
 
 
 
Results  Infants of depressed mothers had significantly more diarrhoeal episodes per year than those of controls (mean 5.5 vs. 4.0; 95% CI 0.9–2.0). The relative risk of having ≥5 diarrhoeal episodes per year in infants of depressed mothers was 2.3 (95% CI 1.6–3.1). The association remained significant after adjustment for other risk factors by multivariate analysis. 
 
 
 
Conclusions  Maternal depression is associated with infant diarrhoeal morbidity in a low-income community setting. It is independent of the effects of known factors such as under-nutrition, socio-economic status and parental education. Preventive child health programmes targeting mothers must consider their mental health.
9050123
Mothers of undernourished Jamaican children have poorer psychosocial functioning and this is associated with stimulation provided in the home
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
30342780
Impact of antenatal common mental disorders upon perinatal outcomes in Ethiopia: the P‐MaMiE population‐based cohort study
Objectives  To examine the impact of antenatal psychosocial stressors, including maternal common mental disorders (CMD), upon low birth weight, stillbirth and neonatal mortality, and other perinatal outcomes in rural Ethiopia.
2808155
Detecting perinatal common mental disorders in Ethiopia: validation of the self-reporting questionnaire and Edinburgh Postnatal Depression Scale.
BACKGROUND
The cultural validity of instruments to detect perinatal common mental disorders (CMD) in rural, community settings has been little-investigated in developing countries.


METHODS
Semantic, content, technical, criterion and construct validity of the Edinburgh Postnatal Depression Scale (EPDS) and Self-Reporting Questionnaire (SRQ) were evaluated in perinatal women in rural Ethiopia. Gold-standard measure of CMD was psychiatric assessment using the Comprehensive Psychopathological Rating Scale (CPRS). Community-based, convenience sampling was used. An initial validation study (n=101) evaluated both EPDS and SRQ. Subsequent validation was of SRQ alone (n=119).


RESULTS
EPDS exhibited poor validity; area under the receiver operating characteristic (AUROC) curve of 0.62 (95%CI 0.49 to 0.76). SRQ-20 showed better validity as a dimensional scale, with AUROC of 0.82 (95%CI 0.68 to 0.96) and 0.70 (95%CI 0.57 to 0.83) in the two studies. The utility of SRQ in detecting 'cases' of CMD was not established, with differing estimates of optimal cut-off score: three and above in Study 1 (sensitivity 85.7%, specificity 75.6%); seven and above in Study 2 (sensitivity 68.4%, specificity 62%). High convergent validity of SRQ as a dimensional measure was demonstrated in a community survey of 1065 pregnant women.


LIMITATIONS
Estimation of optimal cut-off scores and validity coefficients for detecting CMD was limited by sample size.


CONCLUSIONS
EPDS demonstrated limited clinical utility as a screen for perinatal CMD in this rural, low-income setting. The SRQ-20 was superior to EPDS across all domains for evaluating cultural equivalence and showed validity as a dimensional measure of perinatal CMD.
22076939
The prevalence and socio‐demographic correlates of khat chewing in Butajira, Ethiopia
A house‐to‐house survey was carried out in a rural Ethiopian community to determine the prevalence and socio‐demographic correlates of khat use. A total of 10 468 adults were interviewed. Of these, 58% were female, and 740/0 were Muslim. More than half of the study population (55.7%) reported lifetime khat chewing experience and the prevalence of current use was 50%. Among current chewers, 17.40/0 reported taking khat on a daily basis; 16.1% of these were male and 3.4% were female. Various reasons were given for chewing khat; 80% of the chewers used it to gain a good level of concentration for prayer. Muslim religion, smoking and high educational level showed strong association with daily khat chewing.
26210336
Maternal social and pyschological conditions and physical growth in low-income children in Piauí, Northeast Brazil.
Prevalence of child undernutrition remains high in many developing countries. In settings with scarce resources, modifiable maternal social conditions may influence feeding and parenting practices, in turn affecting child growth. This study aims to quantify the association between maternal social support and depression to children's physical growth outcomes in Teresina, Piauí, northeast Brazil. Interviews were conducted with a random sample of 595 mothers of children 6-24 months old in four low-income sections of Teresina, Piauí. We collected data on sociodemographic factors, mothers' social support, mothers' depressive symptomatology, and child's weight and recumbent length. Weight-for-height z-scores (WHZ), height-for-age z-scores (HAZ) and weight-for-age z-scores (WAZ) were calculated using the National Center for Chronic Disease Prevention and Health Promotion Center SAS program based on the 2000 Centers for Disease Control reference growth curves. Multivariable linear regression was used to model the association between maternal social support and depression to child growth, adjusting for biological and socio-demographic variables. Interviewer and neighborhood variation was accounted for through the inclusion of random effects. In adjusted models, material support, measured by number of friends or family members available to mothers when needing food or milk, was related to 0.3 higher average WHZ and 0.2 higher average WAZ in their children. Maternal positive social interaction, which reflects engagement in leisure-time activities with others, was associated with 0.3 higher average WHZ. Mothers' affectionate support was related to 0.2 higher average children's WHZ and WAZ, whereas social support for resolving a conflict was associated with 0.2 lower average HAZ. Maternal depression was not associated with child growth. It is concluded that inadequate growth in children may be sensitive to maternal social support.