‘I Know You’re Angry With Me Right Now Because You’re Hungry’

Originally published on The New York Times.

 Infants and toddlers in food-insecure households were at higher risk for iron deficiency, experienced more hospitalizations and were generally in worse health than children who had enough to eat, according to data collected by Children’s HealthWatch, a network of public health researchers who study how economic conditions impact young children. But along with the physical health risks of so many children going hungry, parents and anti-hunger advocates are worrying about the longer-term impact on child development and the emotional health of families. Dr. Perez said stress is “skyrocketing” among the families in her study. In addition to the effort and risk that goes into procuring enough food for their children, she said, many parents reported going all day without eating so their children wouldn’t miss meals. It’s an understandable choice with potentially dire consequences, because even when children aren’t going hungry themselves, they still suffer as their hungry grown-ups struggle to be patient, present parents.

Mothers in food-insecure households were more likely to report depressive symptoms than mothers who had enough to eat, according to a 2018 review of 31 studies. And depressed moms were less likely to read stories, show affection and offer other interactions critical to a young child’s brain development, said Dr. Deborah Frank, M.D., a founder of Children’s HealthWatch and a professor who studies child health and well-being at Boston University School of Medicine. “Everyone is more worried, irritable, headache-y and lethargic when they aren’t getting enough to eat.”

Dr. Frank’s data also shows that children who experienced household food insecurity may have higher rates of attention issues, anxiety and behavioral outbursts. By age 5, she said, children are old enough to understand the pressures parents are facing. “They’ll try to squash the younger sibling from asking for seconds because there isn’t enough, or share their school lunches with parents,” she said. “Parents try to protect the children and children try to protect their parents.”

Dr. Megan Sandel, M.D., an associate professor of pediatrics at Boston University School of Medicine, is a director of the Grow Clinic for Children at Boston Medical Center, originally founded by Dr. Frank. The clinic treats children from mostly low-income families who have been diagnosed with failure to thrive, a common consequence of household hunger. Since the pandemic started, she said, children who had previously graduated from her program have returned because their families are worried they may fall off the growth curve again in the face of new food insecurity. And many of the families she works with are reporting an increase in behavioral outbursts and regression on milestones like potty training.

“One mom kept saying her 4-year-old was being mean to her, but what it came down to is, he is really anxious,” Dr. Sandel said. “He’s internalizing what’s going on, and he’s worrying about dragons and spiders coming to get him, so he wants to sleep in the bed with her.” Dr. Sandel worked with that mother to figure out a new bedtime routine for her child, because she said getting enough sleep is crucial for all children, but especially those struggling with missed meals and increased stress. “And if he wants to sleep in her bed, right now, I’m going to say that’s OK!”