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. 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!”