Maternal social networks and child nutrition in Belagavi, India: opportunities and risks

BACKGROUND: Strengthening mothers' social networks can help address child malnutrition and improve health outcomes. This is important in Belagavi district, India, where undernutrition and anaemia remain prevalent among children under five. However, social networks may also have unintended negative influences on child health, depending on their structure and the information and support they provide. OBJECTIVE: This study examines the association between maternal social networks, defined by the number of close friends, on child nutritional outcomes in Belagavi, Karnataka, India. METHODS: We used secondary cross-sectional data from the 2024 Health and Demographic Surveillance System catchment area of KAHER JNMC in Belagavi [KAHER HDSS]. A total of 595 children aged 0-61 months and their mothers were included. Descriptive analyses are reported as frequencies and percentages. Bivariable logistic regressions assessed associations between maternal social network [low < 3 friends; high ≥ 3 friends] and nutritional outcome. Multivariable logistic regressions were adjusted for child age, sex, birth order, maternal education, maternal age, and maternal occupation. RESULTS: About half of mothers [54%] had fewer than three close friends. A strong maternal social network was associated with lower odds of stunting, wasting, never breastfeeding, and delayed initiation of breastfeeding. However, it was associated with increased odds of underweight, anaemia, inappropriate introduction of complementary foods, and low birthweight. CONCLUSIONS: Maternal social networks were associated with both favourable and unfavourable child nutritional outcomes. Public health interventions should consider the complexity of these associations when designing strategies to improve child nutrition and minimise its unintended consequences.