Maternal mental health symptoms are positively associated with child dietary diversity and meal frequency but not nutritional status in Eastern Democratic Republic of Congo

Objective: The objective was to examine the association between symptoms of maternal mental health problems and child diet and nutritional status in South Kivu, Democratic Republic of Congo.Design: Maternal depression and anxiety symptoms were measured by the Hopkins Symptom Checklist-25 (HSCL-25), and post-traumatic stress was measured by the Harvard Trauma Questionnaire (HTQ). Participants were classified as having high psychological distress if their mean item score was in the upper quartile of both measures. Dependent variables included child dietary diversity, meal frequency, height-for-age z score (HAZ), weight-for-age z score (WAZ), weight-for-height z score (WHZ), stunting and underweight. Bivariate and multivariate regression analyses were conducted.Setting: The study was nested in a larger quasi-experimental study evaluating Jenga Jamaa II, a food and nutrition assistance project in Uvira and Fizi territories.Participants: In total, 812 mother-child pairs participated. Children ranged from 2·6 to 5·6 years of age.Results: HSCL-25 (β: 0·18, P < 0·05) and HTQ (β: 0·19, P < 0·05) were statistically significantly associated with higher dietary diversity scores, and all maternal mental health measures were associated with higher meal frequency (HSCL-25: β: 0·13, P = 0·001; HTQ: β: 0·12, P = 0·001; high distress: β: 0·15, P < 0·05) and consumption of at least three meals/snacks per day (HSCL-25: OR: 2·06, HTQ: OR: 1·93, high distress: OR: 2·68, P < 0·001 for all). No significant associations were found with HAZ, WAZ, WHZ, stunting or underweight indicators.Conclusions: More severe symptoms of maternal mental health problems were positively associated with child diet, but not anthropometry indicators. More research is needed to understand the role of maternal mental health in child feeding practices in food insecure and resource-poor settings.