Household water security and infant feeding practices in Mexico: insights from the ENSANUT 2021 survey.

BACKGROUND: Water security (WS) and improved socioeconomic conditions are crucial for child nutrition. However, limited research has explored the association between WS and infant and young child feeding (IYCF) practices in low- and middle-income countries. This study aimed to assess the relationship between household WS and IYCF practices in Mexican children aged 0-35 months. METHODS: Data from 939 children from the 2021 Mexican National Health and Nutrition Survey were analyzed. Logistic regressions assessed associations between WS and IYCF indicators, considering interactions by area type, region, and wealth tertile. FINDINGS: The final sample represents 5,256,872 children nationwide. Water insecurity affected 23.1% of children in the lowest wealth tertile and 36.4% of those in food-insecure households. Water-secure children had better IYCF practices: 95.7% had ever been breastfed, and 79.5% met minimum dietary diversity (MDD) and minimum meal frequency (MMF). Analytically, children in urban water-secure households were 72% less likely to have ever been breastfed than those in water-insecure households. Water-secure households in the southern region were 2.84 times more likely to meet MDD, while those in low-wealth conditions were 2.71 times more likely to achieve MMF (OR = 2.71, 95% CI: 1.13-6.52, p = 0.03). CONCLUSIONS: These findings highlight the complex role of WS in IYCF. While WS improves MDD and MMF, it may also influence breastfeeding patterns, particularly in urban areas where formula feeding is more common. Ensuring equitable access to safe water should be a priority, alongside strategies that promote and protect breastfeeding in different socioeconomic contexts.