Maternal employment, child care, and nutritional status of 12-18-month-old children in Managua, Nicaragua.

Relationships among women's employment, child care strategies, and nutritional status of children 12-18 months of age were examined in 80 Nicaraguan households sampled by randomized block design in 10 low income urban communities. Multiple regression analyses showed that children of employed mothers (56%) fared better in weight/height than those whose mothers were not employed, with and without controlling for socioeconomic status and maternal education, paternal financial support, child care adequacy, and sex and age of the child. Children with inadequate alternate child care (care by a preteen or care at the work place) had lower height for age, even controlling for the same variables and for maternal employment. Differences in 10 caregiving behaviors between families as a function of work status of the mother and adequacy of child care were examined. In families with working mothers, caregivers were less likely to be observed washing their hands, suggesting that the positive associations of work for earnings might be due to income rather than improved care. Inadequate care was associated with less food variety, less use of health care, and marginally less hand-washing. Inadequate child care, which tends to be associated with informal work, nuclear families and poverty, should be a concern for child welfare.