TRANSITION FEEDING BRIEF

EAST AFRICA

UKRAINE

NATIVE AMERICAN

AFGHANISTAN

AN ASPHN BRIEF

COMPLEMENTARY FEEDING:
CHILDREN BORN TO AFGHAN FAMILIES

For the first time, the U.S. Departments of Agriculture and Health and Human Services included dietary recommendations for infants and toddlers in the 2020-2025 Dietary Guidelines for Americans, or DGA. ASPHN is providing these complementary feeding briefs to assist nutrition professionals in supporting families’ cultural preferences. Learn more below.

last update: 2024-08-05

INTRODUCTION

Two percent of nearly 6 million refugees from Afghanistan live in the U.S.* Afghan immigrants are less likely to be formally educated than the overall foreign-born and U.S.-born populations, and Afghan women are typically less educated and less likely to speak English than Afghan men. Immigrants arriving since 2010 are likely to speak Pashto (34%), Persian (Farsi) 31% and Dari (26%) as languages other than English spoken at home.

*According to mid-2020 United Nations Population division estimates

INTRODUCTION

Two percent of nearly 6 million refugees from Afghanistan live in the U.S.* Afghan immigrants are less likely to be formally educated than the overall foreign-born and U.S.-born populations, and Afghan women are typically less educated and less likely to speak English than Afghan men. Immigrants arriving since 2010 are likely to speak Pashto (34%), Persian (Farsi) 31% and Dari (26%) as languages other than English spoken at home.

*According to mid-2020 United Nations Population division estimates

RESEARCH SUMMARY

  • Afghanistan has one of the world’s highest rates of stunting in children under age 5: 41%.
  • After years of war, only 47.7% of Afghan babies are exclusively breastfed in their first six months (2023 data). Their exposure to contaminated liquids or foods places them at a greater risk of life-threatening illnesses such as diarrhea and pneumonia.
  • Poverty, relocation, isolation and stress decrease the likelihood of exclusive, successful breastfeeding. Oftentimes the maternal support system is disrupted and very young mothers are overwhelmed by stress and anxiety.
  • Only 12% of Afghan children aged 6 – 24 months receive an appropriate variety of food in amounts needed for their age. Most do not receive any fruit or vegetables on a given day.
  • Knowledge of good diets remains limited. Mothers are typically not aware of their own nutritional needs and are equally malnourished.
  • For many Afghan refugees, food choices are restricted by Islamic law to halal foods – those that adhere to Islamic law. Lack of availability of halal foods may compound the likelihood of food insecurity in some relocation areas.

BREASTFEEDING PRACTICES OBSERVED IN AFGHAN IMMIGRANTS TO THE U.S.

BREASTFEEDING IS ENCOURAGED IN ISLAM, and in peace times, most Afghan women breastfeed for up to two years (as recommended in the Koran). However, potential breastfeeding issues for refugees include:

  • Afghan women may lack knowledge on how to maintain their supply of breast milk.
  • Women may stop breastfeeding their child when they perceive themselves to be in crisis or seriously ill.
  • Introduction of actual infant formula is not common in Afghanistan, unless the woman perceives she doesn’t produce enough breastmilk or unless recommended by the physician. Other less nutritious feedings may be substituted due to formula expense and low maternal education.
  • Vitamin D deficiencies are often seen in Afghan women, due to traditional religious dress and indoor lifestyle preventing sun exposure.

PUBLIC HEALTH NUTRITIONISTS REPORT learning that new Afghan arrivals to the U.S. may have already introduced infant formula in lieu of breastfeeding. Measuring powdered formula correctly can be challenging due to language barriers, so ready-to-feed formula may decrease errors.

COMPLEMENTARY FEEDING PERSPECTIVES OF AFGHAN IMMIGRANTS TO THE U.S.

TRADITIONALLY, solids are introduced at four to six months in this culture.

A COMMON FIRST FOOD IS FIRNI (custard pudding) and a puréed meat and vegetable soup (soft chicken or beef, rice, carrot, herbs and other vegetables).

ADDITION OF SUGAR TO DAILY BEVERAGES, including tea and milk, is common practice for Afghan children, so oral health care education is a valuable topic for parents and caregivers.

SOURCES

  1. Batalova J. Migration Policy Institute. Afghan immigrants in the United States. Accessed 06-04-2023.
  2. UNICEF. Malnutrition: Afghanistan’s silent emergency. Accessed 06-04-2023.
  3. Metro South Health. Afghan food and cultural profile: dietetic consultation guide. Accessed 07-25-2023.
  4. Goliaei Z, Gonzalez M, Pokhrel M, and Burke NJ. Post-resettlement food insecurity: Afghan refugees and challenges of the new environment. Int J Environ Res Public Health. 05/2023; 20(10): 5846.
  5. Première Urgence Internationale. A mother’s burden: The complex interrelation between breastfeeding, infant health and maternal well-being. Accessed 07-30-2023.