To determine if household food insecurity (HFI) is associated with the risk of developmental delays.

Cross-sectional study of a representative sample of children under 2 years old. Risk of developmental delays was assessed with the Denver Developmental Screening Test II. HFI was measured with the Brazilian Food Insecurity Measurement Scale. Multivariable logistic regression was used to test the association between HFI (food secure/insecure) and risk of developmental delays, adjusting for household, maternal and child variables.

Community Health Centers in the Federal District, Brazil.

1004 children under 2 years old.

Among participants, 15 % were at risk of developmental delays and about 40 % of children lived in food-insecure households. HFI was associated with the risk of developmental delays (adjusted OR 2·61; 95 % CI 1·42, 4·80) compared with food-secure households after adjusting for key confounders.

HFI was strongly associated with the risk of developmental delays in children under 2 years. Investments that prevent or mitigate HFI are likely to be key for improved human and national development.