Background: Underweight is a form of malnutrition that has become global public health concern over the past few decades. Underweight prevalence was reported to reach 91.2 million or 13.5% of children worldwide. Data from WHO, UNICEF, and World Bank showed that global coverage of exclusive breastfeeding was still low, only 40% of children. The purpose of this study was to analyze the effect of exclusive breastfeeding on underweight in children under five using meta-analysis. Subject and Method: Systematic review was carried out by searching articles from PubMed, SCOPUS, DOAJ, BASE, EBSCO, Emerald, ProQuest, ScienceDirect, Re-searchGate, and Google Scholar databases. This study sought observational study with multivariate adjusted odds ratio (AOR) analysis. Underweight was defined as weight for age (WAZ) Z score <-2. Meta-analysis study was run on RevMan 5 with fixed and random effects model. Results: There were 10 articles with 3 study design selected for meta-analysis. Cross sectional, case-control, and cohort studies reported that exclusive breastfeeding reduced the risk of underweight in children under five (OR= 0.58; 95% CI= 0.23 to 1.43; p= 0.230), (OR= 0.33; 95% CI= 0.15 to 0.69; p= 0.004), and (OR= 0.77; 95% CI= 0.48 to 1.25; p= 0.210), respectively. There was publication bias in this study.
Conclusion:Exclusive breastfeeding reduces the risk of underweight in children under five.
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