Association Between Breastfeeding and Child Stunting in Mexico

Abstract

Background: Globally, the prevalence of child stunting has been decreasing over the past decades. However, in low- and middle-income countries such as Mexico, stunting is still the most prevalent form of undernutrition affecting a large number of children in the most vulnerable conditions. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child stunting. Objective: To examine the association between breastfeeding (defined as never breastfed, any breastfeeding for <6 months, and any breastfeeding for ≥6 months) and other individual-, household-, and area-level factors with child stunting (defined as length/height-for-age-z-score for sex under –2 standard deviations of the World Health Organization child growth standards’ median) in Mexico. Methods: Secondary data analysis using the 2012 Mexican Health and Nutrition Survey, which allowed representativeness of rural and urban areas at national level and among 4 regions in Mexico. Our subset included data on 2,089 singleton Mexican children aged 6–35 months with information on previously identified risk and protective factors for stunting. We conducted fixed- and mixed-effects logistic regression models sequentially controlling for each level of factors. Findings: Overall, 12.3% of children were stunted and 71.1% were breastfed for ≥6 months. Any breastfeeding and being female were consistent protective factors against child stunting across all models. In contrast, child low birthweight, maternal short stature, higher number of children aged <5 years per household, and moderate to severe food insecurity were consistent risk factors for child stunting across all models. Conclusions: According to our findings, efforts to reduce child stunting in Mexico should include prenatal strategies aiming to prevent low birthweight offspring particularly among short-stature women, moderate to severe food insecure households, families with a higher number of children aged <5 years, and indigenous communities. Postnatal components should include multilevel strategies to support breastfeeding.

Factors Associated with Stunted Children

“…Based on the OR value, it can be said that non-exclusive breastfeeding may result in severe stunting 1.5 times greater than exclusive breastfeeding, but it is not significant when seen from the 95% CI value. This result is different than a study in Mexico which states that exclusive breastfeeding is a factor to protect children's health from stunting [13]. The results of other studies in South Sulawesi also stated that there was a link between exclusive breastfeeding and stunting [14].…”

“…Based on the OR value, it can be said that abnormal maternal posture may result in severe stunting 1.0 times greater than normal posture, but it is not significant when seen from the 95% CI value. This result is different than a study in Mexico which states that short maternal posture is a risk factor for stunted children [13]. Other experts argue that the maternal posture inherits genetically the posture of the child [15].…”

Identification and characterization of factors associated with short stature and pre-shortness in Chinese preschool-aged children

“…Secondly, birth order ≥ 2 was for the first time found to be positively associated with the risk for childhood short stature and pre-shortness. The possible explanation was that latter birth order means larger family size and the association of short stature with large family size was confirmed ( 37 , 38 ). It is hypothesized that children in the larger families are compatible with deprivation of parental care and love, which may affect psychological development or relatively worse family income contributing to limited linear growth of children.…”

The Influence of Factors of Breastfeeding and Food Consumption on Stunting Incidence among Preschool Children in Keerom District, Papua Province, Indonesia

“…Poor diet results in malnutrition in children, further exacerbated by micronutrient deficiencies, which can worsen the nutritional status and level of health of children [8]. Besides, breastfeeding has been identified as a modifiable health behavior to protect children from stunting [9], [10]. Lack of consumption of breast milk can have an effect on increasing the risk of growth and development in preschool children [11].…”

“…It causes the consumption factor to be further analyzed in the model structure analysis. In other words, the relationship between breastfeeding factors could be analyzed directly with nutritional status [10]. Breastfeeding is a priority given to children.…”