Consumption of Micronutrient-Fortified Milk and Noodles is Associated with Lower Risk of Stunting in Preschool-Aged Children in Indonesia

Abstract

The consumption of fortified milk and noodles is associated with decreased odds of stunting among Indonesian children. These findings add to a growing body of evidence regarding the potential benefits of multiple micronutrient fortification on child growth.

A review of child stunting determinants in Indonesia

“…The same study also found an association between poor household environmental sanitation (inappropriate latrine facilities) and stunting in rural children 6–59 months (Bardosono et al, ). Similarly, Semba et al () observed that children 6–59 months in households with an improved latrine were less likely to be stunted in rural communities (UOR 0.81, 95% CI [0.79, 0.84]) and urban slums (UOR 0.85, 95% CI [0.81, 0.89]) than households with an unimproved latrine. In a recent study, purchase of inexpensive drinking water—which was assumed to be untreated—was associated with increased odds of stunting in children 0–59 months in urban slums (UOR 1.32, 95% CI [1.20, 1.45]; Semba et al, ).…”

“…A cross‐sectional analysis of the Indonesia Nutrition Surveillance System (NSS; 2000–2003), which includes nine rural provinces, found that households with mothers <145 cm tall were associated with an AOR of 2.32 (95% CI [2.25, 2.40]) of maternal and child double burden—defined as a household having a stunted child (6–59 months) and overweight mother—and mothers between 145.0 and 149.9 cm an AOR of 1.63 (95% CI [1.59, 1.68]) when compared with mothers ≥150 cm (Oddo et al, ). Semba, de Pee, Sun, et al (2008) also analysed data from the NSS (2000–2003) and found that higher maternal height was associated with reduced stunting in children 0–59 months (AOR per cm 0.917, 95% CI [0.915, 0.919]), whereas Semba et al (), using the same data, found an association between higher maternal height and reduced stunting in children 6–59 months in rural communities (UOR per cm 0.902, 95% CI [0.900, 0.904]) and urban poor communities (UOR per cm 0.898, 95% CI [0.894, 0.901]). Rachmi et al () conducted a secondary analysis of the repeated cross‐sectional Indonesian Family Life Survey (IFLS; 1993, 1997, 2000, and 2007), which includes 13 provinces, and found an AOR of stunting in children 24–59 months of 2.21 (95% CI [1.76, 2.78]) in mothers with a height‐for‐age Z ‐score (HAZ) <−2 of the WHO Standard Growth Reference for 19‐year‐olds versus mothers of normal height.…”

“…Three cross‐sectional studies showed a moderate association between younger maternal age and child stunting (Best et al, ; Semba et al, ; Semba, Kalm, et al, ). In these studies, the odds of women ≤24 years having a stunted child were between 1.09 and 1.23 greater than women ≥33 years.…”

“…Four studies found an association between maternal education and child stunting but did not report or include paternal education in their analyses (Berger et al, ; Fernald, Kariger, Hidrobo, & Gertler, ; Oddo et al, ; Schmidt et al, ). Three studies reported an association between both paternal and maternal education and child stunting but did not specify which association was stronger (Sari et al, ; Semba et al, ; Semba, Kalm, et al, ). Three studies found an association between paternal education and child stunting but a stronger association between maternal education and child stunting (Best et al, ; Rachmi et al, ; Semba, de Pee, Sun, et al, ).…”

Food Fortification for Addressing Iron Deficiency in Filipino Children: Benefits and Cost-Effectiveness

“…One study illustrated the effectiveness of fortified milk and noodles in reducing anemia in Indonesian children aged 6-59 months from a large sample of families (total of 81,885) living in rural and urban slum areas [44]. In this population, consumption of fortified milk and noodles was associated with a significant decrease in the odds of childhood anemia [44] and stunting [45]. A double-blind group-randomized trial assessed the effectiveness of a large-scale iron-fortified subsidized milk program in reducing the rates of anemia and iron deficiency in Mexican children between 12 and 30 months of age [46].…”