Exclusive Breastfeeding History Risk Factor Associated with Stunting of Children Aged 12–23 Months

Nurhalina Sari, Marlida Yuliza Manjorang, Zakiyah Zakiyah, Madeleine Randell


Stunting (low height-for-age) remains a global and national health problem because it increases the risk of disturbances in growth and development and mortality. Banjar Margo District, Tulang Bawang Regency, has the second-highest prevalence in Lampung Province, Indonesia. This study aimed to analyze the association of exclusive breastfeeding history and stunting in children aged 12–23 months in Banjar Margo District. This study used a cross-sectional design on 193 children aged 12–23 months. It was primary data conducted between April and May 2018 with a questionnaire. Data analysis was performed using the chi-square test and multiple logistic regression. The result showed that of 193 children, 29.5% were stunted. Children who were not exclusively breastfed were 3.1 times (95%CI = 1.5–6.4) more at risk of stunting than those exclusively breastfed, after controlling for mothers with low education and unemployment factors as confounding variables. Health promotion activities in primary/integrated health care should be focused not only on mothers but also on other people involved in child care, such as grandparents, at-home caregivers, and day carers.


children aged 12–23 months, exclusive breastfeeding, stunting

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 1. Weise A. WHA global nutrition targets 2025: low birth weight policy brief. Geneva: WHO Publication. 2012.

 2. Fikawati S, Syafiq A, Veratamala A. Gizi anak dan remaja. 1st ed. Jakarta: PT Raja Grafindo Persada. 2017. p. 376.

 3. de Onis M, Branca F. Childhood stunting: a global perspective. Maternal & Child Nutrition. 2016; 12 Suppl 1: 12–26.

 4. Lamid A. Masalah kependekan (stunting) pada anak balita: analisis prospek penanggulangannya di Indonesia. 1st ed. Bogor: IPB Press; 2015.

 5. United Nations International Children's Emergency Fund. Multiple indicator cluster survey (MICS); 2014 [cited 2019 Dec 18].

 6. World Health Organization. World health statistics 2018: monitoring health for the SDGs, sustainable development goals. World Health Organization. Geneva; 2018.

 7. Direktorat Jenderal Kesehatan Masyarakat Kementerian Kesehatan. Buku saku pemantauan status gizi dan indikator kinerja gizi tahun 2015; 2016.

 8. Direktorat Jenderal Kesehatan Masyarakat Kementerian Kesehatan. Hasil pemantauan status gizi (PSG) tahun 2016; 2017.

 9. Direktorat Jenderal Kesehatan Masyarakat Kementerian Kesehatan. Buku saku nasional pemantauan status gizi 2017; 2018.

 10. Badan Penelitian dan Pengembangan Kesehatan. Riset kesehatan dasar (Riskesdas) 2013; 2013.

 11. Badan Penelitian dan Pengembangan Kesehatan. Hasil utama riskesdas (basic health research) 2018. Jakarta: Kementerian Kesehatan Republik Indonesia. 2018.

 12. World Health Organization. Global nutrition targets 2025: stunting policy brief (WHO/NMH/NHD/14.3). Geneva: World Health Organization. 2014.

 13. Wahdah S, Juffrie M, Huriyati E. Faktor risiko kejadian stunting pada anak umur 6-36 bulan di wilayah pedalaman Kecamatan Silat Hulu, Kapuas Hulu, Kalimantan Barat. Jurnal Gizi dan Dietik Indonesia. 2011; 3 (2): 119–30.

 14. World Health Organization. Stunted growth and development framework. Geneva: World Health Organization. 2015. p. 4.

 15. Permadi MR, Hanim D, Kusnandar K, Indarto D. Early breastfeeding initiation and exclusive breastfeeding as risk factors of stunting children 6–24 months-old. Nutrition and Food Research. 2016; 39 (1): 9–14.

 16. Truc, TT. Statistics and sample size; 2018.

 17. Office E. Evaluation of UNICEF strategies and programmes to reduce stunting in children under 5 years of age; 2018.

 18. Shekar M, Kakietek J, Dayton EJ, Walters D. An investment framework for nutrition: executive summary. 2016. p. 1–6.

 19. Kumar A, Singh VK. A study of exclusive breastfeeding and its impact on nutritional status of child in EAG states. 2015; 445 (3): 435–45.

 20. Danaei G, Andrews KG, Sudfeld CR, Fink G, McCoy DC, Peet E, et al. Risk factors for childhood stunting in 137 developing countries: a comparative risk assessment analysis at global, regional, and country levels. PLoS Med. 2016; 13 (11): E1002164.

 21. Aryastami NK, Shankar A, Kusumawardani N, Besral B, Jahari AB, Achadi E. Low birth weight was the most dominant predictor associated with stunting among children aged 12–23 months in Indonesia. BMC Nutrition. 2017; 3 (1): 1–6.

 22. Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, et al. Why invest, and what it will take to improve breastfeeding practices?. Lancet. 2016; 387 (10017): 491–504.

 23. Abuya BA, Ciera J, Kimani-Murage E. Effect of mother's education on child's nutritional status in the slums of Nairobi. BMC Pediatrics. 2012; 12 (1): 80.

 24. Handayani F, Siagian A, Aritonang EY. Mother's education as a determinant of stunting among children of age 24 to 59 months in North Sumatera Province of Indonesia. IOSR JHSS. 2017; 22 (6): 58–64.

 25. Uliyanti Uliyanti, Tamtomo DG, Anantanyu S. Faktor yang berhubungan dengan kejadian stunting pada balita usia 24-59 bulan. Jurnal Kesehatan Vokasional. 2017; 3 (2): 13–9.

 26. Manggala AK, Kenwa KW, Kenwa MM, Jaya AA, Sawitri AA. Risk factors of stunting in children aged 24-59 months. Paediatrica Indonesiana. 2018; 58 (5): 205–12.

 27. Nshimyiryo A, Hedt-Gauthier B, Mutaganzwa C, Kirk CM, Beck K, Ndayisaba A, et al. Risk factors for stunting among children under five years: a cross-sectional population-based study in Rwanda using the 2015 demographic and health survey. BMC Public Health. 2019; 19(1): 1–10.

 28. Shine S, Tadesse F, Shiferaw Z, Mideksa L, Seifu W. Prevalence and associated factors of stunting among 6–59 months children in pastoral community of Korahay Zone, Somali Regional State, Ethiopia 2016. Journal of Nutritional Disorders and Therapy. 2017; 07 (1).

DOI: http://dx.doi.org/10.21109/kesmas.v16i1.3291


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