Objective This meta‐analysis was conducted to examine the association between breastfeeding and undernutrition among children under 5 years of age in developing countries. Study design Systematic review and meta‐analysis. Methods A comprehensive literature search was conducted of datasets from Embase, CINHAL, PubMed, Cochrane Library, and Indonesian databases to include eligible studies. Comprehensive Meta‐Analysis 3.0 statistical software was used to perform data entry and data analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were extracted from each study or were calculated based on the reported number of cases and controls in each study. Random‐effects models or fixed‐effects models were used to demonstrate overall risk estimates. A moderator analysis was conducted to examine possible moderators explaining the heterogeneity across studies. Findings In total, 33 studies were included which examined the association of breastfeeding with undernutrition. A random‐effects model showed that breastfeeding had inverse correlations with overall undernutrition (OR = 0.82, 95% CI = 0.68, 0.99) and the stunting type of undernutrition (OR = 0.73, 95% CI = 0.55, 0.95). A moderator analysis showed that studies which included exclusive breastfeeding and unclear birth weights had low risks of overall undernutrition (p < 0.05). Moreover, studies which included exclusive breastfeeding and adopted a case–control study design exhibited a low risk of the stunting type of undernutrition (p < 0.05). Conclusions Providing breastfeeding or exclusive breastfeeding can benefit children under 5 years of age in developing countries reduce overall undernutrition and the stunting type of undernutrition. Clinical relevance Healthcare professionals should develop and implement suitable strategies to increase awareness regarding the importance of breastfeeding and enhance breastfeeding and exclusive breastfeeding adherence.
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