Association of breastfeeding with undernutrition among children under 5 years of age in developing countries: A systematic review and meta‐analysis

Mardani, Raden Ahmad Dedy; Wu, Wan‐Ru; Nhi, Vo Thi; Huang, Hui‐Chuan

doi:10.1111/jnu.12799

Cited by 7 publications

(2 citation statements)

References 60 publications

(60 reference statements)

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“…We found the odds of OWOBM-SUWC to be lower in situations where the overweight or obese mother was currently breastfeeding. This affirms prior studies [ 36 , 41 ] that have established a strong negative association between breastfeeding practices and nutritional health outcomes among children under five. Thus, underscoring a need for sub-Saharan African countries to emphasize and improve breastfeeding practices among women.…”

Section: Discussionsupporting

confidence: 90%

Mother–child dyads of overnutrition and undernutrition in sub-Saharan Africa

Okyere,

Donkoh,

Seidu

et al. 2024

J Health Popul Nutr

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Background Malnutrition remains one of the major public health concerns globally. To achieve the Sustainable Development Goal 2 which seeks to ensure that hunger and malnutrition are reduced by 2030, it is imperative to ascertain the factors influencing their occurrence. This study examined the prevalence and factors associated with mother–child dyads of overnutrition and undernutrition in sub-Saharan Africa. Methods Demographic and Health Survey data from 25 sub-Saharan African countries were used for the study. The sample was made up of 125,280 mother–child dyads. Descriptive analysis was performed to determine the prevalence of overweight or obese mother (OWOBM) with a stunted child (OWOBM-SC), OWOBM with an underweight child (OWOBM-UC), OWOBM with a wasted child (OWOBM-WC), and OWOBM with any form of child’s undernutrition indicators (OWOBM-SUWC). Multilevel regression models were developed to examine the factors associated with these indicators. The results were presented using an adjusted odds ratio (AOR) with their respective 95% confidence interval (CI). Results Higher likelihood of OWOBM-SUWC was found among women aged 45–49 [AOR 2.20, 95% CI 1.70, 2.85], those with primary [AOR 1.32, 95% CI 1.21, 1.44] or secondary education [AOR 1.21, 95% CI 1.09, 1.35], and divorced women [AOR 1.32, 95% CI 1.02, 1.73]. However, lower odds of OWOBM-SUWC were observed among women who were working [AOR 0.82, 95% CI 0.76, 0.89] and those breastfeeding [AOR 0.75, 95% CI 0.70, 0.82]. The odds of OWOBM-SUWC was lower among females compared to male children [AOR 0.85, 95% CI 0.80, 0.90]. Compared to children aged <1 year, children of all other age groups were more likely to have OWOBM-SUWC. Other child characteristics significantly associated with OWOBM-SUWC were low birth weight [AOR 1.50, 95% CI 1.32, 1.71], having diarrhea [AOR 1.13, 95% CI 1.04, 1.24], and higher birth order [AOR 1.37, 95% CI 1.13, 1.66]. Children whose mothers used unimproved toilet facilities [AOR 0.90, 95% CI 0.83, 0.98], those who lived in rural areas [AOR 0.79, 95% CI 0.71, 0.87], and children from the Central [AOR 0.55, 95% CI 0.46, 0.65], Eastern [AOR 0.44, 95% CI 0.38, 0.52] and Western [AOR 0.76, 95% CI 0.65, 0.89] sub-Saharan Africa were less likely to have OWOBM-SUWC. Conclusion Combination of child, maternal, and contextual factors could explain mother–child dyads of overnutrition and undernutrition in sub-Saharan Africa. Addressing this situation requires multidimensional policies and interventions that empower women through education and economic engagement. The observed sub-regional differences in policies and commitments related to addressing malnutrition suggest the need for comprehensive and coordinated efforts to implement and strengthen multisectoral comprehensive nutrition plans across sub-Saharan Africa. Sharing best practices and lessons learned can help improve the effectiveness and comprehensiveness of nutrition interventions and contribute to reducing the prevalence of malnutrition.

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Section: Discussionsupporting

confidence: 90%

Mother–child dyads of overnutrition and undernutrition in sub-Saharan Africa

Okyere,

Donkoh,

Seidu

et al. 2024

J Health Popul Nutr

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“…Similar findings from studies suggest that exclusive breastfeeding may prevent youngsters from being stunted. 52 – 54 This may pertain to breastfeeding initiation and exclusivity for 6 months, which offer prevention against gastrointestinal illnesses that can cause severe nutritional deficiencies and stunting. 55 Breastmilk is easy to metabolize and supplies vital nutrients and vitamins required for optimal growth and development.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of stunting in children aged 6–59 months, an unresolved chronic nutritional problem in Ethiopia: A systematic review and meta-analysis

Abdilahi,

Osman,

Abate

2024

SAGE Open Medicine

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Background: In developing countries as well as Ethiopia, stunting continues to be a major public health burden. Thus, the aim of this systematic review and meta-analysis is to synthesize the updated pooled prevalence and its determinants of stunting in Ethiopia. Methods: This systematic review and meta-analysis follow the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The protocol has been registered with the International Prospective Register of Systematic Reviews, University of York Center for Reviews, and disseminated at https://www.crd.york.ac.uk/ , with the registration number (CRD42024542984). A wide-ranging literature search was carried out using PubMed/Medline, Science Direct, Hinari, AJOL, and Google Scholar. All lists of qualified study references from 2013 to 2023 were recovered. The pooled estimate with a 95% CI was calculated using a random-effects model in STATA version 13 software. I2 and meta-bias statistics were used to assess the heterogeneity of the incorporated studies. Results: This study included 29 articles with a total of 23,511 participants from 29 qualified studies. The current study found that the pooled prevalence of stunting among children aged 6–59 months was 43% (95% CI: 42–44). Children who were not exclusively breastfed (OR = 2.39; 95% CI: 1.61–3.54), male children (OR = 1.61; 95% CI: 1.13–2.31), children whose mothers had no antenatal care follow-up (OR = 3.03; 95% CI: 1.36–6.76), and women who had no formal education (OR = 4.55; 95% CI: 2.29–9.05) were significantly associated with stunting. Conclusions: In Ethiopia, nearly half of the children suffer from stunting, with those who are not breastfed, the sex of the child, children whose mothers had no antenatal care follow-up, and had no formal education having higher odds of stunting. To reduce the burden, strategies must be designed to intervene and improve maternal health literacy, focusing on children’s nutrition and health-care utilization.

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Causes and consequences of child growth faltering in low-resource settings

Mertens,

Benjamin-Chung,

Colford

et al. 2023

Nature

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Growth faltering in children (low length for age or low weight for length) during the first 1,000 days of life (from conception to 2 years of age) influences short-term and long-term health and survival1,2. Interventions such as nutritional supplementation during pregnancy and the postnatal period could help prevent growth faltering, but programmatic action has been insufficient to eliminate the high burden of stunting and wasting in low- and middle-income countries. Identification of age windows and population subgroups on which to focus will benefit future preventive efforts. Here we use a population intervention effects analysis of 33 longitudinal cohorts (83,671 children, 662,763 measurements) and 30 separate exposures to show that improving maternal anthropometry and child condition at birth accounted for population increases in length-for-age z-scores of up to 0.40 and weight-for-length z-scores of up to 0.15 by 24 months of age. Boys had consistently higher risk of all forms of growth faltering than girls. Early postnatal growth faltering predisposed children to subsequent and persistent growth faltering. Children with multiple growth deficits exhibited higher mortality rates from birth to 2 years of age than children without growth deficits (hazard ratios 1.9 to 8.7). The importance of prenatal causes and severe consequences for children who experienced early growth faltering support a focus on pre-conception and pregnancy as a key opportunity for new preventive interventions.

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Association of breastfeeding with undernutrition among children under 5 years of age in developing countries: A systematic review and meta‐analysis

Cited by 7 publications

References 60 publications

Mother–child dyads of overnutrition and undernutrition in sub-Saharan Africa

Mother–child dyads of overnutrition and undernutrition in sub-Saharan Africa

Epidemiology of stunting in children aged 6–59 months, an unresolved chronic nutritional problem in Ethiopia: A systematic review and meta-analysis

Causes and consequences of child growth faltering in low-resource settings

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