Breastfeeding, feeding practices and stunting in indigenous Ecuadorians under 2 years of age

Abstract

Background The indigenous child population in Ecuador has a high prevalence of stunting. There is limited evidence of the association between breastfeeding, feeding practices, and stunting in indigenous children. This study aimed to analyze the prevalence of breastfeeding and complementary feeding practices and explore their association with stunting in Ecuadorian indigenous children under two years of age. Methods Cross-sectional study of secondary data analysis using the 2012 Ecuador National Health and Nutrition Study, in 625 children aged 0–23 months (48,069 expanded sample), representative for the indigenous population. Breastfeeding and complementary feeding indicators were analyzed by age groups. Timely initiation of breastfeeding (within one hour after birth), exclusive breastfeeding (infants under six months who received only breast milk for the previous day), and other indicators were measured. Chi-square test or Fisher's exact test and logistic regression for complex samples were used to explore association with demographic and socioeconomic factors and stunting. Results Twenty-six-point eight percent of the children were stunted. Stunting occurred mainly in children with rural residence, on poor households, and where there were four or more children. Most of the children had a timely initiation of breastfeeding (69.5% for 0–12 months and 75.5% for 13–23 months) and exclusive breastfeeding up to six months (78.2%). Among children between 6–12 months of age, 99.3% continued to be breastfed. In children from ages 6 to 12 months, 32.5% received food with adequate dietary diversity. Lower percentages of complementary feeding occurred in the poorest, adolescent mothers or those with less education. Children who did not receive the minimum frequency of meals for their age had higher odds of stunting (OR 3.28; 95% CI 1.3, 8.27). Children from age 19 to 23 months who consumed foods rich in iron showed lower probabilities of stunting (OR 0.04; 95% CI 0.00, 0.51). Conclusions Breastfeeding practices reached a prevalence of 70% or more, without being associated with stunting. Complementary feeding practices showed differences by socioeconomic condition. Not reaching the minimum meal frequency between 6 and 12 months of age was associated with stunting. Plans and strategies are necessary to promote adequate feeding and breastfeeding practices in the indigenous population.

Prevalence of breastfeeding among indigenous peoples of the Triple Frontier: Brazil, Argentina and Paraguay

“…A 93.4% prevalence of EBF in the first six months of life and 6.5% of complementary breastfeeding was detected, in agreement with the EBF profile practiced by certain indigenous peoples such as the Nam Qom in Argentina. 12 However, lower prevalence of EBF up to six months is reported in the indigenous population of Ecuador (54.4-78.2%), 11,13 Canada (57.9%), 14 and in the Brazilian Western Amazon (35.0%).…”

“…17 There are reports in the literature that indigenous women with higher education, 14 older 15 and better economic conditions have a tendency to maintain EBF. 11 Regarding the route of childbirth, there is divergence among studies, with the identification of late initiation of EB in women who underwent a cesarean section compared to women who had vaginal delivery; and greater use of milk formulas, 15 while in other studies it is reported that cesarean section does not influence EB in indigenous women. 12,15 It is also reported that ethnicity can influence early weaning.…”

“…17 deficit (SD) among those who do not receive the minimum amount of daily meals. 11 In addition, indigenous children of widowed or divorced mothers had lower prevalence of minimum daily meals compared to children of mothers who had a partner. The lower intake of iron in children's diets was associated with worse socioeconomic conditions, adolescent mothers, and lower education levels.…”

“…[9][10] Considering the diverse health realities reflected in the health indicators, this research was designed to contribute to the generation of evidence and consequently to public policies and strategies to reduce child's malnutrition among indigenous people. 11 In this direction, it is essential to know the practices of breastfeeding and complementary feeding in the population of indigenous children. The present study aimed to verify the prevalence of breastfeeding and nutritional status of indigenous children up to two years of age in the triple frontier region: Brazil, Argentina, and Paraguay.…”

Determinants of Feeding Patterns with Stunting in Children in the Coastal Area of Bengkulu City

“…at pregnancy [9] should develop an effective program to improve the maternal education and health and increase awareness of parents about the standard children's height and weight according to their age and gender [10]. Predictors of malnutrition in children vary, including food insecurity and food supply and diversity [11], [12], child's gender and age, parents' education level [13], household socioeconomic status [14], breastfeeding [15], water, sanitation, hygiene [16], and children's health including diarrhea [17], fever and cough [18], experiencing illness in the previous two weeks, lack of use of latrines, and lack of hand washing practices were predictors of underweight in children in Ethiopia [19].…”