Factors Associated with Stunting in Infants Aged 5–11 Months in the Dodota-Sire District, Rural Ethiopia

Abstract

The contribution of various factors to malnutrition, particularly stunting, may differ among areas and communities. This cross-sectional study aimed to estimate the level of malnutrition and identify factors associated with the high level of stunting in breast-fed infants aged 5-11 mo living in Dodota-Sire District, Ethiopia. Infants (n = 305) and their mothers were examined physically, and anthropometric and demographic data were collected. The content of zinc, calcium and copper in breast milk was measured, and data collected on the type, frequency of consumption, and time of introduction of supplementary feeding. Overall, 36% were stunted, 41% underweight and 13% wasted. The highest prevalence of malnutrition was seen in infants aged 9-11 mo. Among mothers, 27% had chronic energy deficiency (body mass index, <18.5 kg/m(2)) and 20% were night blind, indicating that vitamin A deficiency was a serious problem. Infants fed >3 times/d, consuming >600 mL/d or consuming cow's milk in addition to cereals and/or legumes had markedly higher length-for-age Z-scores than their peers fed less frequently, consuming less food or not consuming cow's milk [differences: 0.39, 95% confidence interval (CI): 0.04-0.74; 0.17, 95% CI: 0.02-0.32; 0.40, 95% CI: 0.07-0.72, respectively). Infants of mothers with low concentrations of zinc in their breast milk were more stunted. In conclusion, the quality and quantity of foods consumed by infants is insufficient to prevent stunting. Thus it is necessary to increase the nutrient supply to infants by increasing intake and nutrient concentration of breast milk and of supplementary foods they consume, and by providing supplements to infants where appropriate.

Low birth weight was the most dominant predictor associated with stunting among children aged 12–23 months in Indonesia

“…At the same time, infants have a lower appetite and loose nutrients because of diarrhea and vomiting. Semba in his study in Indonesia found that there was an association between mortality and a history of diarrhea among children less than 5 years of age [23]. A further study mentioned that the risk of stunting is increased when the infants had repeated or prolonged episodes of diarrhea [22].…”

“…In most of the cases, the mothers breastfeeding are undernourished themselves, resulting in low production of breast milk and earlier introduction of complementary foods. Other possible explanations may be that in developing countries, the age of introduction of complementary foods is not associated with stunting, as shown by a study in rural Ethiopia [23].…”

What Caused the Epidemic ofPneumocystisPneumonia in European Premature Infants in the Mid-20th Century?

“…If women who provided milk for the premature infants were zinc deficient, their milk would have been zinc deficient. 53 Consequently, zinc deficiency could have interfered with the development and function of T cell in the recipient infants. [37][38][39][40][41][42] However, certain aspects of zinc deficiency are less consistent with that possibility.…”

“…(1) Zinc-deficient infants have poor growth. 53 (2) Zinc-deficient women have decreased growth, decreased fertility, and increased risk of infections. 40 (3) Feeding human milk to premature infants may have mitigated the development of a zinc deficiency, because the bioavailability of zinc is greater in human milk than in cow's milk.…”

Prognostic factors at birth for stunting at 24 months of age in rural Indonesia

“…Stool regenerating gene protein (REG 1ß) has been observed to be higher at 3 months of age and predictive of a shortfall in linear growth later in life. 12 In addition, genetic studies among stunted children in developing countries revealed that male gender, 6,13-15 short mothers, 6,15 paternal education, 6,15 paternal occupation, 6,16 low birth weight, 6,14 early supplemental feeding, 6 poor preventive health care, 6 maternal zinc deficiency, 17 low weight gain during pregnancy, 18 short length at birth, 19 history of malnutrition during early life, 19 unhygienic environments, 19 tap water and toilet facilities, 14,15 family income, 14,16 poor breastfeeding practice, 20 lack of supplementation with vitamin A, 16 anemia, 16 infections such as diarrhea and respiratory infections, food-insecure households, maternal tobacco use, 22 preterm, and small-for-gestational age 23 were all potential risk factors for stunting. 21 However, other results have been inconclusive, as gender as well as maternal education and occupation were not found to be predictors of stunting in another study.…”