The Associations between Exclusive Breastfeeding, Complementary Feeding, and the Risk of Stunting in Children Under Five Years of Age: A Path Analysis Evidence from Jombang East Java

Abstract

Background: Stunting in children becomes a health problem that gets priority and must be addressed immediately. Delayed development, a decrease in cognitive function and immune function and the risk of diabetes mellitus, coronary heart disease, hypertension and obesity are the effects of stunting. This study aimed to analyze the determinants of stunting in children aged 2-3 years in Jombang, East Java. Subjects and Method: This was an analytic observational study with case control design. The study was carried out at Plandaan and Kabuh community health centers, Jombang, East Java, from March to April 2019. A sample of 200 children aged 2-3 years old was selected by fixed disease sampling. The dependent variable was stunting. The independent variables were maternal age, maternal height, maternal attitudes, maternal occupation, birth length, infant birth weight, exclusive breastfeeding, breastfeeding, family income, mother's education, and mother's knowledge. The data collection was done using questionnaires and analyzed with path analysis. Results: Stunting was directly and negatively affected by birth length ≥ 48 cm (b=-2.37; 95% CI=-3.25 to-1.50; p <0.001), infant birth weight ≥ 2500 g (b=-1.43; 95% CI=-2.53 to-0.32; p= 0.011), exclusive breastfeeding (b=-1.09; 95% CI=-1.90 to-0.28; p= 0.008), and timely complementary feeding (b=-1.09; 95% CI=-1.94 to-0.24; p= 0.012). Stunting was indirectly affected by family income, maternal age, maternal attitude, maternal height >150 cm, employed mother, maternal education, and maternal knowledge. Conclusion: Stunting is directly and negatively affected by birth length ≥48 cm, birth weight ≥ 2500 g, exclusive breastfeeding, timely complementary feeding. It was indirectly affected by family income, maternal age, attitude, maternal height >150 cm, employment, education, and knowledge.