Inappropriate complementary feeding practice increases risk of stunting in children aged 12-24 months

Main Article Content

Hijra Hijra
Siti Fatimah-Muis
Martha Irene Kartasurya

Abstract

Background
In 2013, the prevalence of stunting in Central Sulawesi province was 41%, which was higher than the national prevalence of 37.2%. Complementary feeding practice, infectious disease, history of exclusive breastfeeding, birth weight and birth length were assumed to contribute to the prevalence of stunting. The objective of the present study was to identify the risk factors for stunting among children aged 12 to 24 months.

Methods
This study was conducted using a case control design. Subjects were children aged 12-24 months, consisting of 58 cases and 58 controls. Data were obtained with a body length infantometer. Data on complementary feeding practices, history of exclusive breastfeeding, and history of infectious diseases were obtained using questionnaires. Nutrient intakes were measured by semi quantitative food frequency questionnaires. Data on birth weight and birth length were obtained from the buku KIA (maternal and child health record). Data were analyzed by chi-square and logistic regression tests.

Results
There was no difference in sex, BMI, and parental education between cases and controls (p>0.05). After controlling for history of exclusive breastfeeding and birth weight, the risk factors for stunting were inappropriate complementary feeding practice in terms of quantity and quality (OR=8.26; 95% CI: 2.69-25.44), history of diarrhea (OR=4.73; 95% CI: 1.08-20.69), birth length (OR=5.11; 95% CI: 1.69-15.46) and respiratory tract infection (OR=5.30; 95% CI: 1.03-27.23). Inappropriate complementary feeding practice was the most dominant factor for stunting.

Conclusion
Inappropriate complementary feeding practice increased the risk of stunting in 12-24 months old children by 8.26. This study confirms the need to scale up interventions during the first 2 years of life, including appropriate infant feeding practices.

Article Details

How to Cite
Hijra, H., Fatimah-Muis, S., & Kartasurya, M. I. (2016). Inappropriate complementary feeding practice increases risk of stunting in children aged 12-24 months. Universa Medicina, 35(3), 146–155. https://doi.org/10.18051/UnivMed.2016.v35.146-155
Section
Original Articles

References

Kementerian Kesehatan Republik Indonesia (Kemenkes RI). Riset Kesehatan Dasar (Riskesdas) tahun 2010. Jakarta: Kementerian Kesehatan Republik Indonesia;2010.

Dinas Kesehatan Provinsi Sulawesi Tengah. Laporan pemantauan status gizi (PSG) tahun 2013. Palu: Dinas Kesehatan Provinsi Sulawesi Tengah;2013.

Dewey KG, Adu-Afarwuah S. Systematic review of the efficacy and effectiveness of compementary feeding interventions in developing countries. Matern Child Nutr 2008;4:24-85.

Shrimpton R, Victora CG, de Onis M, et al. Worldwide timing of growth faltering: implications for nutritional interventions. Pediatrics 2001;107:1-7.

World Health Organization (WHO). Implementing the global strategy for infant and young child feeding. Geneva: World Health Organization;2003.

Lassi ZS, Das JK, Zahid G, et al Impact of education and provision of complementary feeding on growth and morbidity in children less than 2 years of age in developing countries: a systematic review. BMC Public Health 2013; 13:1-10.

Victora CG, de Onis M, Hallal PC, et al. Worldwide timing of growth faltering: revisiting implications for interventions. Pediatrics 2010; 125: 473-480.

Black RE, Allen LH, Bhutta ZA, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet 2008;371:243-60.

Teshome B, Kogi-Makau W, Getahun Z, et al. Magnitude and determinants of stunting in children under-five years of age in food surplus region of Ethiopia: the case of West Gojam Zone. Ethiop J Health Dev 2009;23:98-106.

Dewey KG, Mayers DR. Early child growth: how do nutrition and infection interact? Maternal Child Nutr 2011;7:129–42.

Adeladza AT. The influence of socio-economic and nutritional characteristics on child growth in Kwale district of Kenya. Afr J Food Agric Nutr Dev 2009;9:1570-90.

Weisz A, Meuli G, Thakwalakwa C, et al. The duration of diarrhea and fever is associated with growth faltering in rural Malawian children aged 6-18 months. Nutr J 2011;10:1-4.

Lestari W, Margawati A, Rahfiludin MZ. Faktor risiko stunting pada anak umur 6-24 bulan di kecamatan Penanggalan Kota Subulussalam Provinsi Aceh. J Gizi Indonesia 2014;3:126-34.

AL-Rahmad AH, Miko A, Hadi A. Kajian stunting pada anak balita ditinjau dari pemberian ASI eksklusif, MP-ASI, status imunisasi dan karakteristik keluarga di Kota Banda Aceh. J Kesehatan Ilmiah Nasuwakes 2013;6:169-84.

Paudel R, Pradhan B, Wagle RR, et al. Risk factors for stunting among children: a community based case control study in Nepal. Kathmandu University Medical J 2012;10:18-24.

Imdad A, Yakoob MY, Bhutta ZA. Impact of maternal education about complementary feeding and provision of complementary foods on child growth in developing countries. BMC Public Health 2011;11:1-14.

Stephenson K, Amthor R, Mallowa S, et al. Consuming cassava as a staple food places children 2-5 years old at risk for inadequate protein intake, an observational study in Kenya and Nigeria. Nutr J 2010;9:1-6.

Mardewi KW. Kadar seng serum rendah sebagai faktor risiko perawakan pendek pada anak (Tesis). Denpasar: Universitas Udayana;2014.

Kimane-Murage EW, Ndedda C, Raleigh K, et al. Vitamin A supplementation and stunting levels among two year olds in Kenya: evidence from the 2008-09 Kenya Demographic and Health Survey. Int J Child Health Nutr 2012;1: 135-47.

Black RE, Victora CG, Walker SP, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 2013;382:427-51.

Bhutta ZA, Das JK, Rizvi A, et al. Evidence based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet 2013;382:452–77.

Picauly I, Toy SM. Analisis determinan dan pengaruh stunting terhadap prestasi belajar anak sekolah di Kupang dan Sumba Timur, NTT. J Gizi Pangan 2013;8:55-62.

Dewey KG, Mayers DR. Early child growth: how do nutrition and infection interact?. Matern Child Nutr 2011;7:129–42.

Fikadu T, Assegid S, Dube L. Factors associated with stunting among children of age 24 to 59 months in Meskan district, Gurage Zone, South Ethiopia: a case-control study. BMC Public Health 2014;14:1-7.

Candra A, Puruhita N, Susanto JC. Risk factors of stunting among 1-2 years old children in Semarang City. Media Medika Indonesiana 2011;45:206-12.

Ernawati F, Rosmalina Y, Permanasari Y. Pengaruh asupan protein ibu hamil dan panjang badan bayi lahir terhadap kejadian stunting pada anak usia 12 bulan di Kabupaten Bogor. Penelitian Gizi Makanan 2013;36:1-11.