Page .
Caring : Jurnal Keperawatan Vol.
No.
2, 2024, pp.
01 Ae 11 ISSN 1978-5755 (Onlin.
DOI: 10.
29238/caring.
Journal homepage: http://e-journal.
id/index.
php/caring/ The Effectiveness of Exclusive Breastfeeding in Preventing Stunting Among Children Under Five: A Systematic Literature Review Mohammad Irwansyah1a*.
Zainal Munir1b 1 Faculty of Health.
University of Nurul Jadid.
Paiton Probolinggo a mohammadirwansyah27@gmail.
b zainalmunirnj@gmail.
HIGHLIGHTS
Exclusive breastfeeding during the first 6 months reduces the risk of stunting in toddlers ARTICLE INFO Article history Received date May 04th 2024 Revised date July 18th 2024 Accepted date August 18th 2024 Keywords:
Exclusive breastfeeding Stunting Toddlers Nutritional status
Systematic literature review
ABSTRACT/ABSTRAK
Stunting remains a major global public health issue, particularly in developing countries such as Indonesia.
One of the main contributing factors to the incidence of stunting is the lack of exclusive breastfeeding during the first six months of life, which plays a crucial role in supporting optimal growth and development in toddlers.
This literature review aimed to analyze the effectiveness of exclusive breastfeeding in reducing stunting incidence among children under five years of age.
The review was conducted using electronic databases, including Google Scholar.
Science Direct, and Pro-Quest.
Articles were selected based on inclusion criteria, such as relevance to exclusive breastfeeding and stunting, full-text availability, and publication within the last five years .
7Ae2.
Of the 33 articles initially identified, 19 articles met the eligibility criteria and were included in the analysis.
The results showed that exclusive breastfeeding significantly reduces the risk of stunting in toddlers.
Several studies reported that toddlers who were not exclusively breastfed had a 3 to 61 times higher risk of experiencing stunting compared to those who received exclusive breastfeeding.
In addition to breastfeeding practices, factors such as maternal education, family support, and health education influenced breastfeeding behavior and stunting outcomes.
In conclusion, exclusive breastfeeding is an effective preventive strategy against stunting in toddlers.
Strengthening breastfeeding education and support programs is essential to reduce stunting prevalence and improve child health status.
Copyright A 2024 Caring : Jurnal Keperawatan.
All rights reserved *Corresponding Author:
Mohammad Irwansyah Faculty of Health.
University of Nurul Jadid.
Paiton Probolinggo Email: wahyuni3897@gmail.
INTRODUCTION
Stunting is a global nutritional problem, especially in developing countries, especially in Indonesia that needs attention and improvement (Erika & Luluk, 2.
Stunting also Page .
occurs chronically in conditions of malnutrition starting from the first 1000 days of a child's life according to age below normal limits (Leila et al, 2.
The impact of stunting is not only impaired physical growth, but also affects the pattern of brain growth, and toddlers who experience stunting as adults will have the opportunity to contract chronic diseases such as diabetes, cancer, stroke and hypertension and may have a decrease in work productivity of their productive age (Erika & Luluk, 2.
The prevalence of stunting in Indonesia tends to be static.
In 2010, there was a slight decrease from the previous year, namely 35.
6 %.
However, the prevalence of short toddlers increased again in 2013 to 37.
2 %.
The results of the 2018 Central Statistics Agency show the prevalence of short toddlers in Indonesia is 19.
3% and very short 5% (BAPPENAS & UNICEF, 2.
Monitoring of nutritional status carried out by the Ministry of Health in 2015 obtained a picture of 29% of households with toddlers belonging to the short category.
In addition, the 2021 Indonesian Nutritional Status Survey (SSGI) recorded a national stunting prevalence of 24.
4%, indicating a moderate public health problem category (Ministry of Health Indonesia, 2.
Although this number shows improvement compared to previous years, the target of reducing stunting to below 14% by 2024 has not yet been achieved (BAPPENAS & UNICEF, 2.
Stunting describes growth failure that has accumulated since before and after birth due to insufficient nutritional needs (Esfarjani, 2.
Stunting is a health problem that is influenced by food availability in the community, economic development, poverty, and inappropriate feeding patterns.
In addition, it is also influenced by the high prevalence of infectious diseases (Fitri, 2.
Improper feeding will interfere with the nutritional status and health of infants under five, including the pattern of breastfeeding.
The problem of stunting can be a fatal problem for children if it is not handled According to Fikawati .
, the impact that can be caused by the stunting problem is metabolic disorders in the body.
From the results of research conducted by Sari .
, the average energy of stunted children is lower than that of non-stunted Decreased immunity so children get sick easily.
Factors including before birth such as maternal nutrition during pregnancy and infection factors, socioeconomic, health services, and various other factors that collaborate at certain levels and levels so that ultimately lead to linear growth failure (Fikrina, 2.
One of the factors causing stunting is a history of exclusive breastfeeding.
Ideally, breast milk is the only perfect food for babies to fulfill their physical and psychological needs as they grow and develop (Adriani, 2.
With exclusive breastfeeding without the addition of other fluids, including breastfeeding the baby purely for a minimum period of time until the baby is 6 months old (Maryunani, 2.
The only food that suits the condition of the baby's digestive tract and meets the needs for the first months is breast milk.
Babies who are not exclusively breastfed have a greater risk of stunting than babies who are exclusively breastfed, toddlers who are not exclusively breastfed have a 3.
7 times greater risk of stunting than babies who are exclusively breastfed (Dewi, 2.
RESEARCH METHODS
The research method used in this study is a literature review conducted through electronic databases such as Google Scholar.
Science Direct, and ProQuest.
The search was carried out on August 28, 2021, using the keywords AustuntingAy and Auexclusive breastfeedingAy.
The inclusion criteria included full-text articles published within the last five years .
7Ae2.
, with titles and content relevant to the research objectives and linked to nursing science.
Articles were selected based on their relevance, accessibility, and quality, while duplicates or irrelevant ones were excluded.
The selection process involved screening titles, abstracts, and full texts.
The final articles were grouped by Page .
research findings and analyzed thematically to support the study discussion.
A total of 19 full-text articles met the inclusion criteria, as listed in Figure 1.
Figure 1.
PRISMA
Google Scholar Science Direct Pro-Quest Based on article title .
= .
Issued article .
Articles issued are not in sync with the topic of discussion.
Selected articles .
= .
RESEARCH RESULTS Initial literature search found 33 articles (Google Scholar 14.
Portal Garuda 8.
Science Direct 6.
Pro-Quest .
The 14 articles issued were out of sync with the topic of discussion, namely about the effectiveness of exclusive breastfeeding with the incidence of stunting in toddlers.
The results of 19 articles found that the effectiveness of exclusive breastfeeding with stunting in toddlers was as listed in table 1.
Table 1.
Results From 19 Articles Regarding the Effectiveness of Exclusive Breastfeeding with Stunting Incidence in Toddlers Writer Erika Fitria Lestari.
Luluk Khusnul Dwihestie Year Title Exclusive Breast Milk Related to Stunting Events in Toddlers Method Correlation research with case-control Wahida Yuliana.
Bawon Nulhakim Effectiveness Of Grand's Class on The Success Exclusive Breast Milk to Prevent Stunting Type of experiment by comparing group and the Results Based on the results of the study indicate that there is a relationship between Exclusive breastfeeding with stunting is proven by the results of the chi square test, with p-value < which is 0.
000 and the correlation coefficient value is The results showed that the group that received treatment in the grandmother's class, gave exclusive breastfeeding as many as 20 .
%) and the group that did not receive treatment with a total of 6 .
%).
Value 0.
grandmother's class has an effect on exclusive breastfeeding so that the grandmother's class can also be a solution in increasing the achievement of Page .
Leila siti Merry maeta Andreanda nasution.
Tika noor prastia Description Of Exclusive Breastfeeding Stunting Events in Tolls Aged Month in Tanah Baru Kelurahan.
Bogor in 2018 Descriptive study with sampling data Marlan Pangkong.
Rattu.
Nancy S.
Malonda The Relationship Between Exclusive Breast Milk with The Event Stunting In Children Aged 13-36 Months in The Work Area of The Sonder Health Center This research is an analytical study with a -sectional conducted in area of Sonder Health Center.
Minahasa.
Cynthia.
I Wayan Bikin Suryawan.
A Made Widiasa The Relationship Exclusive Breastfeeding History Stunting Incidence Children 12-59 Months Age at Wangaya Hospital.
Denpasar City This research is an analytical study with method using Lidia Fitri The Relationship Lbw Exclusive Breast Milk Stunting Events Fifty Pekanbaru Puskesmas This type of research with cross sectional exclusive breastfeeding through family support.
The results showed that most of the mothers were around the age of 29 years, the mother's last elementary school graduates by 8%, the mother's occupation was mostly as housewives as much as 92.
A total of 52.
of children under five are female and most of them are around the age of 39 months.
The coverage of exclusive breastfeeding is 5% and the incidence of stunting is 33.
7%, which means that the incidence of stunting in Tanah Baru Village has become a public health problem.
The conducted in the working area of the Sonder Health Center showed that infants who were stunting nutritional status of 7% and infants who were not stunting status of 26.
8% with p value > 0.
05, namely p value 376, which means that there is between exclusive breastfeeding and the incidence of stunting at the age of 13-36 months in the working area of the Sonder Health Center.
The results showed that 25 children .
1 %) were stunted.
History breastfeeding was found in 27 children .
2 %).
The results of the analysis showed a p value of 604 with a prevalence ratio of Statistically there is no significant relationship between exclusive breastfeeding and stunting in children aged 12-59 months at Wangaya Hospital.
Denpasar City.
The results showed that 25 people .
3%) under five experienced stunting, 22 people with LBW .
3%) and 55 people who were not given exclusive breastfeeding .
3%).
There is a significant relationship between low birth weight (LBW) and the incidence of stunting where the p value is 0.
000 and there is a relationship between exclusive breastfeeding and the incidence of stunting, a p value of 0.
means p <0.
It can be concluded that there is a Page .
Nadia Maulidah.
Anggray Duvita Wahyani Relationship between Infant Birth Weight (BBL) and Exclusive Breastfeeding Behavior Stunting Toddlers This type of research with cross sectional Suriana.
Haniarti.
Ayu Dwi Putri Rusman The Relationship of Birth Weight Exclusive Breastfeeding to The Event of Stunting Toddlers.
Cappakala Village.
Mattiro Sompe District.
Pinrang Regency This study is with a research design using a cross-sectional Herliana Monika Azi Djogo.
Yasinta Betan.
Yohanes Dion Relationship Of Mother's Occupation and Exclusive Breastfeeding Practice Stunting Events in Children in South Central Timor District The design of this study was cross-sectional relationship between LBW and exclusive breastfeeding with the incidence of stunting, so Ha is The results showed that 13 toddlers were stunted, no toddlers were born with low birth weight (LBW), and only 2 There is no significant relationship between low birth weight (LBW) and the incidence of stunting where pvalue > 0.
05 is 0.
995 and there is also no relationship between exclusive breastfeeding behavior and the incidence of stunting with p value > 0.
05, which is 0.
can be concluded that there is no relationship between LBW and exclusive breastfeeding with the incidence of stunting.
The results of the bivariate analysis showed that there was a significant relationship between birth weight and exclusive breastfeeding on the incidence of It is recommended for mothers to continue to provide looking at the high incidence of stunting and it is hoped that mothers will be more active in participating in counseling and other health activities in order to information and education (KIE) regarding balanced nutrition.
Then to health workers to improve health promotion efforts by providing counseling to the community on how to prevent stunting in children and providing information about the importance of bringing toddlers to the Posyandu and implementing cross-sectoral collaboration in improving maternal and child health to prevent stunting infants/toddlers.
Results: the study found that 6% were stunted and 73.
of toddlers were not stunted, 5% of mothers did not have jobs and 68.
2% of mothers Conclusion: The results of the Chi-Square test found that there was no significant relationship between maternal occupation and stunting with a p-value of 0.
159 and there was a significant relationship between exclusive breastfeeding Page .
Lidia Fitri.
Ernita Relationship Between Exclusive Breast Milk and Early Mp Asi with Stunting Events in Toddlers This type of research with Sr.
Anita Sampe.
SJMJ.
Rindani Claurita Toban.
Monica Anung Madi The Relationship Exclusive Breastfeeding Stunting Incidences Toddlers This research design uses a case approach control study Sri Indrawati.
Warsiti The Relationship Exclusive Breastfeeding with the Event of Stunting Children Aged 23 Years Gunung Kidul This research is correlational and the incidence of stunting with a p-value of 0.
The results showed that the majority of respondents were 13 people .
7%) in the case group without exclusive breastfeeding, the majority of respondents, namely 12 people .
%) in the complementary feeding.
The test results show that there is a relationship between exclusive breastfeeding and stunting with a p-value 0.
000 and there is a complementary feeding and stunting with a p-value which is Ha accepted.
Conclusion:
there is a significant relationship complementary feeding and the incidence of stunting.
The results of the study used the chi-square test and continued using the odds ratio test.
The results of the chi-square test p = 000 .
000 < 0.
, this indicates that there is a relationship between exclusive breastfeeding and the incidence Meanwhile, in the odds ratio test, the OR value = 61, which means that toddlers who are not exclusively breastfed are 61 times more likely to experience stunting than toddlers who are exclusively breastfed.
Exclusive breastfeeding can reduce the risk of stunting.
Results: Toddlers in Karangrejek village.
Wonosari sub-district.
Gunung Kidul district, most of the respondents gave exclusive breastfeeding, namely 86.
Toddlers 2-3 years old in Karangrejek village.
Wonosari sub-district.
Gunung Kidul district, most of the respondents were in the normal category, 1 %.
There is a relationship between exclusive breastfeeding and the incidence of stunting in children aged 2-3 years p-value .
000< 0.
Conclusions and Suggestions:
There is a relationship between exclusive breastfeeding and the incidence of stunting in toddlers 2-3 years.
The results of this study provide input for mothers to provide exclusive breastfeeding Page .
Arfianingsih Dwi Putri.
Fanny Ayudia The Relationship Exclusive Breast Milk with The Event of Stunting Children Aged 659 Months in Padang City This research study with a study design or a case control Ika Pramulya S.
Fiki Wijayanti.
Mona Saparwati The Relationship Exclusive Breastfeeding with The Event of Stunting in Toddlers Aged 24-60 Months This research Sri Handayani.
Wiwin Noviana Kapota.
Eka Oktavianto Correlation Exclusive Breast Milk Status with Stunting Events in Tolls Aged 2436 Months in Watugajah Village.
Gunungkidul Regency Method: This research with a cross-sectional Novita Eka Kusuma Wardani Exclusive Breastfeeding Protein Information on Stunting Babies Aged 1236 Months This used a crosectional for babies so that they can avoid The results of this study indicate that there is a significant relationship between exclusive breastfeeding and the incidence of stunting.
OR = 38.
89, meaning that the incidence of stunting is 89 times the risk in children who are not exclusively breastfed than children who are exclusively It is recommended for further research to examine other factors, such as mother's The results showed that 44 toddlers .
8 %) were stunted, 38 toddlers were not given exclusive breastfeeding and 6 toddlers were given exclusive Bivariate analysis showed that there was a relationship between exclusive breastfeeding and stunting .
The conclusion of this study is that there is a relationship between exclusive breastfeeding and the incidence of stunting in the working area of the Selopampang Health Center.
Temanggung Regency Results: Bivariate analysis using chi square test.
The history of exclusive breastfeeding in this study reached 56.
8% or 25 children, and the majority of children in this study tended not to experience stunting.
Children breastfeeding tend not to experience stunting as many as 23 children .
3 %).
The results of the chi square test showed that the value of p = 0.
value < .
and the value of r = 0.
Conclusion:
There relationship between exclusive breastfeeding and the incidence of stunting in toddlers aged 24-36 months in Watugajah Village.
Gunungkidul Regency.
The results of the study were infants who were not exclusively stunting by 57.
1% and infants with less protein intake and experienced stunting by 75%.
The results of the chi square statistical test showed that the p value was 0.
< 0.
which indicated that there was a significant relationship between exclusive breastfeeding and the incidence of stunting in infants Page .
Rina Hizriyani.
Toto Santi Aji Exclusive Breast Milk as Stunting Prevention Risva.
Tanti Asrianti.
Nurul Afiah.
Dwi Muliyana The Effect of Breast Milk on Stunting Events in The Work Area of Juanda Puskesmas Samarinda Elfalini Warnelis.
Debora Simamora The Effect of History Infection Exclusive Breast Milk on The Growth Together Preventing Stuanting The used is a descriptive method from the study of literature from and national journals, this method is used to summarize and knowledge about a topic or problem.
This research is an analytic with a case This research Phenomenolo gical design Retrospective cross-sectional 12-36 months and a p value of 02 .
< 0.
which indicates that there is a significant relationship between protein intake and the incidence of stunting in infants 12-36 months.
The follow-up of this research needs to provide counseling about exclusive breastfeeding and nutrition to mothers and toddlers by health workers to improve the nutritional status of Exclusive breastfeeding is the easiest way to meet the nutritional needs of babies.
The breastfeeding have been proven to help children get adequate nutritional intake so as to minimize the risk of stunting in This effort aims so that Indonesian children can grow and develop optimally and maximally, accompanied by emotional, social, and physical abilities that are ready to learn, and able to innovate and compete in any field.
The results showed that the proportion of children under five who experienced stunting was higher with a history of not getting exclusive breastfeeding .
5 %)
although statistically it did not show a significant relationship (OR: 1.
95% CI: 0.
Further research is needed to investigate all factors suspected as risk factors for stunting.
After doing statistical tests through the chi square test, it was found that the p value (< 0.
which means that there is an effect of a history of infection and exclusive breastfeeding on the growth and development of toddlers in preventing stunting.
DISCUSSION