Toddlers Without Exclusive Breastfeeding Face Over Four Times Higher Risk of Stunting

Ilustration by AI 

FORMOSA NEWS

Failing to provide exclusive breastfeeding and experiencing recurrent infectious diseases dramatically increase the likelihood of childhood stunting. A case-control study conducted between February and May 2026 in Oesapa Village, Kupang City, examined 84 toddlers to evaluate key direct determinants of impaired growth. Led by researchers Nursusilawaty and Serlyansie V. Boimau from Poltekkes Kemenkes Kupang, alongside Sri Rahayu and I Komang Lindayani from Poltekkes Kemenkes Denpasar, the investigation offers crucial empirical evidence for public health strategies aimed at curbing chronic child undernutrition.

Address Chronic Malnutrition in Urban East Nusa Tenggara

Stunting is a chronic nutritional disorder marked by a height-for-age measurement below -2 standard deviations according to World Health Organization (WHO) standards. Developing primarily during the first 1,000 days of life, stunting impairs linear physical growth, hinders cognitive development, and increases long-term disease vulnerability.

Although nationwide stunting prevalence in Indonesia declined to 19.8% in 2024, East Nusa Tenggara (NTT) remains heavily burdened. The 2023 Indonesian Nutrition Status Survey (SSGI) recorded a stunting prevalence of 37.9% across NTT and 19.2% in Kupang City. Health center data from Oesapa Village revealed a local stunting rate of 23.1% in 2025. This high prevalence coincided with an exclusive breastfeeding rate of just 16.2% and widespread infectious illnesses, including acute respiratory infections (50.96%) and diarrhea (45.15%).

Clear Methodology

The research team used an analytical quantitative approach with a case-control design. To limit confounding variables, researchers matched stunted children (cases) with non-stunted children (controls) based on age and sex.

• Sample Size: 84 toddlers aged 24 to 59 months, divided evenly into 42 stunted cases and 42 non-stunted controls.
• Demographics: The sex ratio was equal (50% male, 50% female). Mothers' education levels peaked at senior high school (36.9%), followed by junior high school (32.1%), college (19.1%), and elementary school (11.9%). A majority of mothers (42.9%) were housewives.
• Data Sources & Analysis: Data were collected via structured interviews with mothers and validated using Maternal and Child Health (KIA) books and Posyandu records. Associations were evaluated using Chi-square tests at a 95% confidence level ($p < 0.05$) to derive Odds Ratios (OR).

Key Research Findings

Statistical analyses confirmed that non-exclusive breastfeeding and infectious disease histories significantly drive stunting rates:

• Impact of Exclusive Breastfeeding: A strong statistical relationship was identified between exclusive breastfeeding and stunting ($p = 0.003$). Toddlers who did not receive exclusive breastfeeding faced 4.71 times higher odds of stunting compared to those who were exclusively breastfed ($\text{OR} = 4.71$; 95% CI: 1.85–11.97).
• Impact of Infectious Diseases: A history of infectious illnesses such as diarrhea or respiratory infections showed a significant association with stunting ($p = 0.002$). Children with a history of infection had 4.50 times higher odds of stunting than those without prior infection ($\text{OR} = 4.50$; 95% CI: 1.82–11.10).
• Distribution Among Cases: Among the 42 stunted toddlers, 59.5% had not received exclusive breastfeeding, and 64.3% had a history of infectious disease. Conversely, 76.2% of non-stunted children had received exclusive breastfeeding, and 71.4% had no history of infection.

Implications for Public Health Policy

These findings emphasize that combatting stunting requires an integrated approach addressing both infant nutrition and infection control. Breast milk contains essential immunoglobulins and bioactive nutrients that protect the gut mucosa and strengthen immunity. Recurrent infections disrupt nutrient absorption, cause chronic inflammation, and suppress growth pathways.

Policymakers and health officials can utilize these insights to design targeted community interventions. Programs should prioritize lactation support, early childhood immunization, access to clean drinking water, and environmental sanitation to break the cycle of infection and malnutrition.

"Exclusive breastfeeding and a history of infectious diseases were significantly associated with the occurrence of stunting among toddlers," stated researchers Nursusilawaty and Serlyansie V. Boimau from Poltekkes Kemenkes Kupang, together with Sri Rahayu and I Komang Lindayani from Poltekkes Kemenkes Denpasar. "Reducing infections and accelerating stunting reduction require an integrated strategy that combines specific nutrition interventions with sensitive interventions addressing the broader determinants of child health."

Author Profiles

• Nursusilawaty, S.ST., M.Kes. – Researcher and lecturer in the Department of Midwifery at Poltekkes Kemenkes Kupang, specializing in maternal and child health, lactation, and toddler nutrition.
• Serlyansie V. Boimau, S.ST., M.Kes. – Researcher and lecturer at Poltekkes Kemenkes Kupang, focusing on community midwifery and rural public health.
• Sri Rahayu, S.TR.Keb., M.Kes. – Academic researcher at Poltekkes Kemenkes Denpasar, specializing in child growth, development, and reproductive health.
• I Komang Lindayani, S.Pd., S.Tr.Keb., M.Keb. – Researcher and lecturer at Poltekkes Kemenkes Denpasar, specializing in midwifery epidemiology and child health promotion.
• Source Information

Source 

Article Title: The Relationship Between Exclusive Breastfeeding and a History of Infectious Diseases and the Occurrence of Stunting Among Toddlers in Oesapa Village, Kupang City, 2026
Journal: International Journal of Integrative Sciences (IJIS)
Publication Year: 2026
DOI : https://doi.org/10.55927/ijis.v5i8.58
URL : https://journalijis.my.id/index.php/ijis/index