Breastfeeding Practices During The First 1000 Days And Their Long-Term Association With Stunting In Children Under Five: A Systematic Literature Review
Latar Belakang: Stunting merupakan masalah kesehatan masyarakat yang masih bertahan di negara-negara berpenghasilan rendah dan menengah, dengan dampak jangka panjang terhadap pertumbuhan fisik dan perkembangan kognitif anak. Praktik menyusui selama 1000 Hari Pertama Kehidupan telah diidentifikasi sebagai faktor penting yang memengaruhi pertumbuhan linear, meskipun hasil penelitian sebelumnya menunjukkan temuan yang beragam.
Tujuan: Penelitian ini bertujuan untuk meninjau secara sistematis bukti terkini mengenai hubungan antara praktik menyusui selama 1000 HPK dengan risiko stunting pada anak di bawah usia lima tahun.
Metode: Tinjauan literatur sistematis dilakukan mengikuti pedoman PRISMA. Pencarian dilakukan pada database PubMed, ScienceDirect, dan ProQuest, dengan batasan tahun terbit 2020–2025. Seleksi artikel menggunakan kerangka PICOS, dan penilaian kualitas menggunakan instrumen dari Joanna Briggs Institute.
Hasil: Sebanyak 12 artikel memenuhi kriteria inklusi. ASI eksklusif secara konsisten dikaitkan dengan penurunan risiko stunting. Inisiasi menyusui dini bersifat protektif, sementara menyusui lebih dari 12 bulan pada keluarga berpenghasilan rendah dikaitkan dengan peningkatan risiko stunting akibat rendahnya keberagaman makanan. MP-ASI yang tidak memadai, berat badan lahir rendah, dan infeksi berulang turut memperburuk risiko.
Kesimpulan: Praktik menyusui yang optimal selama 1000 HPK sangat penting untuk mencegah stunting. Keberhasilan menyusui perlu didukung oleh pendidikan ibu, pemberian MP-ASI yang sesuai, serta intervensi multifaktorial.
Saran: Diperlukan program edukasi yang berkelanjutan bagi ibu mengenai praktik menyusui dan pemberian MP-ASI yang tepat, serta kebijakan yang mendukung intervensi lintas sektor untuk menanggulangi faktor risiko stunting secara komprehensif.
Kata Kunci: menyusui, stunting, 1000 hari, MP-ASI, nutrisi dini, pertumbuhan anak
ABSTRACT
Background: Stunting remains a persistent public health issue in low- and middle-income countries, with long-term consequences for children's physical and cognitive development. Breastfeeding during the first 1000 days has been identified as a critical factor influencing linear growth, though previous studies have yielded mixed findings.
Objective: This study aims to systematically review recent evidence on the relationship between breastfeeding practices during the first 1000 days and the risk of stunting among children under five.
Methods: A systematic literature review was conducted using the PRISMA framework. Articles were retrieved from PubMed, ScienceDirect, and ProQuest, limited to studies published between 2020 and 2025. The PICOS model guided the inclusion criteria, and the Joanna Briggs Institute checklist was used for quality appraisal.
Results: Twelve articles met the inclusion criteria. Exclusive breastfeeding was consistently associated with reduced stunting risk. Early initiation of breastfeeding had a protective effect, whereas prolonged breastfeeding beyond 12 months in poor households increased stunting risk, likely due to poor dietary diversity. Inadequate complementary feeding, low birth weight, and recurrent infections further compounded the risk.
Conclusion: Optimal breastfeeding during the first 1000 days significantly reduces the risk of stunting. However, successful breastfeeding requires maternal education, appropriate complementary feeding, and multifactorial interventions.
Suggestion: Sustainable maternal education programs and integrated policy support are essential to promote optimal feeding practices. Multisectoral interventions addressing nutrition, healthcare access, food security, and sanitation are recommended to effectively reduce stunting rates in vulnerable populations.
Keywords: breastfeeding, stunting, 1000 days, complementary feeding, early nutrition, child growth
Keywords : breastfeeding; stunting; 1000 days; complementary feeding; early nutrition; child growth
- Andra, A. M., Symond, D., & Puri, I. Y. (2025). Exclusive breastfeeding practices and stunting in Sawahlunto City , West Sumatera , Indonesia : a cross-sectional study. 45(2), 187–193. https://doi.org/10.12873/452resmiati2
- Black, R. E., Victora, C. G., Walker, S. P., Bhutta, Z. A., Christian, P., De Onis, M., Ezzati, M., Grantham-Mcgregor, S., Katz, J., Martorell, R., & Uauy, R. (2013). Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet, 382(9890), 427–451. https://doi.org/10.1016/S0140-6736(13)60937-X/ASSET/EEB37B1B-870D-4DED-A4E8-35EF83555645/MAIN.ASSETS/GR3.JPG
- Bosnjak, A. P., & Grgurić, J. (2013). Long-term health effects of breastfeeding. Lijecnicki Vjesnik, 129(8–9), 293–298. http://www.ncbi.nlm.nih.gov/pubmed/18198630
- Campos, A. P., Vilar-Compte, M., & Hawkins, S. S. (2020). Association Between Breastfeeding and Child Stunting in Mexico. Annals of Global Health, 86(1), 145. https://doi.org/10.5334/AOGH.2836
- Cetthakrikul, N., Topothai, C., Suphanchaimat, R., Tisayaticom, K., Limwattananon, S., & Tangcharoensathien, V. (2018). Childhood stunting in Thailand: When prolonged breastfeeding interacts with household poverty. BMC Pediatrics, 18(1), 1–9. https://doi.org/10.1186/S12887-018-1375-5/TABLES/4
- Dayani, T. R., & Widyantari, K. Y. (2024). Maternal risk factors for stunting in children aged 24-59 months. International Journal of Public Health Science (IJPHS), 13(3), 1366. https://doi.org/10.11591/ijphs.v13i3.24156
- Debes, A. K., Kohli, A., Walker, N., Edmond, K., & Mullany, L. C. (2013). Time to initiation of breastfeeding and neonatal mortality and morbidity: A systematic review. BMC Public Health, 13(SUPPL.3), 1–14. https://doi.org/10.1186/1471-2458-13-S3-S19/FIGURES/5
- Hadi, H., Fatimatasari, F., Irwanti, W., Kusuma, C., Alfiana, R. D., Ischaq Nabil Asshiddiqi, M., Nugroho, S., Lewis, E. C., & Gittelsohn, J. (2021). Exclusive Breastfeeding Protects Young Children from Stunting in a Low-Income Population: A Study from Eastern Indonesia. Nutrients, 13(12), 4264. https://doi.org/10.3390/NU13124264
- Horta, B. L., Loret De Mola, C., & Victora, C. G. (2015). Breastfeeding and intelligence: A systematic review and meta-analysis. Acta Paediatrica, International Journal of Paediatrics, 104, 14–19. https://doi.org/10.1111/APA.13139/ABSTRACT
- Kramer, M. S., & Kakuma, R. (2012). Optimal duration of exclusive breastfeeding. Cochrane Database of Systematic Reviews, 2012(8). https://doi.org/10.1002/14651858.CD003517.PUB2
- Likhar, A., & Patil, M. S. (2022). Importance of Maternal Nutrition in the First 1,000 Days of Life and Its Effects on Child Development: A Narrative Review. Cureus, 14(10), e30083. https://doi.org/10.7759/CUREUS.30083
- Lusiana, E. (2019). The Relationship between Exclusive Breastfeeding ( ASI ) and Mother Heightwith Incident Rates Stunting among Child Age 2-5 Years In Barombong Public Health Center , Gowa , Sulawesi Selatan. 2019, 558–567. https://doi.org/10.18502/kls.v4i13.5306
- Lutter, C. K., Peña-Rosas, J. P., & Pérez-Escamilla, R. (2013). Maternal and child nutrition (IV). The Lancet, 382(9904), 1550–1551. https://doi.org/10.1016/S0140-6736(13)62319-3
- Marquis, G. S., Habicht, J. P., Lanata, C. F., Black, R. E., & Rasmussen, K. M. (1997). Association of breastfeeding and stunting in Peruvian toddlers: an example of reverse causality. International Journal of Epidemiology, 26(2), 349–356. https://doi.org/10.1093/IJE/26.2.349
- Nsereko, E., Mukabutera, A., Iyakaremye, D., Umwungerimwiza, Y. D., Mbarushimana, V., & Nzayirambaho, M. (2018). Early feeding practices and stunting in Rwandan children: a cross-sectional study from the 2010 Rwanda demographic and health survey. The Pan African Medical Journal, 29, 157. https://doi.org/10.11604/PAMJ.2018.29.157.10151
- Rahmadiyah, D. C., Sahar, J., Widyatuti, Sartika, R. A. D., & Hassan, H. (2024). Family Resilience With Stunted Children Aged Below 5 Years: A Qualitative Study in Depok City, Indonesia. Global Qualitative Nursing Research, 11, 23333936231221750. https://doi.org/10.1177/23333936231221753
- Ruel, M. T., & Alderman, H. (2013). Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? The Lancet, 382(9891), 536–551. https://doi.org/10.1016/S0140-6736(13)60843-0
- Safaah, N., Yunitasari, E., Efendi, F., Sunanita, S., & Suhartono, S. (2022). Relationship between exclusive breastfeeding and stunting among children aged 2-5 years in Indonesia. 130(Supl 5), 1019–1024. https://doi.org/10.47307/GMC.2022.130.s5.21
- Sari, N., Manjorang, M. Y., Zakiyah, & Randell, M. (2021). Exclusive Breastfeeding History Risk Factor Associated with Stunting of Children Aged 12–23 Months. Kesmas, 16(1), 28–32. https://doi.org/10.21109/kesmas.v16i1.3291
- Soliman, A., De Sanctis, V., Alaaraj, N., Ahmed, S., Alyafei, F., Hamed, N., & Soliman, N. (2021). Early and Long-term Consequences of Nutritional Stunting: From Childhood to Adulthood. Acta Bio Medica : Atenei Parmensis, 92(1), e2021168. https://doi.org/10.23750/ABM.V92I1.11346
- Soofi, S. B., Khan, G. N., Ariff, S., Ihtesham, Y., Tanimoune, M., Rizvi, A., Sajid, M., Garzon, C., De Pee, S., & Bhutta, Z. A. (2022). Effectiveness of nutritional supplementation during the first 1000-days of life to reduce child undernutrition: A cluster randomized controlled trial in Pakistan. https://doi.org/10.1016/j
- Syeda, B., Agho, K., Wilson, L., Maheshwari, G. K., & Raza, M. Q. (2020). Relationship between breastfeeding duration and undernutrition conditions among children aged 0–3 Years in Pakistan. International Journal of Pediatrics & Adolescent Medicine, 8(1), 10. https://doi.org/10.1016/J.IJPAM.2020.01.006
- Tello, B., Rivadeneira, M. F., Moncayo, A. L., Buitrón, J., Astudillo, F., Estrella, A., & Torres, A. L. (2022). Breastfeeding, feeding practices and stunting in indigenous Ecuadorians under 2 years of age. International Breastfeeding Journal, 17(1), 1–15. https://doi.org/10.1186/S13006-022-00461-0/TABLES/5
- UNICEF. (2019). Global Breastfeeding Collective | Global Breastfeeding Collective. https://www.globalbreastfeedingcollective.org/
- UNICEF. (2025, April). Infant and young child feeding - UNICEF DATA. https://data.unicef.org/topic/nutrition/infant-and-young-child-feeding/
- Victora, C. G., Bahl, R., Barros, A. J. D., França, G. V. A., Horton, S., Krasevec, J., Murch, S., Sankar, M. J., Walker, N., Rollins, N. C., Allen, K., Dharmage, S., Lodge, C., Peres, K. G., Bhandari, N., Chowdhury, R., Sinha, B., Taneja, S., Giugliani, E., … Richter, L. (2016). Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. The Lancet, 387(10017), 475–490. https://doi.org/10.1016/S0140-6736(15)01024-7/ATTACHMENT/B566CEB2-1768-4C8E-9601-2BD8EC55D630/MMC1.PDF
- Walters, C. N., Rakotomanana, H., Komakech, J. J., & Stoecker, B. J. (2019). Maternal determinants of optimal breastfeeding and complementary feeding and their association with child undernutrition in Malawi (2015-2016). BMC Public Health, 19(1), 1–12. https://doi.org/10.1186/S12889-019-7877-8/TABLES/3