Relationship between diarrhea history, exclusive breastfeeding, and feeding patterns with stunting incidence in toddlers aged 24-59 months

Authors

DOI:

https://doi.org/10.53638/phpma.2025.v13.i1.p03

Keywords:

stunting, exclusive breastfeeding, diarrhea, feeding petterns, mother's education

Abstract

Background and purpose: Stunting remains a major public health issue globally, including in Jember District. Despite the significant stunting reduction in the region—from 21.4% in 2020 to 6.6% in 2024—Rambipuji Public Health Center (PHC) reports a comparatively high prevalence of 19.94%, indicating a persistent public health concern. This study aimed to analyze the association between diarrheal history, exclusive breastfeeding, and feeding patterns with the incidence of stunting among children aged 24–59 months.

Methods: An analytical observational study with a case–control design was conducted among 114 children aged 24–59 months (57 cases and 57 controls) selected by simple random sampling in the Rambipuji PHC area based on growth monitoring data from May 2025. Data which include stunting status, children characteristics and maternal characteristics were collected through structured interviews and observations, and analyzed using chi-square tests (α=0.05) with SPSS.

Results: The results indicated significant associations between maternal education (OR=11.25; 95%CI: 1.354-93.504; p=0.026), exclusive breastfeeding (OR=3.352; 95%CI: 1.377-8.159; p=0.006), and feeding patterns (OR=10.5; 95%CI: 2.336-47.201; p=0.005) with stunting incidence. However, a history of diarrhea was not significantly associated with stunting.

Conclusion: Maternal education, exclusive breastfeeding, and feeding patterns are associated with stunting among children. Strengthening maternal nutrition and feeding education, as well as optimizing services at integrated health posts (Posyandu) and public health centers (Puskesmas), are essential to reduce stunting prevalence.

References

De Onis M, Borghi E, Arimond M, Webb P, Croft T, Saha K, et al. Prevalence thresholds for wasting, overweight and stunting in children under 5 years. Public Health Nutr. 2019;22(1):175–179.

Tesema GA, Yeshaw Y, Worku MG, Tessema ZT, Teshale AB. Pooled prevalence and associated factors of chronic undernutrition among under-five children in East Africa: A multilevel analysis. PLoS One. 2021;16(3):e0248637.

Mannar MGV, Micha DR, Afshin A, Baker P, Battersby J, Bhutta Z, et al. Global nutrition report: Action on equity to end malnutrition. Bristol: Development Initiatives; 2020.

WHO. Malnutrition [Internet]. 2024. Available from: https://www.who.int/news-room/fact-sheets/detail/malnutrition/

Martorell R, Young MF. Patterns of stunting and wasting: Potential explanatory factors. Adv Nutr. 2012;3(2):227–233.

Reid BM, Harbin MM, Arend JL, Kelly AS, Dengel DR, Gunnar MR. Early life adversity with height stunting is associated with cardiometabolic risk in adolescents independent of body mass index. J Pediatr. 2018;202:143–149.

PBB. The sustainable development goals report 2022. New York: United Nations; 2022.

Ministry of Health Republic of Indonesia. Laporan tematik survei kesehatan Indonesia tahun 2023 [Thematic report of the 2023 Indonesian health survey]. Jakarta: Badan Kebijakan Pembangunan Kesehatan; 2024.

Jember District Health Office. Prevalensi kejadian stunting di Kabupaten Bulan Agustus 2024 [Prevalence of stunting in Jember District, August 2024]. Jember: Jember District Health Office; 2024.

Center for Health Data and Information. Keluarga bebas stunting [Stunting-free family program]. Jakarta: Kementerian Kesehatan Republik Indonesia; 2022.

Adriani P, Aisyah IS, Wirawan S, Hasanah LN, Idris, Nursiah A, et al. Stunting pada anak [Stunting in children]. Padang: Global Eksekutif Teknologi; 2022.

Neherta M, Deswita, Marlani R. Faktor-Faktor penyebab stunting pada anak [Factors causing stunting in children]. Indramayu: Penerbit Adab; 2023.

Gustriani WA, Taswin, Azis WA. Hubungan faktor ibu, pola pemberian makanan dan ASI eksklusif dengan kejadian stunting pada balita 12-59 bulan di Kelurahan Bataraguru [Association of maternal factors, feeding patterns, and exclusive breastfeeding with stunting among children aged 12–59 months]. Kampurui J Kesehat Masy. 2023;5(1):21–26.

Prakhasita RC. Hubungan pola pemberian makan dengan kejadian stunting pada balita usia 12-59 bulan di wilayah kerja Puskesmas Tambak Wedi Surabaya [Association between feeding practices and stunting among children aged 12–59 months in Tambak Wedi Primary Health Care area, Surabaya] [Undergraduate thesis]. Surabaya: Universitas Airlangga; 2019.

Syafei A, Afriyani R, Apriani. Hubungan pola asuh pemberian makan dengan kejadian stunting [Association between feeding parenting patterns and stunting]. J Kesehat dan Pembang. 2023;13(25):1–5.

Agustina N. Faktor-faktor penyebab kejadian stunting pada balita [Factors causing stunting among children under five] [Internet]. 2022. Available from: https://yankes.kemkes.go.id/view_artikel/1529/faktor-faktor-penyebab-kejadian-stunting-pada-balita

Rokhmah D, Moelyaningrum AD, Ningtyias FW, Rohmawati N. Stunting: Pencegahan dan penanganan di bidang kesehatan masyarakat [Stunting: Prevention and management in public health]. Malang: Inteligensia Media; 2021.

Jakri Y, Ningsih OS, Agus A. Hubungan kualitas sanitasi dan penyakit diare terhadap kejadian stunting pada anak umur 2 - 5 tahun di Puskesmas Bea Muring Kabupaten Manggarai Timur [Association between sanitation quality and diarrheal disease with stunting among children aged 2–5 years at Bea Muring Primary Health Care, East Manggarai District]. Malahayati Nurs J. 2022;4(8):2108–2118.

SJMJ SAS, Toban RC, Madi MA. Hubungan pemberian ASI eksklusif dengan kejadian stunting pada balita. J Ilm Kesehat Sandi Husada. 2020;11(1):448–455.

Indah P, Ainurafik, Malik MF. Pengaruh pemberian ASI eksklusif, pola konsumsi , dan pendapatan keluarga terhadap kejadian stunting pada balita di wilayah kerja Puskesmas Tondasi Kabupaten Muna Barat tahun 2024 [Effects of exclusive breastfeeding, dietary patterns, and family income on stunting among children under five in the Tondasi Primary Health Care area, West Muna District, 2024]. J Penelit Sains dan Kesehat Avicenna. 2024;3(3):267–275.

Kurniawati N, Yulianto Y. Pengaruh jenis kelamin balita, usia balita, status keluarga dan pendapatan keluarga terhadap kejadian pendek (stunted) pada balita di Kota Mojokerto [Effects of child sex, child age, family status, and family income on stunting among children under five in Mojokerto City]. Pengemb Ilmu dan Prakt Kesehat. 2022;1(1):76–92.

Aprilia D. Perbedaan risiko kejadian stunting berdasarkan umur dan jenis kelamin [Differences in stunting risk based on age and sex]. J Kebidanan. 2022;11(2):25–31.

Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–451.

Thompson AL. Greater male vulnerability to stunting? Evaluating sex differences in growth, pathways and biocultural mechanisms. Ann Hum Biol. 2021;48(6):466–473.

Soleha M, Zelharsandy VT. Pengaruh paritas di keluarga terhadap status gizi anak balita: Literature review [Effect of family parity on nutritional status of children under five: A literature review]. Lentera Perawat. 2023;4(1):71–85.

Sugianti E, Buanasita A, Hidayanti H, Putri BD. Analisis faktor ibu terhadap kejadian stunting pada balita usia 24-59 bulan di perkotaan [Analysis of maternal factors associated with stunting among children aged 24–59 months in urban areas]. AcTion Aceh Nutr J. 2023;8(1):30–42.

Trisyani K, Fara YD, Mayasari AT, Abdullah. Hubungan faktor ibu dengan kejadian stunting [Association between maternal factors and stunting]. J Matern Aisyah (JAMAN AISYAH). 2020;1(3):189–197.

Pusmaika R, Novfrida Y, Simatupang EJ, Djami ME, Sumiyati I. Hubungan usia ibu saat hamil dengan kejadian stunting pada balita di Kabupaten Tangerang [Association between maternal age at pregnancy and stunting among children under five in Tangerang District]. Indones Heal Issue. 2022;1(1):49–56.

Sari K, Sartika RAD. The effect of the physical factors of parents and children on stunting at birth among newborns in Indonesia. J Prev Med Public Heal. 2021;54(5):309–316.

Fadlilah AA, Fibriana AI. Kejadian stunting pada balita di wilayah kerja Puskesmas Poncol [Stunting among children under five in the Poncol Primary Health Care area]. HIGEIA (Journal Public Heal Res Dev). 2023;7(2):293–302.

Saputri MS. Hubungan pendidikan ibu, frekuensi dan durasi penyakit infeksi (Diare dan ISPA) dengan kejadian stunting pada balita usia 24-59 bulan di Desa Tepisari Kecamatan Polokarto Kabupaten Sukoharjo [Association of maternal education, frequency and duration of infectious diseases (diarrhea and acute respiratory infection) with stunting among children aged 24–59 months in Tepisari Village, Polokarto District, Sukoharjo District] [Doctoral dissertation]. Surakarta: Universitas Muhammadiyah Surakarta; 2022.

Elfrida AV, Lubis BM, Ramayani OR, Sitorus MS. Analisis hubungan tingkat pendidikan dengan tingkat pengetahuan ibu tentang stunting dan faktor risiko di Kecamatan Medan Denai [Association between maternal education level and maternal knowledge of stunting and its risk factors in Medan Denai District]. Sari Pediatr. 2024;26(3):171–175.

Yorke FR, Wahab S, Turkson D. Maternal education and child malnutrition: evidence from selected West African countries. SN Soc Sci. 2023;3(200):1–30.

Djogo HMA, Betan Y, Dion Y. Hubungan pekerjaan ibu dan praktik ASI ekslusif dengan kejadian stunting pada balita di Kabupaten Timor Tengah Selatan [Association between maternal employment and exclusive breastfeeding practices with stunting among children under five in South Central Timor District]. J Kesehat. 2021;8(2):89–97.

Cormick G, Betrán AP, Ciapponi A, Hall DR, Hofmeyr GJ. Inter-pregnancy interval and risk of recurrent pre-eclampsia: Systematic review and meta-analysis. Reprod Health. 2016;13(83):1–10.

Ruslah. Hubungan Paritas dan jarak kelahiran dengan kejadian stunting di Pustu Pangeranan Wilayah Kerja Puskesmas Bangkelan [Association between parity and birth spacing with stunting at Pangeranan Auxiliary Health Center, Bangkelan Primary Health Care area] [Doctoral dissertation]. Madura: STIKES Ngudia Husada Madura; 2023.

Purwanti DY, Ratnasari D. Hubungan antara kejadian diare, pemberian ASI eksklusif, dan stunting pada batita [Association between diarrhea, exclusive breastfeeding, and stunting among children aged under three years]. JIGK (Jurnal Ilm Gizi Kesehatan). 2020;1(2):15–23.

Choiroh ZM, Windari EN, Proborini A. Hubungan antara frekuensi dan durasi diare dengan kejadian stunting pada balita usia 24-36 bulan di Desa Kedungrejo Kecamatan Pakis [Association between frequency and duration of diarrhea and stunting among children aged 24–36 months in Kedungrejo Village, Pakis District]. J Issues Midwifery. 2020;4(3):131–41.

Fadilah SNN, Ningtyias FW, Sulistiyani S. Tinggi badan orang tua, pola asuh dan kejadian diare sebagai faktor risiko kejadian stunting pada balita di Kabupaten Bondowoso [Parental height, parenting practices, and diarrhea as risk factors for stunting among children under five in Bondowoso District]. Ilmu Gizi Indones. 2020;4(1):11–8.

Hizriyani R. Pemberian ASI eksklusif sebagai pencegahan stunting [Exclusive breastfeeding as a strategy for stunting prevention]. J Jendela Bunda Progr Stud PG-PAUD Univ Muhammadiyah Cirebon. 2021;8(2):55–62.

WHO. Infant and young child feeding [Internet]. 2023 [cited 2025 May 26]. Available from: https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding

Nurrasyidah, Ristia A, Yusdani R. Pola pemberian makan dengan kejadian stunting pada balita usia 12-59 bulan di Desa Bukit Selamat Kecamatan Sungai Raya Kabupaten Aceh Timur [Feeding practices and stunting among children aged 12–59 months in Bukit Selamat Village, Sungai Raya District, East Aceh District]. J Kebidanan Khatulistiwa. 2023;9(2):46–51.

Hasibuan FS. Hubungan pola pemberian makanan dengan kejadian stunting pada balita usia 24-59 bulan di Desa Aek Nauli Kecamatan Hulu Sihapas Kabupaten Padang Lawas Utara tahun 2022 [Association between feeding practices and stunting among children aged 24–59 months in Aek Nauli Village, Hulu Sihapas District, North Padang Lawas District] [Undergraduate thesis]. Padang Sidempuan: Universitas Aufa Royhan; 2022.

Downloads

Published

2025-07-31

How to Cite

Jamilatul Wahida, Candra Bumi, & Citra Anggun Kinanthi. (2025). Relationship between diarrhea history, exclusive breastfeeding, and feeding patterns with stunting incidence in toddlers aged 24-59 months. Public Health and Preventive Medicine Archive, 13(1), 28–39. https://doi.org/10.53638/phpma.2025.v13.i1.p03

Issue

Section

Articles