Correlation Between Postnatal Factors and Stunting Incidence in Toddlers Aged 6-24 Months
DOI:
https://doi.org/10.30989/mik.v15i2.2139Keywords:
complementary feeding, Exclusive Breastfeeding, immunization, postnatal factors, stuntingAbstract
Background: The global prevalence of stunting is 22.3%, while Indonesia's prevalence is 31%. The 2022 Indonesian Nutritional Status Survey (SSGI) reported prevalences of 24.5% in West Nusa Tenggara and 34.03% in West Lombok. The high burden of stunting in the Labuapi Primary Health Center area highlights the need to assess postnatal determinants.
Objective: To examine the association between postnatal factors and stunting among children aged 6-24 months in the Labuapi Primary Health Center area.
Methods: This cross-sectional analytical study included 110 children aged 6–24 months selected by consecutive sampling. Data were collected using questionnaires and anthropometric measurements.
Results: The prevalence of stunting was 20,0% (22 children). Bivariate analysis showed that early initiation of breastfeeding (EIBF) (p = 1,000), exclusive breastfeeding (p = 0,914), complementary feeding practices (p = 1,000), timely immunization (p = 0,495), complete immunization (p = 0,405), vitamin A supplementation (p = 0,727), recurrent acute respiratory infections (p = 0,189), recurrent diarrhea (p = 0,732), water and sanitation (p > 0,05) were not significant risk factors for stunting.
Conclusion: None of the postnatal determinants evaluated were found to be significant risk factors for stunting.
References
1. Kementerian Kesehatan Republik Indonesia. Keputusan Menteri Kesehatan Republik Indonesia Nomor HK.01.07/Menkes/1928/2022 tentang Pedoman Penanggulangan Stunting. Jakarta: Kementerian Kesehatan Republik Indonesia; 2022. https://peraturan.bpk.go.id/Details/280046/keputusan-menkes-nohk0107menkes19282022
2. Soliman A, De Sanctis V, Alaaraj N, Ahmed S, Alyafei F. Early and long-term consequences of nutritional stunting: From childhood to adulthood. Acta Biomedica. 2021; 92(1): 1–12. https://doi.org/10.23750/abm.v92i1.11346
3. World Health Organization. World health statistics 2024. Geneva: World Health Organization; 2024.
4. Asian Development Bank. Prevalence of stunting among children under 5 in Indonesia: Second highest in Southeast Asia. Manila: Asian Development Bank; 2022. https://kidb.adb.org/
5. Badan Kebijakan Pembangunan Kesehatan. Survei Kesehatan Indonesia (SKI) 2023 dalam angka. Jakarta: Kementerian Kesehatan Republik Indonesia; 2024. https://www.badankebijakan.kemkes.go.id/hasil-ski-2023/
6. Badan Kebijakan Pembangunan Kesehatan. Buku saku hasil Survei Status Gizi Indonesia (SSGI) 2022. Jakarta: Kementerian Kesehatan Republik Indonesia; 2022.
7. Kementerian Koordinator Bidang Pembangunan Manusia dan Kebudayaan. 19 K/L Siap Dukung Program Percepatan Penurunan Stunting. Jakarta: Kemenko PMK; 2025. https://www.kemenkopmk.go.id/19-kl-siap-dukung-program-percepatanpenurunan-stunting
8. Pemerintah Provinsi Nusa Tenggara Barat. Peraturan Gubernur Nusa Tenggara Barat Nomor 68 Tahun 2020 tentang Aksi Pencegahan dan Percepatan Penurunan Stunting Terintegrasi. Mataram: Pemerintah Provinsi NTB; 2020.
9. Abri N, Thaha AR, Jafar N. Relationship between economic status, infectious diseases and urinary iodine excretion with stunting incidence of elementary school children in IDD endemic areas, Enrekang Regency. Journal of Health and Nutrition Research. 2022; 1(3): 133–139. https://doi.org/10.56303/jhnresearch.v1i3.21
10. Nurhayati R, Indriani D, Utami RB. Postnatal factors associated with the risk of stunting in toddlers. STRADA Jurnal Ilmiah Kesehatan. 2020; 9(2): 1121–1127. https://doi.org/10.30994/sjik.v9i2.453
11. Muldiasman M, Handayani L, Nugraheni MDS, Soekatri MYE, Rachmad M. Can early initiation to breastfeeding prevent stunting in 6–59 months old children?. Journal of Health Research. 2018; 32(5): 334–341. https://doi.org/10.1108/JHR-08-2018-038
12. Umiyah A, Hamidiyah A. Exclusive breastfeeding with stunting. STRADA Jurnal Ilmiah Kesehatan. 2020; 9(2): 471–477. https://doi.org/10.30994/sjik.v9i2.454
13. Amin NF, Sari GM, Ningrum AG. The relationship of early providing MPASI and recurrent infectional diseases with stunting incidents in children aged 1–5 years in the Lawahing Public Health Care Working Area. Jurnal Sosial dan Sains. 2023; 3(1): 1–8. https://doi.org/10.59188/jurnalsosains.v4i1.1196
14. Kementerian Kesehatan Republik Indonesia. Survei Status Gizi Indonesia (SSGI) 2024 dalam Angka. Jakarta: Kementerian Kesehatan RI; 2025. https://www.badankebijakan.kemkes.go.id/survei-status-gizi-indonesia-ssgi-2024/
15. 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 Nutrition. 2018; 21(1): 1–5. https://doi.org/10.1017/S1368980018002434
16. Pemerintah Provinsi Nusa Tenggara Barat. Stunting NTB 13,39% di bawah nasional, Iqbal: ini kerja bersama kab/kota. Mataram: Pemerintah Provinsi Nusa Tenggara Barat; 2025. https://ntbprov.go.id/post/stunting-ntb-1339-di-bawah-nasional-iqbal-ini-kerja-bersama-kabkota
17. Benjamin-Chung J, Mertens A, Colford Jr JM, Hubbard AE, van der Laan MJ, Coyle J, et al. Early-childhood linear growth faltering in low- and middle-income countries. Nature. 2023; 621: 550–557. https://doi.org/10.1038/s41586-023-06418-5
18. World Health Organization. Exclusive breastfeeding for optimal growth, development and health of infants. Geneva: World Health Organization; 2023. https://www.who.int/tools/elena/interventions/exclusive-breastfeeding
19. Nemerimana M, Havugarurema S, Nshimyiryo A, Karambizi AC, Kirk CM, Beck K, et al. Factors associated with recovery from stunting at 24 months of age among infants and young children enrolled in the Pediatric Development Clinic (PDC): A retrospective cohort study in rural Rwanda. PLOS ONE. 2023; 18(7): e0283504. https://doi.org/10.1371/journal.pone.0283504
20. Harrison L, Padhani Z, Salam R, Oh C, Rahim K, Maqsood M, et al. Dietary strategies for complementary feeding of infants and young children 6–23 months of age: A systematic review. Nutrients. 2023; 15(13): 3041. https://doi.org/10.3390/nu15133041
21. Laksono AD, Wulandari RD, Amaliah N, Wisnuwardani RW. Stunting among children under two years in Indonesia: Does maternal age matter?. PLOS ONE. 2022; 17(7): e0271509. https://doi.org/10.1371/journal.pone.0271509
22. Mutunga M, Rutishauser-Perera A, Laillou A, Prak S, Berger J, Wieringa FT, et al. The relationship between wasting and stunting in Cambodian children below 24 months of age followed the age of 59 months. PLOS ONE. 2021; 16(11): e0259765. https://doi.org/10.1371/journal.pone.0259765
23. Widyaningrum R, Gavine A, Gray NM, Farre A. Supporting adolescent mothers to make infant feeding decisions: A qualitative evidence synthesis. Maternal & Child Nutrition. 2025; 21(1): e70098. https://doi.org/10.1111/mcn.70098
24. Tebeje TM, Tesfaye SH, Abebe M, Seboka BT, Tesfa GA, Seifu BL, et al. Healthcare-seeking behavior for diarrhea in under-five children and associated factors in sub-Saharan Africa: a multilevel robust Poisson regression model. Frontiers in Public Health. 2024; 12: 1441360. https://doi.org/10.3389/fpubh.2024.1441360
25. Waghode RT, Yadav SS, Ghooi R, Razak SA, Menon KC. Work, motherhood, and nutrition: Investigating the association of maternal employment on child nutritional status in South Asia—A systematic review. Nutrients. 2025; 17(6): 1059. https://doi.org/10.3390/nu17061059
26. Mulyani AT, Khairinisa MA, Khatib A, Chaerunisaa AY. Understanding stunting: Impact, causes, and strategy to accelerate stunting reduction—A narrative review. Nutrients. 2025; 17(9): 1493. https://doi.org/10.3390/nu17091493
27. Ciptanurani C, Chen HJ. Household structure and concurrent stunting and overweight among young children in Indonesia. Public Health Nutrition. 2021; 24(9): 2629–2639. https://doi.org/10.1017/S1368980021001385
28. Tello B, Rivadeneira MF, Moncayo AL, Buitrón J, Astudillo F, Estrella A, et al. Breastfeeding, feeding practices and stunting in indigenous Ecuadorians under 2 years of age. International Breastfeeding Journal. 2022; 17(1): 19. https://doi.org/10.1186/s13006-022-00461-0
29. Punuh MI, Akili RH, Tucunan A. The relationship between early initiation of breastfeeding, exclusive breastfeeding with stunting and wasting in toddlers in Bolaang regency of East Mongondow. International Journal of Community Medicine and Public Health. 2022; 9(1): 71–75. https://doi.org/10.18203/2394-6040.ijcmph20214983
30. Dadras O, Suwanbamrung C, Jafari M, et al. Prevalence of stunting and its correlates among children under 5 in Afghanistan: the potential impact of basic and full vaccination. BMC Pediatrics. 2024; 24: 436. https://doi.org/10.1186/s12887-024-04913-w
31. Purwanti ED, Masitoh S, Ronoatmodjo S. Association between basic immunization status and stunting in toddlers aged 12–59 months in Indonesia. Journal of Preventive Medicine and Public Health. 2025; 58(3): 298–306. https://doi.org/10.3961/jpmph.24.230
32. Arslan A, Kaplan M, Duman H, Bayraktar A, Ertürk M, Henrick BM, et al. Bovine colostrum and its potential for human health and nutrition. Frontiers in Nutrition. 2021; 8: 651721. https://doi.org/10.3389/fnut.2021.651721
33. Rogier EW, Frantz AL, Bruno MEC, Wedlund L, Cohen DA, Stromberg AJ, et al. Secretory antibodies in breast milk promote long-term intestinal homeostasis by regulating the gut microbiota and host gene expression. Proceedings of the National Academy of Sciences of the United States of America. 2014; 111(8): 3074–3079. https://doi.org/10.1073/pnas.1315792111
34. Carr LE, Virmani MD, Rosa F, Munblit D, Matazel KS, Elolimy AA, et al. Role of human milk bioactives on infants’ gut and immune health. Frontiers in Immunology. 2021; 12: 604080. https://doi.org/10.3389/fimmu.2021.604080
35. Chichlowski M, van Diepen JA, Prodan A, Olga L, Ong KK, Kortman GAM, et al. Early development of infant gut microbiota in relation to breastfeeding and human milk oligosaccharides. Frontiers in Nutrition. 2023; 10: 1003032. https://doi.org/10.3389/fnut.2023.1003032
36. Mulatu T, Yimer NB, Alemnew B, Linger M, Liben ML. Exclusive breastfeeding lowers the odds of childhood diarrhea and other medical conditions: evidence from the 2016 Ethiopian demographic and health survey. Italian Journal of Pediatrics. 2021; 47: 166. https://doi.org/10.1186/s13052-021-01115-3
37. Campos AP, Vilar-Compte M, Sherburne Hawkins S. Association between breastfeeding and child stunting in Mexico. Annals of Global Health. 2020; 86(1): 145. https://doi.org/10.5334/aogh.2836
38. Mulyani I, Sari N, Andriani Y, Wijaya R, Rahmah A. Exploring the Relationship Between Immunisation and Stunting: Understanding the Impact of Vaccinations on Child Growth and Development. J-Kesmas: Jurnal Fakultas Kesehatan Masyarakat (The Indonesian Journal of Public Health). 2023; 7(2): 1–8. https://doi.org/10.35308/j-kesmas.v10i1.7364
39. Theresia GN, Sudarma V. Immunization status lowers the incidence of stunting in children 1–5 years. World Nutrition Journal. 2022; 6(1): 9–15. https://doi.org/10.25220/WNJ.V06.i1.0003
40. Ramadyani LR, Muh F, Martini M. The role of infectious diseases in stunting incidence: A literature review. Jurnal Riset Kesehatan Poltekkes Depkes Bandung. 2025; 17(2): 421–432. https://doi.org/10.34011/juriskesbdg.v17i2.2896
41. Tickell KD, Atlas HE, Walson JL. Environmental enteric dysfunction: A review of potential mechanisms, consequences and management strategies. BMC Medicine. 2019; 17: 181. https://doi.org/10.1186/s12916-019-1417-3
42. Susianto SC, Suprobo NR, Maharani M. Early breastfeeding initiation effect in stunting: A systematic review. Asian Journal of Health Research. 2022; 1(1): 1–6. https://doi.org/10.55561/ajhr.v1i1.11
43. Azmeraw Y, Akalu TY, Boke M, Gelaye K. The effect of socioeconomic and behavioral factors on childhood stunting in Janamora district, Ethiopia. Nutrition and Dietary Supplements. 2021; 13: 91–101. https://doi.org/10.2147/NDS.S314411
44. Das S, Alam MA, Mahfuz M, El Arifeen S, Ahmed T. Relative contributions of the correlates of stunting in explaining the mean length-for-age z-score difference between 24-month-old stunted and non-stunted children living in a slum of Dhaka, Bangladesh: results from a decomposition analysis. BMJ Open. 2019; 9(1): e025439. https://doi.org/10.1136/bmjopen-2018-025439
45. Arini D, Nursalam N, Mahmudah M, Faradilah I. The incidence of stunting, the frequency/duration of diarrhea and acute respiratory infection in toddlers. Journal of Public Health Research. 2020; 9(2): 1816. https://doi.org/10.4081/jphr.2020.1816
46. Sitorus S, Purba J, Sinaga HT, Sipayung AD. Behavioral predisposing factors in mothers of toddlers affecting the risk of stunting among toddlers in Dairi Regency. Jurnal Penelitian Pendidikan IPA. 2024; 10(Special Issue): 475–481. https://doi.org/10.29303/jppipa.v10iSpecialIssue.7998
47. Suratri MAL, Indriasih E, Warouw TS, Edwin VA, Yulianto A, Faizal DR, et al. The relationship between infectious diseases and stunting among toddlers in Indonesia. Iranian Journal of Nursing and Midwifery Research. 2025; 30(6): 936–940. https://doi.org/10.4103/ijnmr.ijnmr_87_24
48. Sullivan PB. Environmental enteric dysfunction: Reemergence of an old disease. The Journal of Infectious Diseases. 2021; 224(Suppl 7): S873–S875. https://doi.org/10.1093/infdis/jiab454
49. Selimoglu MA, Kansu A, Aydogdu S, Sarioglu AA, Erdogan S, Dalgic B, et al. Nutritional support in malnourished children with compromised gastrointestinal function: Utility of peptide-based enteral therapy. Frontiers in Pediatrics. 2021; 9: 610275. https://doi.org/10.3389/fped.2021.610275
50. Carvalho MCDC, Ribeiro SA, de Sousa LS, Lima AÂM, Maciel BLL. Undernutrition and intestinal infections in children: A narrative review. Nutrients. 2025; 17(9): 1479. https://doi.org/10.3390/nu17091479
51. Otiti MI, Dodd J, K’Oloo A, June M, Chomba M, Wang D, et al. Environmental enteric dysfunction, systemic inflammation, growth hormones, and linear growth in infants in western Kenya: a prospective observational cohort study. The American Journal of Clinical Nutrition. 2026; 123: 101095. https://doi.org/10.1016/j.ajcnut.2025.10.012
52. Witkowska-Sędek E, Pyrżak B. Chronic inflammation and the growth hormone/insulin-like growth factor-1 axis. Central European Journal of Immunology. 2020; 45(4): 469–475. https://doi.org/10.5114/ceji.2020.103422
53. Gabain IL, Ramsteijn AS, Webster JP. Parasites and childhood stunting – a mechanistic interplay with nutrition, anaemia, gut health, microbiota, and epigenetics. Trends in Parasitology. 2023; 39(3): 167–180. https://doi.org/10.1016/j.pt.2022.12.004
54. González-Fernández D, Cousens S, Rizvi A, Chauhadry I, Soofi SB, Bhutta ZA. Infections and nutrient deficiencies during infancy predict impaired growth at 5 years: Findings from the MAL-ED study in Pakistan. Frontiers in Nutrition. 2023; 10: 1104654. https://doi.org/10.3389/fnut.2023.1104654
55. Palanichamy M, Solanki MJ. Infant and child feeding index and nutritional status of children aged 6 to 24 months in a metropolitan city. Journal of Family Medicine and Primary Care. 2021; 10(1): 175–181. https://doi.org/10.4103/jfmpc.jfmpc_1023_20
56. Muslihah N, Wilujeng CS, Kusuma TS. Household food insecurity and complementary feeding practices are related to child stunting in Malang Regency, Indonesia. Current Developments in Nutrition. 2023; 7(Suppl 1): 102771. https://doi.org/10.1093/cdn/nzac067.053
57. Wangiyana NKAS, Karuniawaty TP, John RE, Qurani RM, Tengkawan J, Septisari AA, et al. Praktik pemberian MP-ASI terhadap risiko stunting pada anak usia 6–12 bulan di Lombok Tengah. Penelitian Gizi dan Makanan. 2021; 43(2): 81–88. https://doi.org/10.22435/pgm.v43i2.4118
58. Noles DL, Matzeller KL, Frank DN, Krebs NF, Tang M. Complementary feeding and infant gut microbiota: A narrative review. Nutrients. 2025; 17(5): 743. https://doi.org/10.3390/nu17050743
59. Shi Y, Yin R, Pang J, Chen Y, Li Z, Su S, et al. Impact of complementary feeding on infant gut microbiome, metabolites and early development. Food & Function. 2024; 15(20): 10663–10678. https://doi.org/10.1039/d4fo03948c
60. Sofia N, Prihatanti NR, Aprilea NA, Nashriyah A. Appropriate complementary feeding and parenting practices to prevent stunting in children. INTEREST: Jurnal Ilmu Kesehatan. 2025; 14(2): 130–143. https://doi.org/10.37341/interest.v14i2.751
61. Silva-Neto LGR, dos Santos Neto JE, de Menezes Toledo Florêncio TM. Association between vitamin A supplementation and stunting and anemia in socially vulnerable Brazilian children. European Journal of Nutrition. 2024; 63(8): 3281–3288. https://doi.org/10.1007/s00394-024-03480-1
62. Ssentongo P, Hevener W, Ssentongo AE, Kjerulff KH, Ezzati M, Chinchilli VM. Association of vitamin A deficiency with early childhood stunting in Uganda: A population-based cross-sectional study. PLOS ONE. 2020; 15(5): e0233615. https://doi.org/10.1371/journal.pone.0233615
63. Sahiledengle B, Petrucka P, Kumie A, Mwanri L, Beressa G, Atlaw D, et al. Association between water, sanitation and hygiene (WASH) and child undernutrition in Ethiopia: A hierarchical approach. BMC Public Health. 2022; 22(1): 1943. https://doi.org/10.18289/14309-z
64. Amalina A, Ratnawati LY, Bumi C. Hubungan kualitas air konsumsi, higiene, dan sanitasi rumah tangga dengan kejadian stunting (studi case control pada balita stunting di Kabupaten Lumajang). Jurnal Kesehatan Lingkungan Indonesia. 2023; 22(1): 28–37. https://doi.org/10.14710/jkli.22.1.28-37
65. Batool M, Habib MA, Nisar MI, Aslam MA, Nisar I, Zaidi S. Relationship of Stunting with Water, Sanitation, and Hygiene (WASH) Practices Among Children Under the Age of Five: A Cross-Sectional Study in Southern Punjab, Pakistan. BMC Public Health. 2023; 23(1): 17135. https://doi.org/10.1186/s12889-023-17135-z
66. Budge S, Parker AH, Hutchings PT, Garbutt C. Environmental enteric dysfunction and child stunting. Nutrition Reviews. 2019; 77(4): 240–253. https://doi.org/10.1093/nutrit/nuy068
67. Soe TK, Laohasiriwong W, Sornlorm K, Mahato RK. Safely managed sanitation practice and childhood stunting among under five years old children in Myanmar. PLOS ONE. 2023; 18(11): e0290600. https://doi.org/10.1371/journal.pone.0290600
68. Cammisa I, Rigante D, Cipolla C. A theoretical link between the GH/IGF-1 axis and cytokine family in children: Current knowledge and future perspectives. Children. 2025; 12(4): 495. https://doi.org/10.3390/children12040495
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