Table 1
Descriptive statistics (weighted percentages with frequencies and weighted means with standard deviations (SD)) and unadjusted odds ratios (UOR) with 95% confidence intervals (CI) of risk factors for stunting among Mexican children aged 6–35 months (N = 2,089).
| Subsample | Stunting | ||
|---|---|---|---|
| % (n)/mean (SD) | % (n)/mean (SD) | UOR (95% CI) | |
| Overall | 12.3 (238) | ||
| Individual factors | |||
| Child | |||
| Age (months) | 21.1 (8.7) | 22.0 (8.0) | 1.01 (0.99–1.03) |
| Sex | |||
| Male | 55.2 (1,106) | 14.4 (137) | 1 |
| Female | 44.8 (983) | 9.7 (101) | 0.63 (0.44–0.91)* |
| Birthweight | |||
| Low | 9.6 (172) | 28.2 (49) | 3.19 (1.79–5.69)*** |
| Normal | 84.3 (1,791) | 11.0 (180) | 1 |
| High | 6.1 (126) | 5.1 (9) | 0.44 (0.18–1.04) |
| Delivery mode | |||
| Vaginal | 56.5 (1,226) | 13.4 (159) | 1 |
| Cesarean-section | 43.5 (863) | 10.9 (79) | 0.79 (0.54–1.16) |
| Breastfeeding duration | |||
| Never breastfed | 5.7 (125) | 20.2 (19) | 1 |
| Any breastfeeding <6 months | 23.2 (433) | 7.7 (28) | 0.33 (0.13–0.81)* |
| Any breastfeeding ≥6 months | 71.1 (1,531) | 13.1 (191) | 0.60 (0.29–1.23) |
| Liquids ≠ than breastmilk ≤3 days postpartum | |||
| No | 55.9 (1,128) | 13.8 (135) | 1 |
| Yes | 44.1 (961) | 10.3 (103) | 0.72 (0.48–1.07) |
| Complementary foods <6 months | |||
| No | 36.7 (837) | 11.8 (90) | 1 |
| Yes | 63.3 (1,252) | 12.6 (148) | 1.49 (1.03–2.13)* |
| Maternal | |||
| Age (years) | 27.9 (6.6) | 28.7 (6.1) | 1.02 (0.99–1.05) |
| Employment | |||
| Not working | 67.5 (1,481) | 12.8 (177) | 1 |
| Part-time informal | 6.4 (120) | 15.1 (12) | 1.21 (0.47–3.15) |
| Part-time formal | 10.2 (195) | 10.3 (21) | 0.78 (0.39–1.53) |
| Full-time informal | 9.6 (188) | 9.5 (19) | 0.72 (0.35–1.45) |
| Full-time formal | 6.2 (105) | 11.2 (9) | 0.85 (0.33–2.19) |
| Education | |||
| ≤ Primary | 25.3 (596) | 16.8 (96) | 2.17 (1.16–4.04)* |
| Some secondary or secondary | 41.3 (904) | 13.2 (102) | 1.62 (0.89–2.95) |
| Some high school or high school | 21.0 (388) | 8.5 (32) | 1 |
| Some college or > | 12.4 (201) | 6.5 (8) | 0.75 (0.24–2.33) |
| Partner status | |||
| No | 15.7 (312) | 11.3 (33) | 1 |
| Yes | 84.3 (1,777) | 12.5 (205) | 0.89 (0.51–1.55) |
| Ethnicity | |||
| Non-indigenous | 76.9 (1,539) | 10.5 (136) | 1 |
| Indigenous | 23.1 (550) | 18.2 (102) | 1.89 (1.27–2.81)** |
| Parity (number of live births) | 2.4 (1.4) | 2.7 (1.5) | 1.19 (1.08–1.32)** |
| BMI | |||
| Underweight | 2.7 (60) | 10.8 (8) | 0.74 (0.26–2.13) |
| Normal weight | 38.8 (749) | 14.0 (98) | 1 |
| Overweight | 34.9 (770) | 11.2 (82) | 0.78 (0.48–2.13) |
| Obesity | 23.6 (510) | 11.2 (50) | 0.77 (0.46–1.29) |
| Height (cm) | |||
| (Short stature) ≤ 148.5 | 19.0 (432) | 27.7 (113) | 3.57 (2.34–5.45)*** |
| 148.6 – 157.8 | 49.5 (1,047) | 9.7 (95) | 1 |
| ≥ 157.9 | 31.5 (610) | 7.1 (30) | 0.71 (0.39–1.27) |
| Self-reported diabetes (any type) | |||
| No | 96.2 (2,018) | 12.0 (230) | 1 |
| Yes | 3.7 (71) | 20.5 (8) | 1.89 (0.71–5.06) |
| Current tobacco use | |||
| No | 87.3 (1,907) | 12.1 (216) | 1 |
| Yes | 12.7 (182) | 13.6 (22) | 1.14 (0.59–2.22) |
| Household factors | |||
| Number of children aged <5 years | 1.4 (0.6) | 1.5 (0.6) | 1.43 (1.02–1.99)* |
| Grandparent(s) cohabiting | |||
| No | 69.2 (1,484) | 13.8 (181) | 1 |
| Yes | 30.8 (605) | 8.8 (57) | 0.60 (0.38–0.93)* |
| Socioeconomic status | |||
| Low | 38.5 (898) | 16.9 (135) | 1.83 (1.18–2.82)** |
| Medium | 34.1 (730) | 10.0 (70) | 1 |
| High | 27.4 (461) | 8.7 (33) | 0.86 (0.45–1.64) |
| Food Security | |||
| Secure | 25.7 (491) | 8.3 (39) | 1 |
| Mild Insecure | 42.4 (940) | 10.5 (97) | 1.30 (0.77–2.21) |
| Moderate to Severe Insecure | 31.9 (658) | 17.9 (102) | 2.42 (1.41–4.13)** |
| Drainage system | |||
| Sewer | 69.7 (1,235) | 11.2 (119) | 1 |
| Septic | 22.3 (640) | 13.1 (81) | 1.19 (0.80–1.79) |
| Other | 7.9 (214) | 19.4 (38) | 1.90 (1.09–3.31)* |
| Area factors | |||
| Region/Area Density | |||
| North/Urban | 16.1 (321) | 8.5 (29) | 1 |
| North/Rural | 3.2 (125) | 6.9 (8) | 0.79 (0.29–2.17) |
| Center/Urban | 21.6 (454) | 9.3 (39) | 1.10 (0.57–2.09) |
| Center/Rural | 11.0 (324) | 8.7 (27) | 1.02 (0.52–2.03) |
| Metropolitan/Urban | 16.0 (88) | 18.5 (15) | 2.43 (1.17–5.02)* |
| South/Urban | 18.0 (420) | 9.9 (46) | 1.18 (0.66–2.10) |
| South/Rural | 14.1 (357) | 21.2 (74) | 2.89 (1.67–4.98)*** |
[i] BMI: body mass index. * p < 0.05, ** p < 0.01, *** p < 0.001.
Table 2
Models (odds ratios and 95% confidence intervals) to assess the association between breastfeeding duration and individual, household, and area factors, with stunting in Mexican children aged 6–35 months (N = 2,089).
| Model 1 | Model 2 | Model 3 | Model 4 | Model 5 | |
|---|---|---|---|---|---|
| Bf duration (Ref. NBF) | |||||
| Any breastfeeding <6 months | 0.33 (0.13–0.81)* | 0.36 (0.15–0.90)* | 0.32 (0.13–0.81)* | 0.32 (0.13–0.78)* | 0.47 (0.24–0.94)* |
| Any breastfeeding ≥6 months | 0.60 (0.29–1.23) | 0.52 (0.24–1.13) | 0.46 (0.20–1.06) | 0.45 (0.20–0.99)* | 0.68 (0.37–1.24) |
| Individual factors | |||||
| Child | |||||
| Age (months) | 1.01 (0.99–1.03) | 1.01 (0.99–1.03) | 1.01 (0.99–1.03) | 1.02 (1.01–1.04)* | |
| Sex (Ref. Male) Female | 0.58 (0.38–0.87)* | 0.56 (0.37–0.85)** | 0.56 (0.37–0.85)** | 0.84 (0.63–1.13) | |
| Birthweight (Ref. Normal & High) | |||||
| Low | 3.05 (1.64–5.65)*** | 3.14 (1.71–5.78)*** | 2.91 (1.60–5.29)*** | 3.21 (2.15–4.79)*** | |
| Delivery mode (Ref. Vaginal) | |||||
| Cesarean-section | 0.84 (0.55–1.27) | 0.83 (0.54–1.28) | 0.82 (0.53–1.26) | 0.74 (0.53–1.01) | |
| Liquids ≠ than breastmilk ≤3 days postpartum (Ref. No) | |||||
| Yes | 0.80 (0.51–1.23) | 0.81 (0.53–1.25) | 0.87 (0.58–1.32) | 1.00 (0.73–1.37) | |
| Complementary foods <6 months (Ref. No) | |||||
| Yes | 1.28 (0.85–1.93) | 1.38 (0.91–2.10) | 1.38 (0.90–2.13) | 1.32 (0.97–1.80) | |
| Maternal | |||||
| Age (years) | 1.01 (0.97–1.05) | 1.01 (0.97–1.06) | 1.01 (0.97–1.06) | 1.01 (0.98–1.04) | |
| Employment (Ref. Not working) | |||||
| Part-time informal | 1.60 (0.67–3.80) | 1.76 (0.79–3.90) | 1.77 (0.84–3.72) | 1.19 (0.60–2.34) | |
| Part-time formal | 0.79 (0.39–1.58) | 0.88 (0.44–1.75) | 0.90 (0.45–1.83) | 0.90 (0.53–1.51) | |
| Full-time informal | 1.29 (0.57–2.94) | 1.62 (0.72–3.64) | 1.64 (0.72–3.73) | 1.43 (0.81–2.51) | |
| Full-time formal | 0.99 (0.38–2.56) | 1.12 (0.44–2.87) | 1.05 (0.42–2.65) | 0.93 (0.44–1.98) | |
| Education (Ref. High school) | |||||
| ≤ Primary | 1.80 (0.88–3.66) | 1.60 (0.78–3.26) | 1.62 (0.79–3.35) | 1.39 (0.85–2.28) | |
| Some secondary or secondary | 1.91 (1.08–3.31)* | 1.86 (1.04–3.33)* | 1.92 (1.08–3.45) | 1.41 (0.90–2.22) | |
| Some college or > | 1.02 (0.35–2.95) | 1.02 (0.36–2.95) | 1.04 (0.37–2.94) | 0.61 (0.26–1.44) | |
| Partner status (Ref. Yes) No | 0.88 (0.53–1.46) | 0.94 (0.57–1.54) | 0.95 (0.58–1.56) | 0.95 (0.60–1.52) | |
| Ethnicity (Ref. Non-indigenous) | |||||
| Indigenous | 1.30 (0.83–2.04) | 1.28 (0.81–2.04) | 1.26 (0.78–2.03) | 1.49 (1.07–2.06)* | |
| Parity (number of live births) | 1.06 (0.90–1.26) | 0.95 (0.79–1.15) | 0.95 (0.79–1.15) | 0.98 (0.86–1.13) | |
| BMI (Ref. Normal weight) | |||||
| Underweight | 0.69 (0.20–2.31) | 0.77 (0.21–2.79) | 0.76 (0.20–2.84) | 0.85 (0.36–2.03) | |
| Overweight | 0.61 (0.37–0.99)* | 0.64 (0.39–1.03) | 0.64 (0.40–1.04) | 0.68 (0.48–0.96)* | |
| Obesity | 0.62 (0.36–1.06) | 0.63 (0.37–1.08) | 0.65 (0.38–1.11) | 0.64 (0.43–0.96)* | |
| Height (cm) (Ref. 148.6-157.8) | |||||
| (short stature) ≤ 148.5 | 3.58 (2.21–5.80)*** | 3.59 (2.23–5.77)*** | 3.46 (2.14–5.61)*** | 3.16 (2.26–4.42)*** | |
| ≥ 157.9 | 0.73 (0.42–1.28) | 0.70 (0.40–1.22) | 0.71 (0.41–1.24) | 0.56 (0.36–0.87)* | |
| Diabetes (any type) (Ref. No) Yes | 2.31 (0.90–5.95) | 2.48 (1.00–6.17) | 2.50 (1.05–5.92)* | 1.34 (0.61–2.98) | |
| Current tobacco use (Ref. No) Yes | 1.97 (0.96–4.04) | 2.00 (0.97–4.13) | 1.88 (0.94–3.77) | 1.92 (1.13–3.26)* | |
| Household factors | |||||
| Number of children aged <5 years | 1.60 (1.09–2.35)* | 1.59 (1.09–2.30)* | 1.47 (1.11–1.97)** | ||
| Grandparent(s) cohabiting (Ref.No) | |||||
| Yes | 0.65 (0.42–1.01) | 0.66 (0.43–1.03) | 0.83 (0.57–1.21) | ||
| Socioeconomic status (Ref. Medium) | |||||
| Low | 1.08 (0.64–1.79) | 1.02 (0.61–1.70) | 1.05 (0.73–1.50) | ||
| High | 1.05 (0.54–2.04) | 0.99 (0.52–1.89) | 1.03 (0.63–1.67) | ||
| Food Security (Ref. Secure) | |||||
| Mild Insecure | 1.39 (0.79–2.45) | 1.36 (0.77–2.38) | 1.16 (0.76–1.76) | ||
| Moderate to Severe Insecure | 2.24 (1.23–4.07)** | 2.16 (1.20–3.90)* | 1.58 (1.02–2.46)* | ||
| Drainage system (Ref. Sewer) | |||||
| Septic | 0.94 (0.59–1.52) | 0.93 (0.54–1.59) | 0.93 (0.65–1.32) | ||
| Other | 1.14 (0.56–2.34) | 1.15 (0.51–2.59) | 1.06 (0.66–1.71) | ||
| Area factors | |||||
| Region/Area Density (Ref. N/U) | |||||
| North/Rural | 0.66 (0.22–2.01) | ||||
| Center/Urban | 0.92 (0.46–1.84) | Variance | |||
| Center/Rural | 0.85 (0.38–1.90) | 5.82–33 (SE 1.34–17) | |||
| Metropolitan/Urban | 1.55 (0.75–3.24) | ICC 1.77–33 | |||
| South/Urban | 0.88 (0.43–1.82) | (SE 4.06–18) | |||
| South/Rural | 1.44 (0.70–2.94) | ||||
[i] Bf: breastfeeding, Ref: reference group, NBF: never breastfed, BMI: body mass index, N/U: north urban area, SE: standard error, ICC: intraclass correlation coefficient. Model 1 examined the association between breastfeeding and child stunting without adjusting for any of the covariates; models 2 through 4, sequentially, adjusted for individual, household, and area factors. Model 5 examined the association between breastfeeding and child stunting using a 2-level logistic approach. * p < 0.05, ** p < 0.01, *** p < 0.001.