Exclusive breastfeeding

Exclusive breastfeeding within the first six months of life provides children with nutrition and antibodies while curtailing their exposure to potentially contaminated drinking water. In Peru, mothers were educated on the importance of exclusive breastfeeding through CRED.

Literature Review

Existing literature has yielded mixed results on the relationship between exclusive breastfeeding and childhood stunting. On the one hand, it is included within the Lancet nutrition series as a proven intervention benefiting child nutrition. Multiple Peru-specific studies have also found positive associations between breastfeeding and linear growth. ^{1 2}

However, at least one paper has also found no significant effect of exclusive breastfeeding on HAZ.³ Another found that there is no effect of exclusive breastfeeding on HAZ in low income countries, but that there is a small but significant effect in middle income countries.⁴

Quantitative Analysis

In the linear mixed effects regression analysis, early initiation of breastfeeding surprisingly showed a positive bivariate association with higher stunting; it was therefore not included in the ultimate time- and covariable- adjusted analysis.

According to the Oaxaca-Blinder decomposition, duration of breastfeeding accounted for negligible share of predicted change in HAZ for children under 5 for both 2000-2016 and 2008-2016, as well as children 6-23 months and 24-59 months over the 2008-2016 period.

Qualitative Analysis

Interviewees mentioned exclusive breastfeeding multiple times in the context of PAN. They noted that as a part of PAN, Peru prioritized exclusive breastfeeding as a component of maternal counseling. PAN itself was widely praised as a significant driver of stunting decline.

Conclusion

Both globally and within Peru, it is unclear if exclusive breastfeeding was a significant driver of stunting reduction. The evidence appears to be mixed.

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