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Updated: Oct 20, 2025

Author Spotlight: Studying the Impact of Maternal Dietary Deficiencies on Long-Term Offspring Health Outcomes
Published on: June 28, 2024
Undernutrition and short duration of breastfeeding association with child development: a population-based study
Hermano A L Rocha1, Luciano L Correia2, Álvaro J M Leite3
1Harvard T. H. Chan School of Public Health, Department of Global Health and Population, Boston, United States; Universidade Federal do Ceará, Departamento de Saúde Materno-Infantil, Fortaleza, CE, Brazil; Universidade Federal do Ceará, Departamento de Saúde Comunitária, Fortaleza, CE, Brazil.
Insights
Undernutrition and short breastfeeding duration negatively impact child development in Brazil. Integrated nutritional programs are recommended to improve developmental outcomes for young children.
Area of Science:
- Child Development
- Public Health Nutrition
- Pediatrics
Background:
- Child development is influenced by multiple factors, including nutritional status and infant feeding practices.
- Undernutrition and suboptimal breastfeeding are significant global public health concerns, particularly in low- and middle-income countries.
Purpose of the Study:
- To investigate the association between undernutrition and short breastfeeding duration with child development in children aged 0-66 months in Ceará, Brazil.
- To identify key risk factors for impaired child development within the study population.
Main Methods:
- Utilized population-based data from the Study on Maternal and Child Health in Ceará (PESMIC).
- Assessed child development using the Ages and Stages Questionnaire (ASQ-3) and undernutrition via anthropometric measures.
- Employed logistic regression analysis, adjusted for clustering, within the WHO nurturing framework.
Main Results:
- Prevalence of stunting, underweight, and wasting were 8.2%, 3.0%, and 3.6%, respectively.
- Undernutrition, particularly underweight (AOR 4.14), showed the strongest association with impaired child development.
- Breastfeeding for less than two months was also significantly associated with poorer development outcomes (AOR 2.08).
Conclusions:
- Undernutrition and insufficient breastfeeding duration are linked to adverse child development outcomes in Brazilian children.
- Findings underscore the importance of addressing nutritional deficiencies and promoting adequate breastfeeding for optimal child development.
- Integrated nutritional interventions are suggested as a strategy to enhance child development outcomes.
Objective:
To explore the relationship of undernutrition and the short duration of breastfeeding with child development of children 0-66 months of age residing in Ceará, Brazil.
Methods:
The authors of the present study utilized population-based data from children enrolled in the Study on Maternal and Child Health in Ceará, Brazil (PESMIC). Children's development was assessed with the Ages and Stages Questionnaire third version, validated in Brazil. Undernutrition was accessed through anthropometric measures obtained by trained staff. Breastfeeding information was obtained through the mothers' report and confirmed in the child's governmental booklet. The authors used logistic regressions adjusted for sample clusters used in PESMIC design in a theoretical model for known determinants of child development following the World Health Organization nurturing framework.
Results:
A total of 3,566 children were enrolled in the sixth PESMIC study and had their development assessed. The authors found that 8.2%, 3.0%, 2.1%, and 3.6% of children were stunted, underweight, or wasted, at the time of the interview, respectively. All studied factors were associated with a higher prevalence of child development impairment in at least one of the assessed domains. Underweight was the factor with the strongest effect, with an adjusted odds ratio (AOR) of 4,14 (2,26-7,58), p < 0.001. Breastfeeding for up to two months compared to more than six months (AOR 2,08 (1,38-3,12)) was also associated.
Conclusions:
The authors found that undernutrition and short duration of breastfeeding are associated with development outcomes among Brazilian children. As a result, integrated nutritional programs may improve child development outcomes.
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