Household Food Security, Feeding Practices, and Chrononutrition between Stunted and Non-Stunted Children Aged 6–23 Months

Abstract

Stunting remains an important nutritional problem in Indonesia, particularly during the first 1,000 days of life. Stunting reflects impaired linear growth resulting from chronic or recurrent nutritional and health-related constraints and may have consequences for child development, health, productivity, and human-resource quality. The period from 6 to 23 months is particularly critical because children experience rapid physical and neurodevelopmental growth while transitioning from predominantly breast-milk feeding to complementary foods. During this period, inadequate dietary intake, inappropriate feeding practices, recurrent infection, and unfavorable household conditions may contribute to growth faltering. Household food security and infant and young child feeding practices are important components of the nutritional environment. However, adequate food availability alone does not necessarily guarantee adequate nutritional status because food selection, feeding practices, caregiving, disease, and access to health services also influence child growth. In addition, chrononutrition—the timing, frequency, duration, and regularity of food intake in relation to biological rhythms—has emerged as a potentially relevant dimension of child nutrition. Evidence concerning chrononutrition among children aged 6–23 months remains limited, particularly in relation to stunting. Therefore, examining household food security, feeding practices, nutrient adequacy, morbidity, and chrononutrition together may provide a more comprehensive understanding of the factors associated with linear growth during early childhood. The general objective of this study was to analyze differences in household food security, child feeding practices, and chrononutrition between stunted and non-stunted children aged 6–23 months. The specific objectives were to compare child and family characteristics; household food security; breastfeeding and complementary feeding practices; energy, macronutrient, and micronutrient adequacy; chrononutrition patterns; infectious-disease morbidity; and nutritional status based on weight-for-age (WAZ) and weight-for-height (WHZ). The study also aimed to examine the relationships of these factors with stunting and height-for-age Z-score (HAZ). This was a quantitative exploratory study using a comparative cross-sectional design. The research was conducted in Sayang Village, Cianjur Subdistrict, Cianjur Regency, West Java, Indonesia, a designated stunting locus. Mother-child pairs were recruited purposively according to predefined inclusion and exclusion criteria. The final analytical sample consisted of 160 children aged 6–23 months, including 48 stunted children (30.0%) and 112 non-stunted children (70.0%). ...