Breastfeeding Practices and Maternal Nutritional Status in Relation to Child Growth and Development: A Systematic Review
Keywords:
Breastfeeding Practices, Maternal Nutritional Status, Child Growth, Child DevelopmentAbstract
Child growth and neurodevelopment during the first 1,000 days are shaped by the interaction between maternal nutritional status and breastfeeding practices. Previous reviews often examined these determinants separately and lacked integration of recent evidence (2015–2025). This systematic review synthesizes global findings on how maternal nutrition and breastfeeding jointly influence child growth (stunting, weight gain) and developmental outcomes (cognitive and motor development), while identifying biological and psychosocial mechanisms. A systematic review was conducted following PRISMA guidelines. Searches were performed in PubMed, Scopus, Web of Science, and Google Scholar using combinations of terms such as (“Exclusive Breastfeeding” OR “Breastfeeding Practices”) AND (“Maternal Nutritional Status” OR “Maternal BMI”) AND (“Child Growth” OR “Stunting” OR “Child Development”). Of 1,246 records identified, 48 studies met inclusion criteria after screening and eligibility assessment. Study quality and risk of bias were appraised, and findings were synthesized thematically by outcome domain (physical growth vs. neurodevelopment). Exclusive breastfeeding and appropriate breastfeeding duration were consistently associated with improved linear growth and reduced stunting risk; however, effects were moderated by maternal undernutrition and micronutrient deficiencies. Altered breast milk composition, including reduced DHA and growth-related bioactive factors (e.g., IGF-1), emerged as key biological pathways influencing both growth and cognitive outcomes. Psychosocial mechanisms, such as maternal fatigue and reduced breastfeeding self-efficacy, were linked to early cessation. Evidence also showed context-dependent variability in LMICs where poverty and infection burden attenuated breastfeeding benefits. Maternal nutrition across the preconception-pregnancy-lactation continuum is essential to optimize both physical growth and neurodevelopment and to prevent intergenerational malnutrition.
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