Abstract

Abstract Objectives To examine the effects of breastfeeding duration and contextual factors at individual- and household-levels on child malnutrition, including overweight and stunting, in Mexican and Mexican-American children aged 3–35 months. Methods Secondary data analysis of 2,311 Mexican children from the 2012 Mexican National Health and Nutrition Survey and 829 Mexican-American children from the 2007–2014 US National Health and Nutrition Examination Survey, using independent and pooled logistic regression models to examine bivariate and multivariate associations. Results The prevalence of breastfeeding initiation and any breastfeeding for ≥ 3 months was higher in Mexican (94.2% and 83.5%) versus Mexican-American children (76.4% and 43.0%). Among the latter, those with foreign-born household reference person (HRP) were more likely to initiate and continue breastfeeding than US-born counterparts. The prevalence of child overweight did not differ in either population (9.0% in Mexicans versus 8.8% in Mexican-Americans), but among the latter, those with foreign-born HRP had higher prevalence for child overweight than US-born counterparts. The prevalence of child stunting was higher in Mexicans (11.6%) versus Mexican-Americans (2.0%) and no difference was found between children with foreign- or US-born HRP. We found no evidence for an association between any breastfeeding for ≥ 3 months and either measure of child malnutrition among Mexicans or Mexican-Americans when compared to those who were never breastfed. High- and low-birthweight were risk factors across the 2 populations for child overweight (AOR 2.72, 95% CI 1.81-4.08) and stunting (AOR 4.22, 95% CI 2.79-6.40), accordingly. We also identified additional country-specific risk and protective factors. Conclusions Culturally-sensitive interventions should focus on women prenatally using prophylactic strategies to prevent offspring high- and low-birthweight as these were risk factors for child malnutrition. These interventions should also include postnatal strategies to maintain and foster positive maternal health behaviors, including breastfeeding. Funding Sources No funding was received for this research. Supporting Tables, Images and/or Graphs

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