The Roles of Feeding Practices and Maternal Factors in Determining Nutritional Status among Children Under Five Years of Age: A Structured Narrative Review
Keywords:
Children under five years, Feeding practices, Maternal factors, Nutritional status, Structured narrative review
Abstract
Background: The nutritional status of children under five years remains a major global public health concern due to its substantial impact on child growth, development, and survival. Although numerous studies have investigated factors associated with child malnutrition, evidence regarding the roles of feeding practices and maternal factors remains fragmented across different settings. This structured narrative review aimed to synthesize current evidence on the roles of feeding practices and maternal factors in determining the nutritional status of children under five years. Methods: A structured narrative review was conducted by synthesizing evidence from original studies investigating determinants of nutritional status among children under five years. Eligible studies were identified through a systematic literature search based on predefined inclusion and exclusion criteria. Data were extracted using a standardized form and synthesized narratively through thematic analysis, with findings summarized using an evidence synthesis matrix. Results: Ten original studies conducted in Indonesia, Ethiopia, Bangladesh, India, and Nigeria were included. Six major domains of determinants were identified: maternal factors, feeding practices, child factors, household socioeconomic factors, infectious diseases, and environmental and health service factors. Maternal education, maternal nutritional status, and maternal nutrition knowledge were the most consistently reported determinants of children's nutritional status. Appropriate feeding practices, including exclusive breastfeeding, complementary feeding, dietary diversity, and adequate feeding frequency, were generally associated with improved nutritional outcomes, although findings varied across studies. Conclusion: The nutritional status of children under five years is influenced by multiple interconnected determinants, with maternal characteristics and feeding practices emerging as the most consistent factors. Integrated and multisectoral interventions addressing maternal empowerment, optimal feeding practices, child health, and household environments are essential to improve child nutritional outcomes.
References
Amare, Z. Y., Ahmed, M. E., & Mehari, A. B. (2019). Determinants of nutritional status among children under age 5 in Ethiopia: further analysis of the 2016 Ethiopia demographic and health survey. Globalization and Health, 15(1), 62. https://doi.org/10.1186/s12992-019-0505-7
Amouzou, A., Barros, A. J. D., Requejo, J., Faye, C., Akseer, N., Bendavid, E., Blumenberg, C., Borghi, J., El Baz, S., Federspiel, F., Ferreira, L. Z., Hazel, E., Heft-Neal, S., Hellwig, F., Liu, L., Maïga, A., Munos, M., Pitt, C., Shawar, Y. R., … Boerma, T. (2025). The 2025 report of the Lancet Countdown to 2030 for women’s, children’s, and adolescents’ health: tracking progress on health and nutrition. The Lancet, 405(10488), 1505–1554. https://doi.org/10.1016/S0140-6736(25)00151-5
Bala, F. E., McGrattan, K. E., Valentine, C. J., & Jadcherla, S. R. (2024). A Narrative Review of Strategies to Optimize Nutrition, Feeding, and Growth among Preterm-Born Infants: Implications for Practice. Advances in Nutrition, 15(11), 100305. https://doi.org/https://doi.org/10.1016/j.advnut.2024.100305
Chekol, Y. T., Arefaynie, M., Kassa, A. A., Alene, T. D., & Ngusie, H. S. (2022). Determinants of wasting among children aged 6-59 months in North-East Ethiopia: a community-based case-control study. BMJ Open, 12(8), e057887. https://doi.org/10.1136/bmjopen-2021-057887
de Hoop, T., Molotsky, A., Walcott, R., Gaitán-Rossi, P., Hernández-Cordero, S., Laar, A., Behmer, T., Nguyen, H. T. M., Chakrabarti, A., Siwach, G., Ranjit, V., Lara-Mejía, V., Franco-Lares, B., & Vilar, M. (2025). The role of nutrition-sensitive interventions in improving nutritional outcomes: findings from a systematic review and meta-analysis. International Journal for Equity in Health, 24(1), 325. https://doi.org/10.1186/s12939-025-02596-y
Esmiralda, E., Nursyahraeni, N., Hasnidar, H., & Sulfianti, S. (2025). Socioeconomic and educational determinants of nutritional status among children under five. Jurnal Ilmiah Kesehatan Sandi Husada, 14(2), 368–376. https://doi.org/10.35816/jiskh.v14i2.1325
Fitri, S. A., Ali, J., Widiyawati, R., Muthoharoh, S., Aprilin, H., Adzkia, U., Andalas, U., Husada, S. D., Dian, S., Mojokerto, H., & Husada, S. D. (2026). The Relationship Between Maternal Nutrition Knowledge and Education and Child Nutritional Status : A Systematic Literature Review. Gizi Press Indonesia, 01(1), 1–9.
Hartati, Y., Nilawati, N. S., & Sadiq, A. (2024). Risk factors for undernutrition in children under five (6-59) months based on child and parents characteristics. Journal of SAGO Nutrition and Health, 5(3), 693–701. https://doi.org/http://dx.doi.org/10.30867/gikes.v5i3.1729
Hati, E. P., Yani, A., Paramashanti, B., & Rum, F. F. (2025). Maternal Education and Its Impact on Childhood Stunting in Low Income Settings. NutriSehat : Jurnal Ilmu Gizi , 1(1 SE-Articles), 44–57. https://doi.org/10.61978/nutrisehat.v1i1.621
Katoch, O. R. (2022). Determinants of malnutrition among children: A systematic review. Nutrition (Burbank, Los Angeles County, Calif.), 96, 111565. https://doi.org/10.1016/ j.nut.2021.111565
Li, S., Mohamed Nor, N., & Kaliappan, S. R. (2024). Social determinants of child malnutrition outcomes: Evidence from CHNS in China. Heliyon, 10(1), e23887. https://doi.org/10.1016/ j.heliyon.2023.e23887
Lubis, A. (2025). Understanding Acute Malnutrition: a Global Literature Review on Risk Profiles in Under-Five Children. Journal of Public Health Science, 2(3), 393–402. https://doi.org/ 10.70248/jophs.v2i3.2891
Moramarco, S., Buonomo, E., Andreoli, A., & Palombi, L. (2025). Tackling Global Malnutrition and Hunger in the Final Push Toward the 2030 Agenda. Nutrients, 17(19). https://doi.org/10.3390/nu17193059
Nounkeu, C. D., & Dharod, J. M. (2021). Integrated Approach in Addressing Undernutrition in Developing Countries: A Scoping Review of Integrated Water Access, Sanitation, and Hygiene (WASH) + Nutrition Interventions. Current Developments in Nutrition, 5(7), nzab087. https://doi.org/10.1093/cdn/nzab087
Palupi, I. R., Susetyowati, Meltica, R., & Faza, F. (2019). Feeding Practices and Nutritional Status among Children Under Five Years of Age in Sleman District, Yogyakarta, Indonesia. Pakistan Journal of Nutrition, 18(9), 888–894. https://doi.org/10.3923/pjn.2019.888.894
Pasha, M., Shimul, M. M. H., Hossain, R., Khandker, S., khan, S., & Mehriban, N. (2025). Nutritional status and determinants of malnutrition among under-five children in a specialized hospital in Bangladesh during the COVID-19 pandemic. Clinical Nutrition Open Science, 64, 192–202. https://doi.org/10.1016/j.nutos.2025.10.008
Pradhan, M. R., & Shete, M. R. (2023). Determinants of nutritional status among under-five children receiving Integrated Child Development Services (ICDS) in India. Nutrition and Health, 29(3), 575–590. https://doi.org/10.1177/02601060221085809
Prendergast, A. J., & Humphrey, J. H. (2014). The stunting syndrome in developing countries. Paediatrics and International Child Health, 34(4), 250–265. https://doi.org/10.1179/ 2046905514Y.0000000158
Purba, I. E., Purba, A., & Sembiring, R. (2020). Factors associated with nutritional status of children under the age of 5 years in the working area of Sadabuan Public Health Center. Enfermería Clínica, 30, 140–143. https://doi.org/10.1016/j.enfcli.2019.11.040
Purwanti, R., Rahadiyanti, A., Kurniawati, D. M., & Wijayanti, H. S. (2025). Maternal Factors and Feeding Practices of Children Under Five with and without Malnutrition; [Faktor Ibu dan Praktik Pemberian Makan Balita dengan dan tanpa Malnutrisi]. Amerta Nutrition, 9(1SP), 62–72. https://doi.org/10.20473/amnt.v9i1SP.2025.62
Rezaeizadeh, G., Mansournia, M. A., Keshtkar, A., Farahani, Z., Zarepour, F., Sharafkhah, M., Kelishadi, R., & Poustchi, H. (2024). Maternal education and its influence on child growth and nutritional status during the first two years of life: a systematic review and meta-analysis. EClinicalMedicine, 71, 102574. https://doi.org/10.1016/j.eclinm.2024.102574
Sartorius, B., Sartorius, K., Green, R., Lutge, E., Scheelbeek, P., Tanser, F., Dangour, A. D., & Slotow, R. (2020). Spatial-temporal trends and risk factors for undernutrition and obesity among children (<5 years) in South Africa, 2008-2017: findings from a nationally representative longitudinal panel survey. BMJ Open, 10(4), e034476. https://doi.org/10.1136/bmjopen-2019-034476
Sawicki, M., Kowalkowska, J., Kułaga, Z., Socha, P., Swiąder-Lesniak, A., Swiecicka-Ambroziak, A., Szajewska, H., Wądołowska, L., & Weker, H. (2025). Assessment of dietary practices and nutritional status of children aged 5 to 72 months: study protocol of a nationwide Polish cross-sectional study (PITNUTS 2024). BMJ Open, 15(11), e100921. https://doi.org/10.1136/bmjopen-2025-100921
Schneider, E. B., Jaramillo Echeverri, J., Purcell, M., A’Hearn, B., Arthi, V., Blum, M., Brainerd, E., Capuno, J., Cermeño, A. L., Challú, A., Cho, Y.-J., Cole, T., Corpuz, J., Depauw, E., Droller, F., von Fintel, D., Floris, J., Galofré-Vilà, G., Harris, B., … Roberts, E. (2026). The decline of child stunting in 122 countries: a systematic review of child growth studies since the 19th century. BMJ Global Health, 11(2). https://doi.org/10.1136/bmjgh-2024-018607
Sowunmi, F. A., Ese, P., Adejoorin, M., Omotayo, A. O., & Salman, K. K. (2024). Prevalence Determinants of Malnutrition among Under-five Children of Farming Households in Nigeria. Habitat, 35(3), 250–279. https://doi.org/10.21776/ub.habitat.2024.035.3.22
Suardika, I. N. W., & Bolkiah, H. H. (2025). Nutritional Status and Its Determinants Among Children Under Five in Remote Areas. Media of Health Research, 3(2 SE-Articles), 48–56. https://doi.org/10.70716/mohr.v3i2.208
Venkatesh, J. S., Kulkarni, M., & K, S. K. (2026). Maternal feeding knowledge and practices as determinants of nutritional status in under-five children. Bioinformation, 22(4), 2020–2024. https://doi.org/10.6026/973206300222020
Wambua, J., Ali, A., Ukwizabigira, J. B., & Kuodi, P. (2025). Prevalence and risk factors of under-five mortality due to severe acute malnutrition in Africa: a systematic review and meta-analysis. Systematic Reviews, 14(1), 29. https://doi.org/10.1186/s13643-024-02740-9
Zhang, X., Deng, Y., Xie, T., Gao, S., Tao, Z., Teng, F., Hu, G., Wang, F., Wang, X., & Zhao, G. (2026). Factors associated with child stunting, underweight, and wasting in eight Latin American and Caribbean countries and regions: a regional analysis using Multiple Indicator Cluster Surveys. Journal of Global Health, 16, 04201. https://doi.org/10.7189/jogh.16.04201
Amouzou, A., Barros, A. J. D., Requejo, J., Faye, C., Akseer, N., Bendavid, E., Blumenberg, C., Borghi, J., El Baz, S., Federspiel, F., Ferreira, L. Z., Hazel, E., Heft-Neal, S., Hellwig, F., Liu, L., Maïga, A., Munos, M., Pitt, C., Shawar, Y. R., … Boerma, T. (2025). The 2025 report of the Lancet Countdown to 2030 for women’s, children’s, and adolescents’ health: tracking progress on health and nutrition. The Lancet, 405(10488), 1505–1554. https://doi.org/10.1016/S0140-6736(25)00151-5
Bala, F. E., McGrattan, K. E., Valentine, C. J., & Jadcherla, S. R. (2024). A Narrative Review of Strategies to Optimize Nutrition, Feeding, and Growth among Preterm-Born Infants: Implications for Practice. Advances in Nutrition, 15(11), 100305. https://doi.org/https://doi.org/10.1016/j.advnut.2024.100305
Chekol, Y. T., Arefaynie, M., Kassa, A. A., Alene, T. D., & Ngusie, H. S. (2022). Determinants of wasting among children aged 6-59 months in North-East Ethiopia: a community-based case-control study. BMJ Open, 12(8), e057887. https://doi.org/10.1136/bmjopen-2021-057887
de Hoop, T., Molotsky, A., Walcott, R., Gaitán-Rossi, P., Hernández-Cordero, S., Laar, A., Behmer, T., Nguyen, H. T. M., Chakrabarti, A., Siwach, G., Ranjit, V., Lara-Mejía, V., Franco-Lares, B., & Vilar, M. (2025). The role of nutrition-sensitive interventions in improving nutritional outcomes: findings from a systematic review and meta-analysis. International Journal for Equity in Health, 24(1), 325. https://doi.org/10.1186/s12939-025-02596-y
Esmiralda, E., Nursyahraeni, N., Hasnidar, H., & Sulfianti, S. (2025). Socioeconomic and educational determinants of nutritional status among children under five. Jurnal Ilmiah Kesehatan Sandi Husada, 14(2), 368–376. https://doi.org/10.35816/jiskh.v14i2.1325
Fitri, S. A., Ali, J., Widiyawati, R., Muthoharoh, S., Aprilin, H., Adzkia, U., Andalas, U., Husada, S. D., Dian, S., Mojokerto, H., & Husada, S. D. (2026). The Relationship Between Maternal Nutrition Knowledge and Education and Child Nutritional Status : A Systematic Literature Review. Gizi Press Indonesia, 01(1), 1–9.
Hartati, Y., Nilawati, N. S., & Sadiq, A. (2024). Risk factors for undernutrition in children under five (6-59) months based on child and parents characteristics. Journal of SAGO Nutrition and Health, 5(3), 693–701. https://doi.org/http://dx.doi.org/10.30867/gikes.v5i3.1729
Hati, E. P., Yani, A., Paramashanti, B., & Rum, F. F. (2025). Maternal Education and Its Impact on Childhood Stunting in Low Income Settings. NutriSehat : Jurnal Ilmu Gizi , 1(1 SE-Articles), 44–57. https://doi.org/10.61978/nutrisehat.v1i1.621
Katoch, O. R. (2022). Determinants of malnutrition among children: A systematic review. Nutrition (Burbank, Los Angeles County, Calif.), 96, 111565. https://doi.org/10.1016/ j.nut.2021.111565
Li, S., Mohamed Nor, N., & Kaliappan, S. R. (2024). Social determinants of child malnutrition outcomes: Evidence from CHNS in China. Heliyon, 10(1), e23887. https://doi.org/10.1016/ j.heliyon.2023.e23887
Lubis, A. (2025). Understanding Acute Malnutrition: a Global Literature Review on Risk Profiles in Under-Five Children. Journal of Public Health Science, 2(3), 393–402. https://doi.org/ 10.70248/jophs.v2i3.2891
Moramarco, S., Buonomo, E., Andreoli, A., & Palombi, L. (2025). Tackling Global Malnutrition and Hunger in the Final Push Toward the 2030 Agenda. Nutrients, 17(19). https://doi.org/10.3390/nu17193059
Nounkeu, C. D., & Dharod, J. M. (2021). Integrated Approach in Addressing Undernutrition in Developing Countries: A Scoping Review of Integrated Water Access, Sanitation, and Hygiene (WASH) + Nutrition Interventions. Current Developments in Nutrition, 5(7), nzab087. https://doi.org/10.1093/cdn/nzab087
Palupi, I. R., Susetyowati, Meltica, R., & Faza, F. (2019). Feeding Practices and Nutritional Status among Children Under Five Years of Age in Sleman District, Yogyakarta, Indonesia. Pakistan Journal of Nutrition, 18(9), 888–894. https://doi.org/10.3923/pjn.2019.888.894
Pasha, M., Shimul, M. M. H., Hossain, R., Khandker, S., khan, S., & Mehriban, N. (2025). Nutritional status and determinants of malnutrition among under-five children in a specialized hospital in Bangladesh during the COVID-19 pandemic. Clinical Nutrition Open Science, 64, 192–202. https://doi.org/10.1016/j.nutos.2025.10.008
Pradhan, M. R., & Shete, M. R. (2023). Determinants of nutritional status among under-five children receiving Integrated Child Development Services (ICDS) in India. Nutrition and Health, 29(3), 575–590. https://doi.org/10.1177/02601060221085809
Prendergast, A. J., & Humphrey, J. H. (2014). The stunting syndrome in developing countries. Paediatrics and International Child Health, 34(4), 250–265. https://doi.org/10.1179/ 2046905514Y.0000000158
Purba, I. E., Purba, A., & Sembiring, R. (2020). Factors associated with nutritional status of children under the age of 5 years in the working area of Sadabuan Public Health Center. Enfermería Clínica, 30, 140–143. https://doi.org/10.1016/j.enfcli.2019.11.040
Purwanti, R., Rahadiyanti, A., Kurniawati, D. M., & Wijayanti, H. S. (2025). Maternal Factors and Feeding Practices of Children Under Five with and without Malnutrition; [Faktor Ibu dan Praktik Pemberian Makan Balita dengan dan tanpa Malnutrisi]. Amerta Nutrition, 9(1SP), 62–72. https://doi.org/10.20473/amnt.v9i1SP.2025.62
Rezaeizadeh, G., Mansournia, M. A., Keshtkar, A., Farahani, Z., Zarepour, F., Sharafkhah, M., Kelishadi, R., & Poustchi, H. (2024). Maternal education and its influence on child growth and nutritional status during the first two years of life: a systematic review and meta-analysis. EClinicalMedicine, 71, 102574. https://doi.org/10.1016/j.eclinm.2024.102574
Sartorius, B., Sartorius, K., Green, R., Lutge, E., Scheelbeek, P., Tanser, F., Dangour, A. D., & Slotow, R. (2020). Spatial-temporal trends and risk factors for undernutrition and obesity among children (<5 years) in South Africa, 2008-2017: findings from a nationally representative longitudinal panel survey. BMJ Open, 10(4), e034476. https://doi.org/10.1136/bmjopen-2019-034476
Sawicki, M., Kowalkowska, J., Kułaga, Z., Socha, P., Swiąder-Lesniak, A., Swiecicka-Ambroziak, A., Szajewska, H., Wądołowska, L., & Weker, H. (2025). Assessment of dietary practices and nutritional status of children aged 5 to 72 months: study protocol of a nationwide Polish cross-sectional study (PITNUTS 2024). BMJ Open, 15(11), e100921. https://doi.org/10.1136/bmjopen-2025-100921
Schneider, E. B., Jaramillo Echeverri, J., Purcell, M., A’Hearn, B., Arthi, V., Blum, M., Brainerd, E., Capuno, J., Cermeño, A. L., Challú, A., Cho, Y.-J., Cole, T., Corpuz, J., Depauw, E., Droller, F., von Fintel, D., Floris, J., Galofré-Vilà, G., Harris, B., … Roberts, E. (2026). The decline of child stunting in 122 countries: a systematic review of child growth studies since the 19th century. BMJ Global Health, 11(2). https://doi.org/10.1136/bmjgh-2024-018607
Sowunmi, F. A., Ese, P., Adejoorin, M., Omotayo, A. O., & Salman, K. K. (2024). Prevalence Determinants of Malnutrition among Under-five Children of Farming Households in Nigeria. Habitat, 35(3), 250–279. https://doi.org/10.21776/ub.habitat.2024.035.3.22
Suardika, I. N. W., & Bolkiah, H. H. (2025). Nutritional Status and Its Determinants Among Children Under Five in Remote Areas. Media of Health Research, 3(2 SE-Articles), 48–56. https://doi.org/10.70716/mohr.v3i2.208
Venkatesh, J. S., Kulkarni, M., & K, S. K. (2026). Maternal feeding knowledge and practices as determinants of nutritional status in under-five children. Bioinformation, 22(4), 2020–2024. https://doi.org/10.6026/973206300222020
Wambua, J., Ali, A., Ukwizabigira, J. B., & Kuodi, P. (2025). Prevalence and risk factors of under-five mortality due to severe acute malnutrition in Africa: a systematic review and meta-analysis. Systematic Reviews, 14(1), 29. https://doi.org/10.1186/s13643-024-02740-9
Zhang, X., Deng, Y., Xie, T., Gao, S., Tao, Z., Teng, F., Hu, G., Wang, F., Wang, X., & Zhao, G. (2026). Factors associated with child stunting, underweight, and wasting in eight Latin American and Caribbean countries and regions: a regional analysis using Multiple Indicator Cluster Surveys. Journal of Global Health, 16, 04201. https://doi.org/10.7189/jogh.16.04201
Published
2026-09-11
How to Cite
Saftari Apriani, S., Ratna Anisa, W., & Handayani, T. (2026). The Roles of Feeding Practices and Maternal Factors in Determining Nutritional Status among Children Under Five Years of Age: A Structured Narrative Review . Caring : Jurnal Keperawatan Al-Ikhlas, 3(1), 37-45. https://doi.org/10.70800/jckk.v3i1.191
Section
Articles
.jpg)
