Extended breastfeeding for over one year is associated with a higher likelihood of underweight and stunting among children under 3 years of age in Ethiopia, EDHS from 2000–2019

The World Health Organization (WHO) has implemented various strategies to combat undernutrition in developing countries, with one of the most common recommendations being to breastfeed for two years or beyond. This is based on the belief that breast milk provides essential nutrition for growth and development, particularly in low-income settings. However, insufficient research explores the relationship between breastfeeding duration and undernutrition..The Ethiopia Demographic and Health Survey 2000–2019 was used to perform the study, which included 18,580, children aged three and under. A multilevel logistic regression analysis was conducted to explore the relationship between undernutrition status and independent variables, including breastfeeding duration. The strength of the association was assessed using an adjusted odds ratio (AOR) with a 95% confidence interval (CI). A P-value of less than 0.05 was considered statistically significant. The overall prevalence of undernutrition among children under 3 years of age was 51.8% (95% CI: 51.10, 52.54). Specifically, the prevalence of stunting was 42.9% (95% CI: 42.14, 43.56), followed by underweight at 30.28% (95% CI: 29.63, 30.92), and wasting at 13.84% (95% CI: 13.35, 12.04).Children breastfed into their third year of life were more likely to develop underweight (AOR: 1.55; 95% CI 1.41, 1.70) and stunting (AOR: 5.45; 95% CI 4.83, 6.15). Conversely, the likelihood of wasting decreased in children breastfeeding in their second and third year of life (AOR: 0.75; 95% CI 0.67, 0.83) and (AOR: 0.50; 95% CI 0.43, 0.60) respectively. Similarly, children who breastfed until the second year of life had a greater chance of underweight and stunting. This study highlights a significant prevalence of undernutrition among children. Children breastfed into their third year of life were more likely to experience underweight and stunting, while breastfeeding during this period was associated with a lower likelihood of wasting.