Researchers in Tanzania discovered something puzzling: children in a region that grows lots of food are still not growing to their full height. Scientists studied nearly 400 children under 2 years old and found that 59% had stunting (being shorter than normal for their age), even though most kids were eating enough food. The real problems weren’t about having food—they were about how babies were fed, bathroom cleanliness, and whether they continued breastfeeding. Boys were more likely to be stunted than girls, and kids who kept breastfeeding after 6 months were healthier and taller. This research shows that having food available isn’t enough; how families feed and care for babies matters just as much.

The Quick Take

  • What they studied: Why so many young children in Iringa, Tanzania aren’t growing to normal height, even though the region produces lots of food
  • Who participated: 397 children under 2 years old (about half boys, half girls) from four districts in Iringa Region, Tanzania, studied in September-October 2024
  • Key finding: 59% of children were stunted (shorter than normal), but this wasn’t because of lack of food—most kids were eating well. Instead, problems with breastfeeding practices, bathroom cleanliness, and hand washing were the main issues. Boys were 2.2 times more likely to be stunted than girls.
  • What it means for you: If you live in or care about communities with food security issues, this shows that simply providing food isn’t enough. Families also need education about continuing to breastfeed, keeping bathrooms clean, and washing hands. This may apply to similar communities worldwide, though more research is needed to confirm these findings in other areas.

The Research Details

Researchers conducted a community-based survey in four districts of Iringa Region, Tanzania, between September and October 2024. They visited households and asked families detailed questions about how they feed their babies, their bathroom and water practices, vaccinations, recent illnesses, and basic family information. This type of study, called a cross-sectional survey, takes a snapshot of a community at one point in time rather than following people over months or years.

The study included 397 children under 2 years old. Researchers measured each child’s height and weight to determine if they were stunted (too short for their age), underweight, or wasted (too thin). They also collected information about what babies ate, whether they were breastfed, and details about household sanitation and hygiene practices.

This approach allowed researchers to identify which factors were most strongly connected to stunting by comparing children who were stunted with those who weren’t. The researchers then used statistical analysis to figure out which factors were most important.

Understanding why children aren’t growing properly is crucial because stunting affects not just height—it impacts brain development, school performance, and lifelong health. This study was important because it investigated a puzzle: why was stunting so high (57%) in a region known for producing food? By looking at feeding practices and hygiene rather than just food availability, the research points to solutions that go beyond simply providing more food.

This study provides useful real-world information from a specific community at a specific time. The researchers collected detailed information directly from families through household visits, which is more reliable than estimates. However, because this is a snapshot study rather than following families over time, it can show which factors are connected to stunting but cannot prove that one thing directly causes another. The study was conducted in one region of Tanzania, so findings may not apply exactly the same way in other countries or regions. The researchers identified important patterns, but other studies would be needed to confirm whether the same patterns exist elsewhere.

What the Results Show

The most striking finding was that 59% of children under 2 in the study were stunted (shorter than normal for their age), yet 89% had normal weight and 97.5% were not wasted (too thin). This unusual pattern—short but not thin—suggested the problem wasn’t simply lack of food. In fact, 94% of children met minimum dietary diversity, meaning they were eating foods from different food groups.

When researchers looked at which factors were connected to stunting, they found that boys were significantly more affected than girls. Male children had 2.2 times higher odds of being stunted compared to girls. This means that if a girl and boy lived in similar conditions, the boy would be more likely to be stunted.

One of the most important protective factors was continuing to breastfeed after 6 months. Children who continued breastfeeding after 6 months had 61% lower odds of being stunted. This was a strong and clear finding. Additionally, children under 1 year old had lower odds of stunting compared to older children in the study, suggesting that stunting develops and worsens as children get older.

Interestingly, children in households that shared toilets with neighbors had almost half the odds of stunting compared to those in households with other bathroom situations. This unexpected finding may reflect other differences in these communities that weren’t measured.

Several other factors showed connections to stunting in the initial analysis but became less important when researchers looked at all factors together. These included hand washing practices (both before and after feeding), measles vaccination status, and vitamin A supplementation. While these factors were connected to stunting, they appeared less critical than gender, breastfeeding practices, and underweight status when all factors were considered together. Children who were underweight also had higher odds of being stunted, which makes sense because both conditions reflect poor growth.

This research adds important information to what scientists already knew about stunting in Tanzania. Previous studies showed that 28% of children under 5 nationwide were stunted, but Iringa Region had much higher rates at 57%. This study helps explain why: it’s not simply about food availability. The finding that breastfeeding beyond 6 months is protective aligns with global health recommendations and previous research showing breastfeeding’s importance for child development. However, the strong gender difference (boys being more affected) and the unexpected finding about toilet sharing suggest that local factors in this region may be unique and worth further investigation.

This study provides a snapshot of one moment in time in one region, so we cannot be certain the same patterns would appear at different times or in different places. The researchers collected information by asking families questions, which means some answers might not be completely accurate—families might forget details or answer differently than they would if researchers observed them directly. The study cannot prove that one factor directly causes stunting; it only shows which factors are connected. For example, while continued breastfeeding was protective, we cannot be completely certain that breastfeeding itself caused the protection or if breastfeeding families had other advantages not measured in the study. Additionally, the study measured children at one point in time, so we don’t know how stunting developed over time or whether the same children would show the same patterns if studied again.

The Bottom Line

Based on this research, health programs in similar communities should: (1) Promote and support breastfeeding beyond 6 months through education and community support—this showed the strongest protective effect; (2) Improve water, sanitation, and hygiene practices, particularly hand washing before and after feeding; (3) Pay special attention to boys and underweight children, who appear to be at higher risk; (4) Provide nutrition education that goes beyond just increasing food quantity to focus on feeding practices and quality. These recommendations have moderate confidence because they come from a well-designed study in a real community, though more research in other areas would strengthen confidence.

Health workers, community health programs, and government nutrition programs in Tanzania and similar regions should prioritize these findings. Parents and caregivers of young children, particularly boys, should pay attention to breastfeeding recommendations and hygiene practices. International development organizations working on child nutrition should consider that food availability alone may not solve stunting problems. However, these findings are most directly applicable to communities similar to Iringa Region in Tanzania. People in very different environments or countries should be cautious about assuming the same patterns apply without local research.

Improvements in stunting rates typically take time because stunting develops gradually during early childhood. If families implement these recommendations—particularly continuing breastfeeding and improving hygiene—benefits might appear within several months, but significant improvements in community-wide stunting rates would likely take 1-2 years or longer to become visible. The critical window is the first two years of life, so early intervention is important.

Want to Apply This Research?

  • Track breastfeeding duration and frequency, hand washing before and after feeding, and child height measurements monthly. Users can log whether they breastfed that day and record the child’s height to monitor growth progress over time.
  • The app could send reminders to continue breastfeeding beyond 6 months with educational content about benefits, provide checklists for hand washing before and after feeding, and offer tips for improving household sanitation. Users could set goals like ‘continue breastfeeding until 24 months’ and track progress.
  • Implement monthly height tracking with growth charts that show whether the child is growing at a normal rate. The app could alert caregivers if growth slows unexpectedly and suggest discussing this with a health worker. Track feeding practices weekly and hygiene habits daily, with trends shown monthly to help families see improvements in their routines.

This research describes patterns found in one community in Tanzania and should not be considered medical advice. The findings suggest associations between certain practices and stunting but do not prove direct cause-and-effect relationships. Parents and caregivers concerned about their child’s growth should consult with a healthcare provider for personalized advice. While the research supports continuing breastfeeding beyond 6 months and improving hygiene practices, individual circumstances vary. This summary is for educational purposes and should not replace professional medical guidance. Anyone making decisions about child nutrition and health should discuss them with qualified healthcare professionals familiar with their specific situation.