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Bayi umur 4 - 6 bulan mulai mendapatkan makanan pendamping ASI (MP-AS1) secara bertahap, disamping masih tetap mendapat ASI. Pada masa ini kekebalan anak yang didapat secara pasif dari ibunya mulai menurun, sementara bayi mulai mendapatkan makanan yang kurang mencukupi dari kebutuhannya. Beberapa basil penelitian menunjukkan bahwa prevalensi KEP pada bayi lebib dari 15% berdasarkan indeks status gizi (BB/U). Hal ini menunjukkan bahwa masalah gizi pada bayi merupakan hal yang serius yang perlu segera ditangani.Penelitian ini menganalisis data sekunder dari Penelitian " Pola menyusui, Usia penyapihan dan Pemberian MP-ASI dalam Kaitannya dengan Status Gizi Batita (6 - 36 bulan) Di Kecamatan Pedamaran Kabupaten Ogan Komering Mir Sumatera Selatan Tabun 2001". Tujuan penelitian ini adalah untuk memperoleh tentang kekuatan hubungan umur pertama kali pemberian MP-ASI dengan status gizi bayi. Pada penelitian ini desain yang digunakan adalah cross sectional (potong lintang). Sampel adalah bayi umur 6 - 12 bulan yang mendapatkan ASI. Analisis yang digunakan adalah univariat, bivariat dan multivariat_Hasil penelitian didapatkan bahwa prevalensi KEP sebesar 20,7%, rata-rata umur pemberian MP-ASI 3,8 bulan, sedangakan bayi yang diberi MP-ASI < 4 bulan sebesar 31,0%. Asupan energi dari rata-rata 764 kkal sedangkan asupan protein 16 gr. Dari basil analisis multivari.at didapatkan adanya hubungan yang bermakna antara umur pertama kali pemberian MP-ASI dengan status gizi bayi umur 6 - 12 bulan. Bayi yang mendapatkan MP-ASI pada umur < 4 bulan kemungkinan akan mengalami risiko gizi kurang 5,2251 kali dibandingkan dengan bayi yang mendapatkan MP-ASI pads mnur 4 - 6 bulan setelah dikontrol oleh asupan energi. Ternyata asupan energi berperan sebagai confounder, atau mempunyai pengaruh dalam meningkatkan hubungan umur pertama kali pemberian MP-ASI dengan status gizi bayi.Untuk meningkatkan status gizi bayi maka perlu dilakukan peningkatan pelaksanaan monitoring pertumbuhan melalui kegiatan UPGK di posyandu, selain itu kepada ibu menyusui hams diupayakan untuk tidak memberikan makanan prelakteal dan memberikan MP-ASI dini, karena bila sudah mendapat makanan prelakteal dan IvfP-ASI yang diberikan pada umur < 4 bulan bisa merugikan bayi. Petugas kesehatan berperan penting dalam memberikan pendidikan/konseling terhadap ibu hamil tentang manajemen laktasi. Agar bayi dapat memenuhi kebutuhan gizinya perlu dikembangkan makanan lokal melalui pelatihan pembuatan makanan lokal yang memenuhi syarat gizi dan cita rasa.
The Relationship between the First Age of Introducing Complementary Feeding with Nutritional Status of Babies aged 6 - 12 Months at Pedamaran Subdistrict Ogan Komering Ilir District South Sumatera in 2001Babies aged 6 -12 months begins to get complemernary feeding gradually while still breast feeded. In this age, baby immunity which was received passively from his mother decreases, while he begins to receive an inadequate food. Several researches show that protein energy malnutrition (PEM) prevalence to babies is more than 15% based on nutritional status index (Weight/Age). This shows that baby nutrition remains serious matter to overcome.The research analyzes secondary data obtained from the previous research titled "Breast feeding pattern, weaning age and complementary feeding in relation to the nutrition status of baby under three years ( 6 - 36 months) at Pedamaran Subdistrict, Ogan Komering Ilir District, South Sumatera in 2001". This research purpose is to obtain the relational strength between the first age of introducing complementary feeding and nutritional status of babies 6 - 12 months. This research uses cross sectional design, through univariat, bivariat, and multivariate analyses. Samples are baby aged 6 - 12 months who received Breast milkThe research result shows that Protein Energy Malnutrition (PEM) prevalence is 20,7%, mean of ages introducing complementary feeding is 3,8 months, mean of babies of age of introducing complementary feeding < 4 months is 31,0%, mean of energy intake is 764 kkal, and mean of protein intake is 16 gr. Multivariate analysis shows that there is significant relationship between first age of introducing complementary feeding and nutritional status of infant age 6 -12 months. Babies who received complementary feeding <4 months possible might experience with under nutrition (Weight/Age) risk more than 5,2251 than babies who received complementary feeding at 4 - 6 months of age after controlled by energy intake. Apparently, energy intake plays as confounder role, or has influence to increase the relationship between first age of complementary feeding and nutritional status of infants.In order to improve baby nutritional status, there should be monitoring improvement through UPGK program at Posyandu. In addition, mother is expected not to administer prelacteal food and able to administer exclusive breast-feeding, because babies given prelacteal and administered of introducing complementary feeding at the age <4 months, they will be harmful. On the other hand there should be information given both to health officers and pregnant mothers about lactation management . In order to baby nutrient necessity, there should be it needs local/ordinary foods development through the training of local food production which fulfills nutrition condition and flavor.
Indonesia has targeted a reduction in stunting prevalence to 14,2% in 2029. However, this effort still faces major challenges such as the complexity of the double burden of malnutrition and suboptimal feeding practices during the first 1000 days of life. At individual level, a child can experience more than one malnutrition problem at once, which called the double burden of malnutrition. Limited studies have examined the double burden of malnutrition at individual level in Indonesia. Therefore, this study was conducted to identify the association of complementary feeding practices and the double burden of malnutrition among children aged 6-23 months in Indonesia. This was a cross-sectional study using secondary data from the 2022 Indonesia Nutritional Status Survey. The double burden of malnutrition was assessed in forms of coexisting stunting-wasting and stunting-overweight, while complementary feeding practices was measured based on WHO and UNICEF IYCF indicators. A total of 69.884 children were analyzed for stunting-wasting and 72.158 children for stunting-overweight after meeting data completeness and no extreme values. Multiple logistic regression analysis was conducted to estimated asjusted prevalence odds ratio (aPOR). This study found the prevalence of stunting-wasting and stunting-overweight was 2.7% and 0.7%, respectively. Among the children, 50.9% met the minimum dietary diversity (MDD), 83.5% met the minimum meal frequency (MMF), 45.3% met the minimum acceptable diet (MAD), 72.5% consumed eggs and flesh foods (EFF), 24.9% consumed sweet beverages (SwB), and 21.6% had zero consumption of fruits and vegetables (ZVF). SwB and ZVF indicators were significantly associated with both forms of the double burden of malnutrition. Children who did not consume sweet beverages had a 10% lower risk of stunting-wasting (aPOR: 0.90; 95% CI: 0.81–0.996) and a 31% lower risk of stunting-overweight (aPOR: 0.69; 95% CI: 0.57–0.84) compared to children who consume sweet beverages. Meanwhile, children who consumed fruits and vegetables had a 20% lower risk of stunting-wasting (aPOR: 0.80; 95% CI: 0.71–0.90) and a 29% lower risk of stunting-overweight (aPOR: 0.71; 95% CI: 0.57–0.89) than those with zero intake of fruits and vegetables. These findings highlight the importance of improving the diversity and quality of foods provided in government programs, along with strengthening nutrition education and sweet beverages nutrition labeling policies to prevent the double burden of malnutrition among children.
Penyakit diare akut masih merupakan masaiah kesehatan masyarakat yang utama di dunia. Rotavirus merupakan penycbab utama gastroenteritis pada bayi dan anak-anak serta menyebabkan dehidrasi yang serius. Beberapa hasil penelitian menunjukkan bahwa pemberian air susu ibu secara ekslusif meningkatkan sistcm imunitas pada bayi berusia 4 - 6 bulan berkaitan dengan pcnyakit diare. I-Iubungan ini tidak konsisten pada infeksi rotavirus namun sangat kuat hubungannya pada intbksi non virus seperti bakteri. Pemberian air susu ibu hanya dapat menurunkan ringkat keparahan diare yang disebabkan rotavirus. Tujuan dari penelitian ini untuk mengetahui hubungan pemberian air susu ibu dengan keparahan diare rotavirus pada anak-anak 0 - 24 bulan di Rumah Sakit Mataram September 2005-Desember 2007 setelah dikendalikan oleh faktor umur, jenis kelamin, tingkat pendidikan ibu, adanya infeksi lain, terapi di rumah, proses rehidrasi di rumah sakit, mjukan umuk rawat inap dan rawat inap. Desain penelitian ini adalah studi cross sectional dengan menggunakan data sekunder yang berasal dari kuesioner yang merupakan bagian dari penelitian yang dilakukan NAMRU-2 Jakarta yang bekeija sama dcngan Badan Penelitian dan Pengembangan Biomedis dan Farmasi Departemen Kesehatan Rl dan Rumah Sakit Mataram, Lombok. Populasi studi sejumlah 739 orang adalah pasien yang menderita diare rotavirus yang bcrumur 0-24 bulan di RSU Mataram Lombok antara bulan September 2005 sampai bulan Desember 2007. Hubungan pemberian air susu ibu dcngan keparahan diarc rotavirus ditentukan dengan anlisis mullmle logistic regression menggunakan perangkat STATA 9,0. Dari hasil analisis didapatkan bahwa prcvalcnsi diare rotavirus pada anak-anak usia 0 - 2 tahun yang memberikan sampel dan data yang lcngkap di RS Mataram adalah 64,l3%. Sebelum dikendalikan oleh variabel-variabel lainnya terlihat bahwa anak-anak yang mendapat ASI mempunyai kemungkinan untuk terjadinya diare parah 20% lebih rendah dibandingkan dengan anak-anak yang tidak mendapatkan ASI (ORcrude=0,80; 95%CI 0,53-l,22. Variabel lain yang mempengaruhi untuk tenjadinya keparahan diare rotavirus adalah rawat inap, terapi dirumah dengan ORS dan/lanpa antibiotik/obat diare dan tempi dengan antibiotik dan/tanpa obat diare serta pendidikan ibu. Setelah dikendalikan oleh variabel tersebut di atas ditemukan bahwa kemungkinan anak-anak yang mendapat ASI akan menjacli parah adalah 26% lebih rendah (ORu¢#us!ea'=0,74; 95%CI 0,46-l,l9) dari anak-anak yang tidak mendapat ASI. Genotipe predominan untuk tipe G adalah G1 (l9,35%), G2 (20,03%) dan G4G9 (40,l9%) sedangkan untuk tipe P adalah P[4] (l9,35%), P[6] (1l,34%) dan P[8] (48,7I %).
Acute dirrheae is a major health problem a worldwide. Rotavirus has become a predominant cause of gastroenteritis to infant and children which also causes severe dehydration. Some studies suggested that exclusive breastfeeding increased immunity related to diarrheaeof infant aged 4-6 months old. This association is inconsistent between breasfeeding and rotavirus infection, however strong association between breasfeeding and nonviral infection, such as bacteria infection. Nevertheles, brcastfeedeng reduces the severity of diarrlteae caused by rotavirus infection. The object of this study is to determine the association between breastfeeding and the severity of diarrheae caused by rotavirus in children aged 0-24 months old at Mataram General Hospital in the period of September 2005 through December 2007, with control measures of age, sex, educational background of mother, presence of other gastroenteritis infection, home medication, rchydration process at the hospital, hospital referral and hospitalization. Design of this study is across sectional using secondary data from questionares which are a part of a collaborative study conducted by US Naval Medical Research Unit No. 2 (US NAMRU-2), Biomedical and Pharmaceutical division of' Indonesia National Institution Health Research and Development, and Mataram general hospital at Lombok. The total of study population was 739 children aged 0-24 months old with diarrheae caused by rotavirus, who were pediatric patients at Mataram general hospital, I .ombok, September 2005-December 2007. The association between breasfeeding and the severity of dianheac was dtermined using multiple logistic regression with the application of STA'l`A 9.0 soltware (Stata Corp, Texas, USA). Analysis result suggested that the prevalence in our study population was 64.13%. Prior to the control measures application of other variables, it was concluded that children who were breasfed had the tendency to develop severe diarrheae 20% less than children who were neverbreasfed (Orcrude=0.80; 95%: Cl 0.53-1.22. Other variables which had effect on the diarrheae severity were hospitalization, home medication using oral rehydration solution (ORS) with or without antibiotics or anti diarrhea, and educational bacground of mothers. After those control measured were applied, it was concluded that children who were breasfed tended to develop severe diarrhea 26% less than children who were never breasfed (OR adjusted=0.74; 95% Cl: 0.46-l.l9). Predominant genotype for G-type rotavirus were G4G9, G2, and G1 with 40.l9%, 20.03%, and 19.35% respectively, meanwhile for P-type rotavirus were P[8], P[4], and P[6] with 48.7l%, l9.35%, and l l.34% respectively.
Kata Kunci : ASI eksklusif, gizi buruk (BB/U), anak usia 6-35 bulan
Indonesia has a nutritional problem is characterized by the magnitude of theprevalence of malnutrition among children under five. Malnutrition in childrenfrom birth to age three years will greatly affect the growth and development ofglial cells and brain myelination process, and therefore contributes to the qualityof his brain. In Karawang district proportion malnutrition (weight / age) infantsweighing in July 2013 was approximately 0.4 % , and 35.76 % of that number ischildren aged 6-35 months. The purpose of this study was to determine therelation of exclusive breastfeeding history with severe malnutrition status(weight/age) children aged 6-35 months in Karawang district in 2013 after beingcontrolled by the variable birth weight, child 's health status, dietary intake,maternal education, knowledge mother, maternal employment status, familyincome, number of family members and liveliness visit the neighborhood healthcenter. This study was conducted in August 2013 in Karawang district using case-control design. Cases were children aged 6-35 months in Karawang measuredweight on the weighing in July 2013 and have severe nutritional status (weight /age) and controls were children aged 6-35 months in Karawang measured weightonthe weighing in July 2013 and had a good nutritional status. In this study a totalsample of 276 (138 cases and 138 controls). Data were analyzed by multiplelogistic regression. The results showed a relation of exclusive breastfeedinghistory with severe malnutrition status (weight/age) children aged 6-35 months inKarawang districtin 2013. Children aged 6-35 months who had a history ofexclusive breastfeeding risk 0.26 times (95% CI 0,12-0,55) exposed to severemalnutrition (weight/age) compared with no history of exclusive breastfeedingafter controlled by food intake, maternal knowledge, and liveliness visit theneighborhood health center. History of exclusive breastfeeding decrease the riskof severe malnutrition (weight/age) in children aged 6-35 months in Karawangdistrict in 2013 by 74%.Efforts to prevent malnutrition in infants one of which isthe exclusive breastfeeding.Necessary of increases the health promotion ofexclusive breastfeeding with good and correct way to the target group effectivelyin order to get a good nutritional status.
Keyword : Exclusive breastfeeding, severe malnutrition status, childrenaged 6-35 months
Prevalensi gizi kurang pada anak usia kurang dari 36 bulan semakin meningkat seiring dengan bertambahnya jumlah keluarga miskin di Indonesia. Untuk mencegah semakin memburuknya status gizi dan kesehatan masyarakat, pemerintah telah melaksanakan program Jaring Pengaman Sosial Bidang Kesehatan (JPS-BK). Salah satu pelayanannya adalah intervensi gizi berupa pemberian makanan tambahan (PMT) bagi anak keluarga miskin.Penelitian ini menganalisis data sekunder dari penelitian "Studi Dampak PMT terhadap Status Gizi dan Kesehatan Bayi dan Anak". Tujuan penelitian ini untuk memperoleh informasi kekuatan hubungan PMT dengan status gizi anak usia 12 - 36 bulan. Lokasi penelitian di Propinsi Jawa Tengah yang merupakan salah satu wilayah sasaran program PMT JPS-BK. Faktor lain meliputi umur anak, jenis kelamin, lama pemberian ASI, penyakit infeksi, konsumsi energi, umur ibu, dan pendidikan ibu diduga mempengaruhi hubungan PMT dengan status gizi anak.Desain yang digunakan adalah Case Control. Kelompok kasus adalah anak yang memiliki status gizi kurang dengan indeks BBIU (Z-skor <-2 SD). Sedangkan kelompok kontrol adalah anak dengan status gizi baik (Z-skor > -2 SD). Besar sampel 214 anak, terdiri dari 107 sampel kasus dan 107 sampel kontrol. Evaluasi dari PMT yang diterima anak merupakan komposit dari kandungan energi PMT dan lama mendapat PMT.Hasil penelitian menunjukkan, dari seluruh sampel, sebagian anak ternyata menerima PMT dengan kualitas kurang. Penyelenggaraan PMT dengan model paket dibawa pulang ke rumah, ternyata hanya sebagian anak yang mengkonsumsi sendiri PMT tersebut. Proporsi anak yang menerima PMT kualitas kurang, lebih banyak ditemukan di kelompok kasus dibandingkan kontrol. Kesimpulan dari studi ini adalah tidak terbukti adanya hubungan yang bermakna antara PMT kualitas kurang dan cukup dengan status gizi anak. Diketahui pula faktor konsumsi energi ternyata berperan sebagai confounder, atau mempunyai pengaruh terhadap hubungan PMT dengan status gizi anak. Adanya bias misklasifikasi dalam pengukuran PMT.Saran yang diajukan adalah program PMT akan lebih efektif dengan model feedings centers. Selain itu, perlu adanya kerjasama lintas sektor, seperti "dana bergulir" untuk meningkatkan pendapatan keluarga, atau pemanfaatan pekarangan rumah, yang dapat digunakan oleh anggota keluarga itu sendiri. Dengan demikian, konsumsi energi anak dapat meningkat dan berdampak terhadap status gizinya. Untuk meminimalkan bias misklasifikasi, perlu penelitian lebih lanjut dengan populasi terdiri dari anak yang mendapat PMT dan tidak mendapat PMT.
The relationship between supplementary feeding program (PMT) and nutritional status of children 12-36 months of age at Central Java Province(secondary data analysis)The prevalence of underweight on children under 36 months of age increasingly with increment of poor families in Indonesia. To prevent more badly nutritional status and public health, the government has launched Social Safety Net Program in Health (JPS-BK). One of the services is nutritional intervention such as supplementary feeding program (PMT) for children from poor families.The study was analyzed the secondary data "impact study supplementary feeding program on nutritional status and health on baby and children". The aim of the study to get information strength of relationship between supplementary feeding program and nutritional status on children 12 - 36 months of age. Location's study at Central Java Province, one of the target area JPS-BK supplementary feeding programs. Several factors such as age, sex, length of breastfeeding, infection, energy consumption, mother?s age, mother's education, was predicted influenced the relationship between PMT and nutritional status on children.The design was case control study. Cases group is children who underweight by weight for age index (Z-score < -2 SD). Control group is children with nutritional status was good (Z-score > -2 SD). Sample size was 214, that was 107 cases and 107 control. Evaluation of PMT was composite from energy of PMT and duration of feeding.Result of the study showed a half of the sample have gotten PMT as insufficient quality. All the supplement were delivered to the home, and showed a half of children who consumed PMT by himself/herself. Proportion of children who got PMT as insufficient quality, was more at cases group than control. The study concluded no significant relationship between insufficient quality and sufficient quality of PMT and nutritional status of children. Energy consumption was role as confounder. There was misclassification bias on measured PMT.It is suggested that supplementary feeding program were more effectively with feeding centers model. It's necessary cross sector program such as "rotation fund" to increase income families or using garden home for members of families. Consequently, energy consumption of children increased, and have given indirect impact on nutritional status on children. To minimize misclassification bias, it's necessary a further study with population on children who supplemented and non supplemented.
