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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
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.
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.