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Prevalensi stunting pada balita di Indonesia, khususnya Kabupaten Bogor masih tergolong tinggi. Minimum Acceptable Diet (MAD), salah satu penilaian pada praktik pemberian makanan pendamping ASI, merupakan salah satu determinan utama dalam kejadian stunting. Penelitian ini bertujuan melihat hubungan MAD dan faktor lainnya dengan kejadian stunting pada anak umur 6-23 bulan. Metode penelitian ini menggunakan desain studi kohor prospektif data penelitian Kohor Tumbuh Kembang Anak (TKA) yang dilaksanakan sejak tahun 2012 di Kota Bogor. Sampel penelitian ini adalah anak umur 6-23 bulan pada studi kohor TKA yang dilakukan pengukuran berulang secara lengkap. Anak yang lahir pada pada tahun 2012-2017 dan diikuti hingga umur 23 bulan (pada tahun 2014-2019).
Variabel dependen pada penelitian ini ialah anak stunting yang diamati pada saaat usia 12, 18 dan 24 bulan. Variabel independen utama pada penelitian ini ialah MAD yang diamati pada rentang umur 6-11, 12-17 dan 18-23 bulan.
Hasil: Prevalensi stunting dalam penelitian ini masih cukup tinggi yaitu anak umur 12 bulan (23,8%), 18 bulan (33,2%) dan 24 bulan (24,6%). Capaian MAD tidak adekuat paling banyak terjadi pada anak umur 6-11 bulan (77,9%). Analisis bivariat menunjukkan bahwa MAD umur 6-11, 12-17 dan 18-23 tidak berhubungan terhadap kejadian stunting pada anak umur 12,18 dan 24 bulan.. Analisis Multivariat Regresi Cox menunjukkan stunted usia sebelumnya dan asupan protein mempengaruhi terjadinya stunting.
Kesimpulan: Upaya lebih lanjut perlu dilakukan untuk capaian MAD yang direkomendasikan pada anak usia 6-23 bulan untuk mencegah stunting. Studi skala besar untuk mengeksplorasi peran MAD dalam mengurangi stunting dan studi kualitatif untuk mengidentifikasi kendala dan faktor yang mempengaruhi praktik pemberian makan bayi dan anak yang lebih baik sangat penting untuk perbaikan program.
The prevalence of stunting among children under-fives in Indonesia, particularly in Bogor, West Java, is still relatively high. Minimum Acceptable Diet (MAD), one of the assesments on the practice of complementary feeding is one of the main determinants of stunting. This study aims to examine the relationship between MAD and other factors with the incidennce of stunting in children aged 6-23 months. Methods: This research method uses a prospective cohort study design from the Cohort of Growth and Development of children (TKA) research data which has been carried out since 2012 in Bogor City.
The sample of this study was children aged 6-23 months in the TKA cohort study whio underwent complete repeated measurements. Children born in 2012-2017 and followed up to 23 months of age (in 2014-2019).
The dependent variables were stunted children at ages 6-11, 12-17. 18-23 and 24 months. The main independent variable was Minimum Acceptable Diet at the age interval of 6-11, 12-17, and 18-23 months. The data collection on the MDD, the MMF, and the MAD used twenty-four-hour dietary recall. Result: Prevalence of stunting was higher for child aged 12 months (41,7%) than for those in 18 months (8,1%) and 24 months (4,0%) category. Inadequate MAD achievement was most common in children aged 6-11 months (41.7%). Bivariate analysis showed that fulfilment MAD aged 6-11, 12-17 and 18-23 were not associated with stunting. Multivariate analysis Cox Regression indicated that stunted early age and protein intake were significantly associated with stunting.
Conclusion: More efforts need to be done to achieve the recommended MAD for all children aged between 6-23 months and to prevent stunting. Large scale studies to explore the role of MAD in reducing stunting and qualitative studies to identify the constraints and promoting factors to better infant and young child feeding practices are imperative for programme improvement.
The fatty acid DHA is one of the omega-3 fatty acids PUFA that plays a role in cognitive development. Sea fish and seafood is the main source of DHA. However, DHA and the prekusor is also found in other foodstuffs such as eggs, chicken meat, nuts or seeds. In addition to intake of DHA, cognitive development is also influenced by the intake of other nutrients and support environment. The purpose of this research is to get influence of PUFA and consumption of foods rich in omega-3 from marine fish/ seafood during pregnancy in third trimester, breastfeeding, Docosahexanoic acid (DHA)-Red Blood Cell of infants and its relation to cognitive development of infant at 4 months. Design study is prospective cohort study by the number of sample is 102 pairs of mothers with their newborn who checks into public health center (puskesmas)/ maternal and child health center (posyandu) in Panimbang and Majasari. The sample examined since the third trimester of pregnancy to childbirth and infants aged 4 months. Samples of breast milk and baby's cognitive development was measured at the time of a baby aged 4 months. The results showed that the intake of PUFA mothers during pregnancy and lactation is 549.45 (95% CI 491,48-607,42) mg and 240.86 (95% CI 228,06-103.02) mg. Most respondents baby has cognitive development of the appropriate chronological age or above (85,3%) and only 14.5% of the respondents have less cognitive development of infants age from chronological. Multivariate analysis of the effects of intake of PUFA and foods rich in omega-3 from marine fish / seafood in third tremester pregnant women and mother breastfeeding on cognitive development of infants aged 4 months after being controlled by the variable characteristics of respondents mothers and infants, mother consumption and environmental support (covariate variable) showed that the variables that could predict infant cognitive development is the consumption of foods rich in omega-3 from marine fish / seafood (OR=5,647 95% CI 1,45-21,986), intake of PUFA (OR= 1,862, 95% CI 0,5-6,935), aspects of emotional and verbal responsiveness (OR=7,52, 95% CI: 1,804-31,346) and fat intake (OR=0,204 CI 0,051-0,810). Mothers frequently consuming foods rich in omega-3 from fish has a chance 5,6 times get a baby with better cognitive development. Granting of stimulation in the form of hugs, kisses, attention, affection, and sensitive as well as the mother's responsiveness to the needs of the infant cognitive development increase gives the opportunity of baby 7.52 times.
