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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.
ABSTRAK Penelitian ini bertujuan untuk memperoleh informasi yang mendalam tentang Peran Kelas Ibu Hamil Terhadap Praktik Inisiasi Menyusu Dini Pada Ibu Bayi Usia 0-12 Bulan, di Wilayah Kelurahan Tengah, Kramatjati, Tahun 2012. Penelitian ini menggunakan metode kualitatif dengan Rapid Assesment Procedures. Total informan dalam penelitian adalah 26 orang dengan jumlah informan kunci sebanyak 4 orang. Pada penelitian ini diperoleh hasil bahwa Kelas Ibu Hamil kurang cukup berperan Terhadap Praktik Inisiasi Menyusu Dini. Praktik IMD yang berhasil dilakukan oleh informan lebih besar disebabkan oleh adanya kebijakan penyedia layanan bersalin serta kondisi pasca bersalin baik ibu maupun bayinya. Hampir seluruh informan telah memiliki niat, telah mendapat dukungan sosial, dan telah menerima informasi mengenai IMD. Namun hampir semua informan belum memiliki otonomi pribadi dan situasi yang paling mendukung melakukan IMD adalah adanya kebijakan penyedia layanan bersalin serta kondisi pasca persalinan. Hampir semua informan tidak memiliki pengetahuan yang baik mengenai IMD, namun telah memiliki sikap yang positif terhadap IMD. Perlu upaya untuk meningkatkan peran Kelas Ibu Hamil agar dapat meningkatkan pengetahuan ibu hamil mengenai IMD.
Abstract This study aims to gain an in-depth information on the role of antenatal class and its correlation with mother?s infant behavior of immediate breastfeeding at Kelurahan Tengah, Kramatjati, East Jakarta. This study used qualitative methods with Rapid Assessment Procedures. Total informants in the study were 26 people with a number of key informants as many as 4 people. In this study obtained results that the antenatal class is not enough against Immediate Breastfeeding Practices. Immediate Breastfeeding Practice that successfully carried out by the informant is greater due to the policy of the maternity service providers as well as post-partum condition of both mother and baby. Almost all the informants had had the intention, has received social support, and has received information on the Immediate Breastfeeding. But almost all the informants do not have personal autonomy and the situation most favorable to the Immediate Breastfeeding is the policy of the maternity service providers and postpartum conditions. Almost all the informants had no knowledge of the Immediate Breastfeeding, but have had a positive attitude to it. Necessary efforts to enhance the role of class in order pregnant mothers can increase their knowledge about Immediate Breastfeeding.
Bayi mengalami pertumbuhan sangat cepat. Setelah usia 6 bulan merupakan masa paling kritis karena pada saat itu pemberian ASI saja tidak mencukupi untuk pemenuhan kebutuhan gizi. Gangguan pertumbuhan pada periode ini berkaitan dengan praktik pemberian makan bayi karena itu jika pemberian MPASI tidak diberikan secara tepat akan menyebabkan gangguan pertumbuhan optimal. Penelitian tentang program peningkatan MPASI menemukan bahwa masih banyak ibu belum mengerti cara pemberian dan waktu tepat memberikan MPASI. Menurut SDKI 2002-2003 sekitar 47,9% bayi mendapat makanan pralakteal dan 50 % bayi sudah mendapat MPASI pada usia kurang dari 1 bulan, bahkan pada usia 2-3 bulan sudah mendapat makanan padat. Di Kabupaten Bangka belum pernah dilakukan penelitian tentang MPASI sebelumya. Tujuan penelitian untuk memperoleh informasi mengenai faktor-faktor yang berhubungan dengan praktik pemberian MPASI pada bayi usia 0-12 bulan di Kecamatan Sungailiat Kabupaten Bangka 2008. Penelitian ini menggunakan pendekatan kuantitatif dengan desain potong lintang. Sampel adalah ibu mempunyai bayi usia 0-12 bulan yang tinggal di Kecamatan Sungailiat Kabupaten Bangka pada saat penelitian dengan kriteria inklusi masih menyusui, belum pernah diberikan bantuan MPASI oleh pemerintah atau MPASI program gakin dan bersedia mengikuti penelitian. Cara pengambilan sampel menggunakan survei cepat dengan rancangan klaster. Sebagai klaster adalah kelompok ibu yang mempunyai karakteristik homogen di wilayah posyandu di Kecamatan Sungailiat. Jumlah sampel 270 orang dan 30 klaster, pemilihan secara acak sehingga setiap klaster dibutuhkan 9 responden. Variabel dependen penelitian adalah praktik pemberian MPASI, sedangkan variabel independen adalah umur ibu, paritas, pendidikan ibu, pekerjaan ibu, jumlah anggota keluarga, pengetahuan ibu tentang MPASI, pendapatan keluarga dan peran petugas kesehatan. Analisis dengan menggunakan univariat, bivariat dan multivariat. Hasil penelitian didapatkan praktik pemberian MPASI pada bayi usia 0-12 bulan di Kecamatan Sungailiat tahun 2008 sudah dilaksanakan sebesar 87,0%. Dari responden melaksanakan praktik tersebut sebanyak 54,7% dengan praktik pemberian MPASI baik dan kurang baik sebesar 42,6%. Hasil uji bivariat dengan chi square ada hubungan bermakna antara pendidikan ibu (p=0,086), pengetahuan MPASI ibu (p=0,002, OR=2,394 ; CI (1,410-4,065) dan peran petugas kesehatan (p=0,000, OR=10,605 ; CI (5593-20,108) dengan praktik pemberian MPASI pada bayi usia 0-12 bulan di Kecamatan Sungailiat Kabupaten Bangka 2008. Analisis multivariat dengan regresi logistik menghasilkan faktor paling dominan adalah peran petugas kesehatan. Ibu dengan peran atau dukungan kurang baik oleh petugas kesehatan memberikan peluang 10,538 kali untuk melakukan praktik pemberian MPASI kurang baik dibandingkan ibu dengan peran atau dukungan petugas kesehatan baik setelah dikontrol oleh umur ibu, pendidikan , pekerjaan dan pengetahuan ibu tentang MPASI. Faktor determinan adalah peran petugas kesehatan yaitu dengan meningkatkan pengetahuan dan keterampilan petugas kesehatan di bidang gizi khususnya dalam memberikan makanan tepat pada bayi sesuai dengan waktu dan cara pemberian. Pentingnya pemberian ASI eksklusif serta manajemen laktasi pada ibu mempunyai bayi di seluruh Kecamatan Sungailiat secara benar dan terus menerus. Meningkatkan promosi praktik pemberian MPASI sehat dan higienis di posyandu, puskesmas dan pertemuan warga, penyediaan sarana penyuluhan dan klinik gizi seperti poster, leaflet, booklet, food model atau contoh MPASI dan makanan bergizi seimbang. Meningkatkan promosi ASI eksklusif dengan sasaran remaja atau wanita usia subur belum menikah dan meningkatkan motivasi petugas kesehatan yang berprestasi di tingkat puskesmas.
Infant grows very fast. The critical period is started after the age of six months. This is because, in that period giving breastfeeding exclusively to the infant does not sufficiently fulfill the nutrition need. Growth interference in this period is closely related with the infant's feedings. Therefore, if complementary feeding is not given correctly, it will cause the interference of optimal growth. The research result of complementary feeding increasing program finds that there is a big number of mothers who still do not understand about the way and the right time of complementary feeding. Based on SDKI's data, in 2002-2003, 47,9% of the infant were given pralacteal food and 50% of the infant had been given complementary feeding in the age of less than one month, and in the age of 2-3 months the infant were given solid food. There has not ever been a research about complementary feeding being done in Bangka District. The aim of this research is to obtain the information about related factors dealing with complementary feeding practices to the infant ages 0-12 months in Sungailiat, Bangka District on 2008. The research uses quantitative approach and cross sectional design. The samples are mothers who have 0-12 months infant and live in Sungailiat, Bangka District. The mothers are characterized as follows; breasting, never been given MPASI donation from the government or complementary feeding program for poor family, and able to participate in the research. The samples are taken by using a rapid survey with cluster design. The cluster is a group of mothers who have homogenic characteristic in the area of Integrated Health Service at Sungailiat. The sample number is 270 people and 30 clusters, which are chosen randomly. Therefore, each cluster needs 9 respondents. The dependent variable of the research is complementary feeding practices, and the independent variables are mothers' ages, mothers' education, mothers' works, the number of family member, mothers' knowledge about complementary feeding, family income, and the role of medical officers. The research result shows that complementary feeding practices to the infant ages 0-12 months in Sungailiat has been done and reached 87,0%. 54,7 % of the respondents have complementary feeding practices well and 42,6% of the respondents have not complementary feeding practices very well. The brivariat test by using chisquare shows that there is a relationship between mothers' education (p=0,086), mothers' knowledge about complementary feeding (p=0,002, OR=2,394; CI (1,410-4,0645) and medical officers' role (p=0,000, OR=10,605; CI (5593-20,108) with complementary feeding practices to the infant age 0-12 months in Sungailiat on 2008. Multivariate analysis with logistic regression shows that the most dominant factor is the role of medical officers, after controlled by variables of mothers' ages, education, works and mothers' knowledge about complementary feeding practices. Since the determinant factor is the role of medical officers, therefore increasing their knowledges and abilities in nutrition field especially in giving the right food in the right time for infant is the best solution. The importance of giving breastfeeding exclusively and lactation management for mothers who have infant in Sungailiat should run well and continually. Increasing the promotions of giving a health and hygienic complementary feeding Integrated Health Service, Public Health Service and people's meetings, providing the meetings facilities, and nutrition clinic, such as poster, leaflet, booklet, food model. Increasing the promotions of giving brestfeeding exclusively to the teenagers or unmarried woman who are in the fertilities ages, and increasing the motivation for the medical officers especially those who have good achievement in the area of public health service.