Hasil Pencarian  ::  Simpan CSV :: Kembali

"Latar belakang. Air susu ibu ASI merupakan nutrisi ideal bagi seorang bayi, namunkomposisi ASI bervariasi dan sangat individual. Human milk fortifier HMF direkomendasikan oleh WHO untuk diberikan pada bayi sangat prematur dan/atau bayiberat lahir sangat rendah BBLSR , namun belum terdapat kesepakatan kapan waktumemulainya. Selain itu kelompok ini berisiko mengalami kekurangan atau kelebihan zatbesi akibat pemberian suplementasi besi rutin. Objektif. Mendapatkan profil perubahan kandungan energi makronutrien dan zat besi dariASI bayi sangat prematur dan/atau BBLSR, serta kecukupan kandungan nutrisi dan zat besipada ASI untuk memenuhi kebutuhan yang direkomendasikan.Metode. Studi deskriptif analitik dengan desain multiple measurement pada studilongitudinal. Sampel penelitian adalah ASI ibu yang melahirkan bayi sangat prematurdan/atau BBLSR periode bulan Juli-Oktober 2017 di unit perinatologi RSCM. PemeriksaanASI menggunakan MIRIS dilakukan secara serial selama 4 minggu dan pada minggu 4dilakukan pemeriksaan kadar besi ASI menggunakan ICP-MS. Sebanyak 30 ibu yang memiliki data lengkap hingga minggu 4 dilakukan analisis.Hasil. Terdapat penurunan kandungan protein di ASI p=0,0003 disertai peningkatanlemak p=0,0004 dan kalori p=0,0006 setiap minggunya, namun tidak demikian dengankarbohidrat p=0,447 . Kekurangan protein di ASI didapatkan sejak minggu II pascakelahiran walaupun kalori lemak ASI masih mencukupi. Kadar zat besi ASI pada hari 28ditemukan lebih rendah dari nilai rekomendasi ESPGHAN dan AAP-Con ditemukan padapemeriksaan hari ke 28.Kesimpulan. Terdapat perubahan kandungan makronutrien setiap minggunya pada ASIbayi sangat prematur dan/atau BBLSR dan tidak mencukupi kebutuhan yang direkomendasikan. Pemberian HMF dapat dipertimbangkan untuk diberikan sejak minggu IIuntuk mencukupi kebutuhan tumbuh kejar.

---

Background. Mother rsquo s own milk MOM is an ideal nutrition for a baby, but thecomposition is varied and highly individualized. Human milk fortifier HMF is recommended by WHO for very premature infants and or very low birth weight VLBW infants, yet no agreement when to start. In addition, this group is at risk of iron deficiencyor excess due to routine iron supplementation.Objective. To find the changes in macronutrient and iron contents from MOM in verypremature infants and or VLBW infants, as well as the adequacy of nutrients and ironcontents in MOM to conform recommended needs.Method. Analytical descriptive study with multiple measurement design in longitudinalstudy. Subjects were mothers who delivered very premature infants and or VLBW infantsfrom July to October 2017. Breast milk was serialized with MIRIS for 4 weeks and ironcontent was researched with ICP MS at 4th week. The study took place in neonatolgy unitin Cipto Mangunkusumo Hospital. A total of 30 mothers who had complete data for 4weeks were analyzed.Results. There was a decrease in protein content in breast milk p 0.0003 and increasedfat p 0.0004 and calories p 0.0006 per week, but not in carbohydrates p 0.447 .Although this result is higher than the study of systematic review in Australia in 2016.Protein deficiency in breast milk was found from the first week after birth and iron contentis lower than the value of recommendation of ESPGHAN and AAP Con at 28 dayexamination.Conclusion. Macronutrient content changes each week in breast milk of very prematureand or VLBW infants and not enough from dietary recommendation. Giving HMF may beconsidered at 1st week after birth."

"ASI menjadi nutrisi terbaik yang dapat membantu menurunkan morbiditas dan mortalitas BBLR. Namun, pemberian ASI pada BBLR selama masa perawatan di rumah sakit sering menemukan berbagai macam hambatan. Intervensi yang dapat dilakukan berupa pemberian edukasi dan dukungan menyusui BBLR melalui program SATUPAS. Tujuan penelitian ini adalah untuk mengidentifikasikan pengaruh program “SATUPAS” terhadap produksi ASI, frekuensi perah, dan ASI parsial bayi berat lahir rendah. Desain penelitian adalah true experiment dengan pendekatan pre-post test control group dan pengambilan sampel menggunakan metode random sampling. Responden berjumlah 82 ibu dan bayi berat lahir rendah yang dibagi menjadi 41 responden mendapat intervensi program SATUPAS dan 41 responden mendapat intervensi rutin. Analisis univariat menunjukkan kedua kelompok homogen dan analisis bivariat menggunakan uji Wilcoxon dan Mann-Whitney menunjukkan terdapat perbedaan yang signifikan antara produksi ASI (p=0,001), frekuensi perah (p=0,001), dan ASI parsial (p=0,001) kelompok kontrol dan kelompok intervensi. Penelitian ini merekomendasikan penerapan program SATUPAS sebagai upaya untuk meningkatkan pemberian ASI bagi bayi berat lahir rendah yang menjalani hospitalisasi.

---

Breast milk is the best nutrition that can help reduce morbidity and mortality of Low Birth Weight (LBW) infants. However, breastfeeding LBW infants during hospitalization often has many problems. Intervention in the form of providing education and support for LBW infants breastfeeding through the SATUPAS program is attempted to overcome this problem. The purpose of this study was to identify the effect of the "SATUPAS" program on breastmilk production, frequency of breastmilk expression, and partial breastfeeding of low birth weight infants. The research design was a true experiment with a pre-post test control group approach and the sampling method used a random sampling. Respondents were 82 mothers and low birth weight babies, divided into 41 respondents who received the SATUPAS program intervention and 41 respondents received routine intervention. Univariate analysis showed that both groups were homogeneous and bivariate analysis using the Wilcoxon and Mann-Whitney tests showed that there was a significant difference between breastmilk production (p = 0.001), frequency of breastmilk expression (p = 0.001), and partial breastfeeding (p = 0.001) in the control group and the intervention group. This study recommends the implementation of the SATUPAS program as an effort to increase breastfeeding for low birth weight infants undergoing hospitalization."

"[ABSTRAKPersepsi Ketidakcukupan ASI (PKA) adalah pikiran atau perasaan ibu terhadap kondisi ketiadaan atau berkurangnya produksi ASI sehingga ibu merasa bahwa ASI-nya tidak cukup untuk memenuhi kebutuhan bayinya. PKA menjadi alasan utama ibu berhenti menyusui secara dini dan alasan untuk memberikan makanan tambahan lebih awal pada bayinya. Prevalensi PKA belum diketahui secara pasti, diperkirakan antara 30-80% dari ibu yang menyusui mempunyai PKA. Penelitian ini bertujuan untuk membuktikan faktor ?faktor yang berhubungan dengan PKA pada ibu yang memiliki bayi usia 0-6 bulan di wilayah kerja Puskesmas Sewon Yogyakarta. Desain penelitian ini menggunakan Cross Sectional. Jumlah sampel dalam penelitian ini sebanyak 71 sampel ibu yang memiliki bayi 0-6 bulan yang gagal menyusui secara eksklusif dikarenakan mengalami PKA. Hasil analisis didapatkan sebanyak 59 (83,1%) ibu memiliki PKA dengan ASI yang cukup. Ada hubungan yang bermakna konseling ASI saat Antenatal Care (ANC) dengan PKA yang mempunyai ASI cukup, ibu yang tidak mendapatkan konseling saat ANC berpeluang 19,7 kali mempunyai PKA, p=0,012; OR=19,746 (CI 95% 1,926-202,456). Konseling ASI pada saat ANC yang berkualitas merupakan hal yang sangat penting dilaksanakan oleh petugas kesehatan untuk persiapan menyusui. Pemanfaatan ?Temu wicara? dalam konsep 10 T dalam ANC perlu diefektifkan untuk membahas persiapan laktasi.

---

ABSTRACTInsufficient perception ASI (PKA) is the mother's thoughts or feelings about the condition of the absence or reduction in milk production. She felt that her breast milk is not enough to satisfy the needs of the baby. PKA was the main reason mothers stop breastfeeding early and a reason to give extra food early on the baby. Prevalence of PKA is not certain, it is estimated between 30-80% of breastfeeding mothers has PKA. This study aims to prove the factors related to PKA in mothers whom had infants aged 0-6 months in Sewon Health Centre Yogyakarta. Design of this study using cross sectional. The numbers of samples in this study were 71 samples of mothers with babies? 0-6 months exclusive breastfeeding failure due to experiencing PKA. Found as many as 59 (83.1%) mothers had PKA with enough milk. There is a significant relationship counseling milk during Antenatal Care (ANC) by PKA that have enough milk, mothers who did not receive counseling when the ANC likely to have 19.7 times PKA, p = 0.012; OR = 19.746 (95% CI 1.926 to 202.456). Breastfeeding counseling during ANC quality do health personnel in preparation for breastfeeding implement a very important thing. Utilization of ?Gathering of speech? in the concept of 10 T in the ANC should be effected to discuss preparation for lactation.;Insufficient perception ASI (PKA) is the mother's thoughts or feelings about thecondition of the absence or reduction in milk production. She felt that her breast milkis not enough to satisfy the needs of the baby. PKA was the main reason mothers stopbreastfeeding early and a reason to give extra food early on the baby. Prevalence of PKA is not certain, it is estimated between 30-80% of breastfeeding mothers hasPKA. This study aims to prove the factors related to PKA in mothers whom had infants aged 0-6 months in Sewon Health Centre Yogyakarta. Design of this study using cross sectional. The numbers of samples in this study were 71 samples ofmothers with babies? 0-6 months exclusive breastfeeding failure due to experiencingPKA. Found as many as 59 (83.1%) mothers had PKA with enough milk. There is a significant relationship counseling milk during Antenatal Care (ANC) by PKA that have enough milk, mothers who did not receive counseling when the ANC likely to have 19.7 times PKA, p = 0.012; OR = 19.746 (95% CI 1.926 to 202.456).Breastfeeding counseling during ANC quality do health personnel in preparation forbreastfeeding implement a very important thing. Utilization of Gathering of speechin the concept of 10 T in the ANC should be effected to discuss preparation for lactation;Insufficient perception ASI (PKA) is the mother's thoughts or feelings about thecondition of the absence or reduction in milk production. She felt that her breast milkis not enough to satisfy the needs of the baby. PKA was the main reason mothers stopbreastfeeding early and a reason to give extra food early on the baby. Prevalence of PKA is not certain, it is estimated between 30-80% of breastfeeding mothers hasPKA. This study aims to prove the factors related to PKA in mothers whom had infants aged 0-6 months in Sewon Health Centre Yogyakarta. Design of this study using cross sectional. The numbers of samples in this study were 71 samples ofmothers with babies? 0-6 months exclusive breastfeeding failure due to experiencingPKA. Found as many as 59 (83.1%) mothers had PKA with enough milk. There is a significant relationship counseling milk during Antenatal Care (ANC) by PKA that have enough milk, mothers who did not receive counseling when the ANC likely to have 19.7 times PKA, p = 0.012; OR = 19.746 (95% CI 1.926 to 202.456).Breastfeeding counseling during ANC quality do health personnel in preparation forbreastfeeding implement a very important thing. Utilization of Gathering of speechin the concept of 10 T in the ANC should be effected to discuss preparation for lactation;Insufficient perception ASI (PKA) is the mother's thoughts or feelings about thecondition of the absence or reduction in milk production. She felt that her breast milkis not enough to satisfy the needs of the baby. PKA was the main reason mothers stopbreastfeeding early and a reason to give extra food early on the baby. Prevalence of PKA is not certain, it is estimated between 30-80% of breastfeeding mothers hasPKA. This study aims to prove the factors related to PKA in mothers whom had infants aged 0-6 months in Sewon Health Centre Yogyakarta. Design of this study using cross sectional. The numbers of samples in this study were 71 samples ofmothers with babies? 0-6 months exclusive breastfeeding failure due to experiencingPKA. Found as many as 59 (83.1%) mothers had PKA with enough milk. There is a significant relationship counseling milk during Antenatal Care (ANC) by PKA that have enough milk, mothers who did not receive counseling when the ANC likely to have 19.7 times PKA, p = 0.012; OR = 19.746 (95% CI 1.926 to 202.456).Breastfeeding counseling during ANC quality do health personnel in preparation forbreastfeeding implement a very important thing. Utilization of Gathering of speechin the concept of 10 T in the ANC should be effected to discuss preparation for lactation;Insufficient perception ASI (PKA) is the mother's thoughts or feelings about thecondition of the absence or reduction in milk production. She felt that her breast milkis not enough to satisfy the needs of the baby. PKA was the main reason mothers stopbreastfeeding early and a reason to give extra food early on the baby. Prevalence of PKA is not certain, it is estimated between 30-80% of breastfeeding mothers hasPKA. This study aims to prove the factors related to PKA in mothers whom had infants aged 0-6 months in Sewon Health Centre Yogyakarta. Design of this study using cross sectional. The numbers of samples in this study were 71 samples ofmothers with babies? 0-6 months exclusive breastfeeding failure due to experiencingPKA. Found as many as 59 (83.1%) mothers had PKA with enough milk. There is a significant relationship counseling milk during Antenatal Care (ANC) by PKA that have enough milk, mothers who did not receive counseling when the ANC likely to have 19.7 times PKA, p = 0.012; OR = 19.746 (95% CI 1.926 to 202.456).Breastfeeding counseling during ANC quality do health personnel in preparation forbreastfeeding implement a very important thing. Utilization of Gathering of speechin the concept of 10 T in the ANC should be effected to discuss preparation for lactation, Insufficient perception ASI (PKA) is the mother's thoughts or feelings about thecondition of the absence or reduction in milk production. She felt that her breast milkis not enough to satisfy the needs of the baby. PKA was the main reason mothers stopbreastfeeding early and a reason to give extra food early on the baby. Prevalence of PKA is not certain, it is estimated between 30-80% of breastfeeding mothers hasPKA. This study aims to prove the factors related to PKA in mothers whom had infants aged 0-6 months in Sewon Health Centre Yogyakarta. Design of this study using cross sectional. The numbers of samples in this study were 71 samples ofmothers with babies’ 0-6 months exclusive breastfeeding failure due to experiencingPKA. Found as many as 59 (83.1%) mothers had PKA with enough milk. There is a significant relationship counseling milk during Antenatal Care (ANC) by PKA that have enough milk, mothers who did not receive counseling when the ANC likely to have 19.7 times PKA, p = 0.012; OR = 19.746 (95% CI 1.926 to 202.456).Breastfeeding counseling during ANC quality do health personnel in preparation forbreastfeeding implement a very important thing. Utilization of Gathering of speechin the concept of 10 T in the ANC should be effected to discuss preparation for lactation]"

"ABSTRAKAir susu ibu (ASI) merupakan makanan yang paling sesuai untuk bayi karena ASI mengandung semua zat-zat yang dibutuhkan bagi pertumbuhan serta perkembangan bayi dan juga mengandung zat-zat yang dapat melindungi bayi terhadap penyakit infeksi (Sastroamidjojo, 1989). ASI mempunyai banyak kelebihan dibanding susu sapi. Protein ASI lebih mudah dicerna daripada protein susu sapi, selain itu ASI mempunyai susunan asam amino esensial yang secara biologik paling sesuai bagi bayi (Ebrahim, 1979; Heine, dkk, 1991). Pemberian nutrisi yang optimal pada bayi kurang bulan adalah pemberian nutrisi yang akan memberikan pertumbuhan yang cepat seperti pertumbuhan dalam kandungan pada trimester ke-III sehingga dapat dicapai tumbuh kembang yang memuaskan sekarang dan pada masa yang akan datang (American Academy of Pediatrics Commitee on Nutrition, 1977). Protein penting untuk menunjang pertumbuhan. Bila bayi kurang bulan diharapkan tumbuh dengan memuaskan, maka harus terjadi kondisi keseimbangan nitrogen yang positif atau terdapat nitrogen yang tertahan dalam tubuh dalam jumlah yang cukup dan terus menerus, sehingga pertumbuhan dapat berlangsung normal (Davies, 1977; Atkinson, dkk, 1981; Lau, dkk, 1986; Brooke, dkk, 1987 dan De Curtis, 1987). Hal tersebut telah terbukti pada penelitian yang dilakukan oleh Atkinson, dkk, (1981), dimana bayi kurang bulan yang mendapatkan ASI dari ibunya sendiri akan menunjukkan keseimbangan nitrogen yang positif, penambahan berat badan, pertumbuhan linear dan lingkar kepala yang bermakna, dibandingkan dengan bayi kurang bulan yang mendapatkan ASI dari bank ASI (ASI ibu kurang bulan mengandung protein yang sesuai dengan kebutuhan bayi). Lemak merupakan sumber energi terbesar didalam ASI (35-45%), juga merupakan bahan penyusun yang penting bagi sistem saraf yang mengalami perkembangan cepat pada waktu bayi, berperan dalam pengangkutan vitamin yang larut dalam lemak. Selain itu lemak merupakan unsur penting dari membran sel dan merupakan prekursor hormon (Benson, 1981). Laktosa merupakan salah satu karbohidrat yang paling menonjol di dalam ASI. Kadar laktosa ASI lebih tinggi daripada laktosa susu sapi. Tekanan osmotik dalam ASI harus seimbang dengan plasma, keadaan ini diatur oleh kadar laktosa dan ion-ion Na, dan Cl (ion monovalen). Dalam hal ini laktosa memegang peran penting. Bila kadar laktosa lebih tinggi, maka kadar ion-ion monovalen akan lebih rendah daripada di dalam susu sapi. Keadaan ini sangat menguntungkan karena cairan dengan kadar ion monovalen yang rendah tidak membebani ginjal (Lawrence, 1989 c)."

"Air susu ibu adalah makanan bayi yang terbaik karena mengandung komposisi nutrisi yang lengkap dan mengandung faktor-faktor penting untuk kekebalan tubuh bayi termasuk leukosit. Pemberian ASI ekslusif kepada bayi banyak mengalami hambatan, akibat ibu yang harus bekerja kembali  setelah cuti melahirkan. Berbagai upaya dilakukan agar bayi tetap mendapatkan ASI pada saat ibu bekerja, salah satunya adalah dengan cara penyimpanan ASI. Penelitian ini bertujuan untuk mengetahui pengaruh proses penyimpanan ASI pada wadah plastik terhadap jumlah, viabilitas dan morfologi leukosit. Sampel penelitian ini adalah ASI yang diperoleh dari 7 ibu menyusui selama periode bulan September tahun 2022 hingga Februari tahun 2023, kemudian dibagi menjadi 4 kelompok perlakuan berdasarkan suhu, lama penyimpanan dan metode pencairan ASI beku berdasarkan  rekomendasi CDC. Hasil penelitian menunjukkan tidak adanya penurunan yang signifikan pada jumlah total dan viabilitas sel  pada ASI yang disimpan pada wadah plastik. Walaupun terjadi perubahan pada gambaran morfologi leukosit namun proses penyimpanan dan pencairan tidak mempengaruhi populasi CD45+ secara keseluruhan.  Tetapi, perubahan yang signifikan ditemukan pada jumlah monosit dan basofil. Hasil penelitian ini menunjukkan bahwa rekomendasi penyimpanan berdasarkan rekomendasi CDC dengan menggunakan wadah plastik tidak memengaruhi kuantitas leukosit. Meskipun demikian, masih diperlukan penelitian lebih lanjut untuk memahami apakah perubahan morfologi ini mempengaruhi fungsional dari sel tersebut.

---

Mother's milk is the best baby food because it contains a complete nutritional composition and contains important factors for the baby's immune system including leukocytes. Exclusive breastfeeding for babies is increasingly experiencing obstacles, due to social changes that affect women who work after maternity leave. Various efforts have been made so that the baby continues to get breast milk when the mother is working, one of which is by storing breast milk. This study aims to determine the effect of the storage process on the number, viability and morphology of breast milk leukocytes. The sample for this study was breast milk obtained from 7 breastfeeding mothers during the period September 2022 to February 2023, then divided into 4 treatment groups based on temperature, storage time and method of thawing frozen breast milk from the recommendation guide at the CDC. The results showed that there was no significant decrease in the total number and viability of cells in breast milk. Although there was a change in the leukocyte morphology, the storage and thawing processes did not affect the CD45+ population as a whole. However, there were significant changes in the number of monocytes and basophils. The results of this study indicate that the storage recommendations from the CDC do not affect the quantity of leukocytes. Nevertheless, further research is still needed to understand whether these morphological changes affect the function of these cells."

"Suami berperan penting membangun motivasi ibu untuk menyusui. Penelitian ini bertujuan mengetahui hubungan tingkat pengetahuan suami tentang pemberian air susu ibu (ASI) terhadap motivasi ibu dalam menyusui. Desain penelitian yang digunakan yaitu cross sectional dengan pendekatan analitik komparatif kategorikal tidak berpasangan dan menggunakan teknik purposive sampling terhadap 68 orangtua dari bayi yang sedang menyusu berusia 7-12 bulan.Hasil penelitian menunjukkan tidak ada hubungan bermakna antara tingkat pengetahuan suami tentang pemberian ASI terhadap motivasi ibu dalam menyusui dengan pvalue=0,230 yang menggunakan uji Chi-square (α=0,05).Saran penelitian selanjutnya adalah mengidentifikasi hubungan tingkat pengetahuan suami tentang pemberian ASI terhadap dukungan kepada istrinya pada masa menyusui.

---

Father have role to increase mother?s motivation to breastfeed. The objective of this research is to find the relation of fathers? knowledge level about giving breast milk to maternal motivation of breastfeeding. This research was conducted using cross sectional design with approach analytical comparative categorical nonpaired and using purposive sampling technique to 68 parents of baby who suckling and aged 7-12 months.

The result shows that no significant relation between fathers? knowledge level about giving breast milk to maternal motivation of breastfeeding with p=value=0,230 using Chi-square test (α=0,05).

Recommendation for next research is identifying relation of fathers? knowledge level about giving breast milk toward support to his wife breastfeeding."

"Air Susu Ibu tidak hanya mengandung nutrisi namun juga sel-sel imun untuk melindungi bayi dari patogen pada awal kehidupannya. Salah satu sel yang berperan penting adalah makrofag (CD14+ mononuclear cells), sebagai komponen dari sistem kekebalan bawaan bagi bayi. Penelitian ini bertujuan untuk menganalisis perbandingan populasi, viabilitas serta kemampuan fagositosis CD14+ mononuclear cells ASI dan darah tepi. Total 20 subjek dianalisis populasi CD14+ mononuclear cells, M1 (CD86) dan M2 (CD206) dengan flow cytometry. Viabilitas sel dianalisis dengan CCK assay dan kemampuan fagositosis dengan sheep red blood cell (SRBC). Hasil penelitian menunjukkan bahwa populasi CD14+ mononuclear cells ASI lebih tinggi 20% dibanding darah tepi (38,93 ± 5,29% versus 1,88 ± 0,55%, p=0.0005). Populasi CD14+ mononuclear cells ASI terbukti memiliki kemampuan polarisasi yang ditandai dengan ekspresi M1 (CD86) dan M2 (CD206). Ratio M1/M2 pada ASI adalah < 1, namun tidak memiliki perbedaan signifikan dengan darah tepi (p=0,238). Viabilitas dan kemampuan fagositosis CD14+ mononuclear cells ASI secara signifikan lebih tinggi dibandingkan darah tepi (viabilitas, p=0,0032; kemampuan fagositosis, p=0,0001). Hasil penelitian ini menunjukkan bahwa CD14+ mononuclear cells ASI mempunyai populasi yang lebih tinggi dengan polarisasi dominan M2, serta mempunyai viabilitas dan kemampuan fagosistosis yang lebih baik daripada CD14+ mononuclear cells yang berasal dari darah tepi.

---

Breast milk contains nutrients and immune cells that protect infants from early-life pathogens. Macrophages (CD14+ mononuclear cells), play a crucial role as a component of the innate immune system in infants. This study compared the populations, viability, and phagocytic ability of CD14+ mononuclear cells derived from breast milk and peripheral blood in 20 subjects. The population of CD14+ mononuclear cells, M1 (CD86), and M2 (CD206) were analyzed using flow cytometry. Cell viability was assessed using the CCK assay, and phagocytic ability was measured with sheep red blood cells (SRBC). The results showed that the CD14+ mononuclear cell population in breast milk was 20% higher than in peripheral blood (38.93 ± 5.29% versus 1.88 ± 0.55%, p=0.0005. Breast milk CD14+ mononuclear cells exhibit M1 (CD86) and M2 (CD206) polarization, with an M1/M2 ratio <1, compared to peripheral blood (p=0.238). The viability and phagocytic ability of CD14+ mononuclear cells in breast milk were significantly higher compared to those in peripheral blood (viability, p=0.0032; phagocytic ability, p=0.0001). These findings indicate breast milk CD14+ mononuclear cells have a higher population with dominant M2 polarization, viability, and phagocytic ability compared to those from peripheral blood."

"Pneumonia termasuk Infeksi Saluran Pernafasan Akut (ISPA) yang banyak menyerang pada balita. Insidens pneumonia balita di Indonesia diperkirakan 10%-20% per tahun. Di kabupaten Indramayu, jumlah kasus pneumonia yang dilaporkan puskesmas selama tahun 1997 s/d 2000 menunjukkan adanya peningkatan. Air Susu Ibu (ASI) pada masa bayi merupakan nutrisi yang terbaik dan terpenting untuk mencapai tumbuh kembang yang optimal. Dewasa ini terdapat kecendungan menurunnya pemberian ASI ekslusif, padahal pemberian ASI tersebut akan memberikan perlindungan terhadap berbagai penyakit termasuk infeksi pernafasan dan infeksi usus. Penelitian ini bertujuan untuk mengetahui hubungan pemberian ASI terhadap terjadinya pneumonia pada anak umur 4-24 bulan di kabupaten Indramayu. Pada penelitian ini sebagai variabel independen utama adalah pemberian ASI. Rancangan penelitian ini menggunakan kasus kontrol tidak berpadanan (unmatched). Sampel kasus sebanyak 167 orang yaitu anak umur 4-24 bulan yang menderita pneumonia yang datang ke puskesmas di kabupaten Indramayu selama periode Juli-Agustus 2001, sedangkan kontrol juga sebanyak 167 orang yaitu anak umur 4-24 bulan yang merupakan tetangga kasus dan tidak menderita pneumonia, sehingga total sampel sebanyak 334 orang. Pengolahan data menggunakan analisis bivariat dan multivariat yakni multiple regression logistic dengan bantuan software statistik STATA versi 6.0. Hasil penelitian menunjukan bahwa bayi yang diberi ASI tidak eksklusif mempunyai risiko terjadinya pneumonia pada umur 4-24 bulan sebesar 4,89 kali (95% CI 2,86 - 8,36) dibandingkan dengan bayi yang mendapatkan ASI eksklusif. Hubungan pemberian ASI terhadap terjadinya pneumonia tersebut sudah dilakukan pengendalian variabel independen lainnya. Disamping itu ada variabel lain yakni adanya perokok, adanya asap pembakaran, riwayat imunisasi campak dan jenis kelamin anak yang secara bermakna terdapat hubungan dengan terjadinya pneumonia pada anak umur 4-24 bulan. Penelitian ini menyimpulkan adanya hubungan yang cukup kuat antara pemberian ASI tidak eksklusif terhadap terjadinya pneumonia pada anak umur 4-24 bulan. Oleh karena itu perlu dilakukan Gerakan Pemberian ASI Eksklusif melalui pendidikan kesehatan dan promosi kesehatan bagi ibu-ibu balita rentang pentingnya pemberian ASI eksklusif dalam mencegah terjadinya pneumonia balita.

---

Pneumonia is one the Acute Respiratory Infections (ARI) which attacked to infant. The incident of infant pneumonia in Indonesia estimated 10-20% each year. In Indramayu district, the number of pneumonia cases that reported by Health Center during the year of 1997-2000 showed there was increasing. Breast-feeding on childhood is the best nutrition and important to achieve the optimal development of infant. Nowadays, there is tendency of the decreasing in giving exclusively breast-feeding; even it will give the protection to varieties of diseases, including lung and intestine infections.

The objective of this study was to identify the relationship of breast-feeding to pneumonia at infant age 4-24 months in Indramayu District. In this study, as Main dependent variable was the breast-feeding. The design.of this study using unmatched. The number of samples were 167 people, they were infants age 4-24 months whose suffering pneumonia that came to Health Center in Indramayu District during the period of July - August 2001. While the control were 167 infants age 4 - 24 months whose the neighbor of cases and *as not suffering pneumonia, so the total of samples were 334 people. The data management used for analysis were bivariate and multivariate, those were multiple regression logistic with supported software statistic STATA version 6.0.

The result of the study showed that the infant who gave the breast-feeding not exclusively had the risk to pneumonia 4,89 times (95% CI 2,86 - 8,36) at the of 4 - 24 months compared to infant whose gave the breast-feeding exclusively The relationship of breast-feeding to such pneumonia has been conducted to control the another independent variable_ Besides that, there were other variables, they - were: smoking, smoke of fire, history of measles immunization and the sex of infant that significantly had the relationship to pneumonia at infant age 4 - 24 months.

The conclusion of this study, there was relationship significantly between breast-feeding not exclusively to pneumonia at infant age 4 - 24 months. So that, it is needed to do the Breast-feeding Movement Exclusively through Health Education and Promotion to infants mothers on the important of breast-feeding in pre-venting to infant pneumonia."

"Pemberian ASI bagi bayi merupakan cara yang terbaik untuk meningkatkan kualitas sumberdaya manusia sejak dini, karena dengan memberikan ASI berarti memberikan zat gizi yang bernilai tinggi untuk pertumbuhan dan perkembangan syaraf serta otak, memberikan kekebalan pada tubuh serta mempererat ikatan tali kasih ibu dan bayi.Pemberian ASI yang benar adalah memberikan ASI segera dalam 30 menit setelah kelahiran; tidak memberikan makanan dan minuman selain ASI sampai bayi berumur 4 bulan. Selanjutnya setelah bayi berumur lebih dari 4 bulan mulai diberikan makanan tambahan yang disebut dengan makanan pendamping ASI sampai bayi berumur 2 tahun.Makanan pendamping ASI (MP-ASI) merupakan makanan bagi bayi atau anak yang masih mendapat ASI/PASI yang diberikan secara bertahap sehingga bayi/anak menjadi terbiasa dengan makanan keluarga. Agar ibu dapat berperilaku dengan benar dalam memberikan ASI dan MP-ASI, banyak faktor yang mempengaruhinya antara lain pengetahuan, sikap, kepercayaan, dukungan keluarga, dukungan petugas, tersedianya sarana dan fasilitas yang menunjang pemberian ASI dan MP ASI serta adanya intervensi pendidikan kesehatan terhadap individu, keluarga, kelompok dan masyarakat Hasil survei pada bulan Maret 2002 di desa Waru Jaya Kecamatan Parung Kabupaten Bogor, ditemukan masih rendahnya tingkat pemberian ASI eksklusif den pemberian MP-ASI yang terlalu dini pada bayi. Penelitian ini bertujuan untuk mendapatkan gambaran hubungan karakteristik ibu, dukungan keluarga dan pendidikan kesehatan dengan perilaku pemberian ASI dan MP-ASI dan selanjutnya dapat diketahui faktor yang paling berkontribusi terhadap perilaku pemberian ASI dan MP-ASI di desa Waru Jaya Kecamatan Parung Kabupaten Bogor.Desain penelitian adalah diskriptif analitik dengan pendekatan cross sectional. Populasi penelitian adalah ibu-ibu yang memiliki bayi berumur 0-12 bulan di Desa Waru Jaya Kecamatan Parung Kabupaten Bogor. Sampel diambil secara total, pengumpulan data dengan cara kunjungan rumah yang dilakukan pada bulan Juli sampai September 2002. Instrumen penelitian terdiri dari karakteristik ibu (demografi, pengetahuan, sikap); karakteristik dukungan keluarga, karakteristik pendidikan kesehatan dan perilaku pemberian ASI dan MP-ASI. Hasil uji coba instrumen pongetahuan, sikap, dukungan keluarga, pendidikan kesehatan dan perilaku pemberian ASI dan MP-ASI dengan nilai Alpha Gronhach (reliabilitas) berkisar antara 0,74-0,96 sedangkan nitai validitas berkisar antara r = 0,72 - 0,96 dari 30 impel yang diuji cobakan. Data kemudian diolah dan dianalisis: untuk analisis univariat disajikan dalam bentuk data numerik, analisis bivariat menggunakan korelasi -regresi dan analisis multivariat menggunakan regresi linear gander. Hasil analisis univariat menunjukkan bahwakarakteristik umur ibu sebagian besar > 25-35 tabus (50%), berpendidikan rendah (58,62%), responden berpendapatan rendah (68,10%). Secara umum pengetahuan responden tentang ASI cukup baik (52,59%) begitu juga pengetahuan responden tentang MP-ASI cukup baik (60,34%). Sikap responden negatif terhadap pemberian ASI (50,86%) dan sikap negatif terhadap pemberian MP-ASI (66,38%). Secara umum dukungan keluarga adalah negatif terhadap pemberian ASI dan MP-ASI (55,17%). Kadang-kadang petugas kesehatan memberikan pendidikan kesehatan di pelayanan kesehatan atau di posyandu tentang ASI (66,38%) dan MP ASI sebesar 56,90%. Perilaku responden secara umum kurang baik dalam memberikan ASI (53,45%) dan perilaku kurang baik dalam memberikan MP-ASI sebesar 54,31%.Berdasarkan hasil analisis bivariat yaitu uji korelasi den regresi didapatkan hubungan bermakna antara pengetahuan, sikap dan dukungan keluarga dengan perilaku pemberian ASI. Hasil analisis multivariat menunjukkan adanya faktor yang paling berkontribusi terhadap perilaku pemberian ASI adalah pengetahuan dan sikap dengan signifikan F = 0,0001 dan R square 0,268.Sedangkan hasil analisis bivariat dengan uji korelasi dan regresi pada perilaku pemberian MP-ASI menunjukkan hubungan yang bermakna dari pengetahuan, dukungan keluarga dan pendidikan kesehatan. Hasil analisis multivariat menunjukkan faktor yang paling berkontribusi terhadap perilaku pemberian MP-ASI adalah pengetahuan dengan signifikan F = 0,001 dan R square 0,141. Dari hasil penelitian ini dapat disimpulkan bahwa karakteristik ibu (pengetahuan dan sikap) dapat menggambarkan perilaku pemberian ASI (26,8%) dan MP-ASI (14,1%).Untuk meningkatkan pengetahuan ibu tentang pemberian AM dan MP-ASI pada bayi dapat diperoleh melalui penyuluhan di posyandu, atau di tempat pelayanan kesehatan lainnya secara berkesinambungan. Kemudian ibu dilatih tentang cara menyusui, serta menyiapkan dan membuat MP-ASI sesuai dengan kondisi keuangan keluarga.Disamping itu perlu ditingkatkan dan dikembangkan program kunjungan rumah aehingga dapat berpengaruh terhadap aktifitas ibu dalam merawat bayi khususnya pemberian ASI dan MP-ASI. Dukungan keluarga juga sangat penting bagi ibu, sejak masa hamil hingga perawatan bayi selanjutnya serta perlunya meningkatkan pembinaan petugas kesehatan di masyarakat dalam rangka meningkatkan mutu manajemen laktasi. Bekerjasama dengan bidang promosi kesehatan DepKes Rl dalam mengembangkan model pembelajaran yang mudah digunakan pada tingkat individu, keluarga, kelompok dan masyarakat pada umumnya. Perlu penelitian lebih lanjut tentang perilaku pemberian ASI dan MP-ASI dangers menggunakan rancangan kualitatif dan dilanjutkan dengan quasi eksperimen.Kepustakaan 59 (1980 - 2001)

---

The Relationship among the Characters of Mother, Family Support, Health Education and the Behavior of Giving Breast-Feeding (ASI) and Additional Food (MP-ASI) in Waru Jaya village, Parung, Bogor regency, Indonesia.

Breast feeding (ASI) to the baby is the best way to increase the quality of human resources as early as possible. Because by giving breast feeding (ASI) means giving the nutrient profitably for the growth and the progression of nerves and brain, giving antibody and strengthening the chain of love between a mother and her baby. Well breast feeding means giving `ASI' as 30 minutes after labor. Do not giving other food and drinks except ASI till 4 months of baby's age. Beside ASI, the next 4 months till 2 years of baby will be accustomed to the family's food. There are some factor! that influence a mother behaves well in breast-feeding and giving additional food, namely knowledge, attitude, belief: family support, officers support, the available facilities which conduct breast feeding (ASi) and additional food, the intervention of health education to individual, family, group and society. The survey result on Maret 2002 in Waru Jaya village, Panmg district, Bogor regency, found that the exclusive breast feeding has been law and giving additional food. Finally, the most contributed factors to the behavior in breast feeding and giving additional food in the community mentioned can be known.

The design of this research used ` descriptive analysis' and cross sectional approach. The population of analysis is the mothers whose babies are 0 - 12 months of age. In Waru Jaya village, Parting district, Bogor regency. The sampling was taken totally_ Data collecting done by doing home visit on July till September 2002. The instrument of research consist of the character of family support, the character of health education and the behavior in breast feeding (ASI) and giving additional food The result of the test to the knowledge, attitude, family support, health education and behavior of giving breast feeding and additional food using the `Alpha Cronbach' around 0,74 - 0,96 and the score of validity around (r = 0,72 - 0,96) of the sample tested.

The data was processed and analyzed; for univariat analysis was presented based on the numeral data and used correlation - regression and multivariat analysis used double linear regression. The result of univariat analysis showed that the character of mother's age most > 25 -- 35 years (50%), low education (58,62%), low income (68,10%). Generally the respondents' knowledge about breast- feeding is good enough (52,59%) and the knowledge about additional food as well (60,34%). The negative attitude of respondent to breast- feeding is 50,86% and the negative attitude to giving additional food is 66,38 %. Anyway in general, the family support to breast- feeding and giving additional food is negative (55,17%). Sometimes the health officers (66,38%) give health education about breast-feeding in doing health service or at Posyandu (central for integrated service) and as many as 56,90% about giving additional food. The behavior of respondent is generally worse in breast-feeding (53,45%) and giving additionnl food (54,31%).

Based on the result of bivariat analysis found that there is a significant relationship between the knowledge, the attitude, the family support and the behavior of breast-feeding. The result of multivariat analysis shows the most contributed factor to the behavior of breast-feeding, namely the factor of knowledge and attitude significantly F = 0,0001 and R square 0,268. Mean while by using the correlation and regression teat about behavior of additional food, there is a significant relationship between knowledge, family support and health education. The result of multivariat analysis shows that the most contributed to behavior of giving additional food is the factor of knowledge, significantly F = 0,001 and R square 0,141. From this can be concluded that the character of mother (in knowledge and attitude) can illustrate the behavior of breast-feeding and giving additional food to the baby in 0-12 months of age.

To increase the mothers' knowledge about breast-feeding and additional food to the baby can be done by giving the information about it in Posyandu or in other health sevices continuously. Then, the mothers are trained how to do breast-feeding and making or providing additional food according to their finance condition they face_ Beside that, it is necessary do increase and develop `home visit programe', so it can influence the mothers activities in looking after their babies, especially in breast-feeding and giving additional food. Family support also has an import= role for the mother since she is in pregnancy till the time of baby's treatment. The establishment of health officers needs to be done in community to increase the quality of lactation management It is necessary to work together with the institution of health promotion, Departement of Health in developing the type of easier learning used in the level of individual, family, group and society in general. It is also necessary to have continuous research about the behavior in the breast-feeding and giving additional food using the qualitative design in order to get better result.

Bibliography 59 (1980 - 2001)"

"ASI atau air susu ibu secara alamiah merupakan makanan terbaik bagi bayi oleh karena kandungan dalam ASI banyak mengandung gizi yang bermanfaat bagi pertumbuhan dan perkembangan bayi. Perilaku untuk memberikan ASI secara eksklusif masih sangat rendah di Indonesia. Berdasarkan data yang dipublikasikan oleh Departemen Kesehatan tahun 2005, sebanyak 39,5% ibu memberikan ASI sccara eksklusifi Khususnya untuk propinsi Lampung scbanyak 34,5% ibu membcrikan ASI secara eksklusif terhadap bayinya (Dinas Kesehatan propinsi Lampung, 2006). Sementara itu berdasarkan data yang dipublikasikan oleh laporan bulanan ke-3 Dinas Kesehatan Kota Metro pada tahun 2006 unluk Kota Metro sebanyak 58,8% ibu memberikan ASI secara eksklusif dan untuk Kecamatan Metro Timur sebunyak 47,3%. Tujuan dari penelitian ini adalah untuk mengetahui faktor-faktor yang bcrhubungan dengan pemberian ASI eksklusif oleh ibu-ibu bayi yang berumur 6-12 bulan di Kecarnatan Metro Timur. Pcnelitian ini dilakukan selama dua minggu pada bulan Mei 2007. Jumlah sampel sebanyak 127 ibu yang menyusui bayi yang berumur 6-12 bulan. Penelitian im menggunakan metode "Cross sectional", data terbagi menjadi dua jenis yaitu data primer berasal dari hasil wawancara, sementara data sekunder berasal dari laporan yang dipublikasikan oleh Dinas Kesehatan Kota Metro. Sampel diambil dengan menggunakan teknik random sampling. Wawancara dilakukan oleh mahasiswa Kebidanan, dan selanjutnya data dianalisis secara univariat, bivariat (chi square) dan multivariat (regresi logislik) dengan sepenuhnya menggunakan program SPSS. Langkah-langkah penelitian, pertama dilakukan studi pendahuluan dengan pengamatan dan dialog pada lima orang ibu yang menyusui bayi yang berumur 6- I2 bulan untuk mengetahui pemahaman tentang ASI cksklusif dan untuk mcmperbaiki kucsioner yang tidak valid dan tidak realiabel dcngan cara mengajukan pertanyaan pada 30 orang ibu-ibu yang menyusui. Dari 39 pcrtanyaan diperoleh satu pertanyaan pada variabel pengetahuan tidak valid dan tidak reliabel kemudian penanyaan tersebut didrop, lalu dilakukan penambahan satu pcrtanyaan pada variabel sikap, dari hasil uji yang kcdua temyata seluruh variabcl yang diuji coba scmua adalah valif’ dan reliabel sehingga dijadikan alat kuesioner untuk penelitian. Dari hasil penelitian disimpulkan bahwa ibu yang memiliki bayi 6-12 bulan hanya 25,2% yang memberikan ASI secara eksklusif. Dan dari hasil analisis bivarial menunjukkan bahwa umur, pcndidikan, pekerjaan, sikap, kepcrcayaan, pcrsepsi, budaya, tempat persalinanf penolong persalinan tidak mempunyai hubungan yang bermakna terhadap perilaku pemberian ASI secara eksklusifi Selanjutnya dengan menggnmakan regresi logistik menunjukkan bahwa faktor dominan yang berhubungan dengan pemberian ASI cksklusif adalah penyuluhan yang dilakukan oleh tenaga kesehatan, analisis menunjukkan bahwa OR 5,664 (Cl 95% = 1,586-20,23l) dan dukungan dari maeyarakat OR 1,119(CI 95% = 1,121-8,360). Saran, pertama bahwa tenaga kesehatan agar dapat meningkatkan kuantitas pcnyuluhan clan dapat meningkatkan kerjasama dengan tokoh masyarakal yang ada di wilayah kecamatan Metro dalam menggalakan program ASI eksklusif. Kedua agar Dinas Kesehatan meningkatkan pelatihan tenaga keschatan dan pengawasan terhadap pelaksanaan program ASI eksklusif di masyarakat. Ketiga perlu penelitian lebih lanjut dengau desain kohort dan pengamatan untuk mempelajari perilaku pcmbcrian ASI eksklusif dengan tingkal vulidilas yang tinggi.

---

Breast milk is nature’s best food or drink for the baby because of its highly nutrient and is very beneficial for growth and development of the infant. In Indonesia prevalence of exclusive breastfeeding is still very low. Based on data of the Minister of Health (2005), only 39.5% of the mothers practicing exclusive breastfeeding, for Lampung Province this figure was 34.5% (Provincial l-lealth Office of Lantpung, 2006). Based onthe existing data which was published in the third monthly report of the Metro City Health Office (2006), there was 58.8% of the mothers who practiced exclusive breastfeeding in .he City of Metro and 47.3% in sub~district Metro Timur.

The objective of this study was to identity factors related to exclusive breastfeeding among mothers with 6-12 months old infants in sub-district Metro Timur. Data collection was conducted for 2 weeks during May, 2007.

The design of this study was cross-sectional survey. The sample was withdrawn using simple random sampling technique so there were 107 mothers whose babies were 6-12 months old. Primary data was collected using interview with standardized questionnaire.

As preparation for the study, observation and interview were made of the five mothers whose breastfed their 6-12 months old newboms. The purpose was to identify the knowledge of exclusive breastfeeding and assessment was made to identity both valid and invalid items of questionnaire among 30 mothers who were breastfeeding. Revision was made on the questionnaire. In addition, for secondary data the report fiom the Dinas Kcscltatun was used to compliment thc data collection. Interviews were performed by students of midwifery school who were provided special training prior to data collection. In addition, the data was analyzed using univariate, bivariate (chi-square test) and logistic regression using SPSS program.

The results showed that the prevalence of practice of exclusive breastfeeding among mothers with 6-12 months old babies was 25.2%. From the bivariate analysis it was indicated that age, education, occupation, attitude, beliefs, perception, and socio-culture relevant to exclusive breastfeeding did not have signiiicant relationship with the practice of exclusive breastfeeding. In addition, both place and attendance of delivery also did not have a significant relationship with the respondents’ practice ol` exclusive breastfeeding. Furthermore, results of logistic regression analysis showed that dominant factors related to practice of exclusive l:reastfeedir.g very much depended on health education by the health personnel (OR=5,664, Cl or confidence interval 95%=l,586-20,23l) and support provided by the community was also significant (OR=I .l 19, Cl 95% = 1,121 up to 8,350).

Based on the results ofthe study, it was strongly recommended to the Chief Sub- district City of Metro to increase the quantity and quality of health education to the community in sub-district Metro in relation to promotion of exclusive breastfeeding. Furthermore, Dinas Kesehatan was also encouragcc’ to promote the training for health personnel and supervision and monitoring to the exclusive lmrcastfccding program in the community. Recommendation is also made for further research in relation to exclusive breastfeeding using the cohort design and with observation tbr studying the practice exclusive breastfeeding for securing high validity of data on the practice of the subject of the study."