Pemberian ASI eksklusif tidak berhubungan dengan stunting pada anak usia 6–23 bulan di Indonesia

Bunga Astria Paramashanti; Hamam Hadi; I Made Alit Gunawan

doi:10.21927/ijnd.2015.3(3).162-174

Pemberian ASI eksklusif tidak berhubungan dengan stunting pada anak usia 6–23 bulan di Indonesia

Bunga Astria Paramashanti, Hamam Hadi, I Made Alit Gunawan

Abstract

ABSTRACT

Background: Stunting in children is one of public health problem in Indonesia. Stunting is a serious problem because it is linked with the quality of human capital in future.

Objectives: To determine the association between exclusive breastfeeding practice and stunting in young children 6 – 23 months in Indonesia.

Methods: This study used a cross-sectional design. Data was obtained from Basic Health Research (Riskesdas) 2013. Riskesdas 2013 used multistage cluster sampling. Subject in this study was 6.956 young children 6 – 23 months in Indonesia which was selected purposively. Data was analyzed by using descriptive analysis, chi-square, and multiple logistic regression by adjusting the sampling weight for survey analysis.

Results: Exclusive breastfeeding was protective against stunting, but the result was not significant both for exclusive breastfeeding >6 months (OR=0,99, 95% CI: 0,63–1,59) and exclusive breastfeeding 4-<6 bulan (OR=0,93, 95% CI: 0,63–1,39). Young children with low birth weight history had higher risk to become stunting (OR=1,77, 95% CI: 1,33–2,37). Household economic status which were very poor (OR=1,96, CI: 1,53–2,52), poor (OR=1,62, 95% CI:1,30–2,03) and middle (OR=1,32, 95% CI: 1,06–1,64) were also associated with the risk of stunting.

Conclusions: Exclusive breastfeeding is not the only factor contributing to stunting in children. Optimal complementary feeding practice should also be the focus of intervention. Improvement in nutritional status since the preconception and during the pregnancy, and household economy status may reduce stunting problem in children.

KEYWORDS: stunting, exclusive breastfeeding, feeding practice, growth

ABSTRAK

Latar belakang: Stunting pada anak-anak merupakan salah satu masalah kesehatan masyarakat yang utama di Indonesia. Stunting menjadi masalah yang serius karena dikaitkan dengan kualitas sumber daya manusia di kemudian hari.

Tujuan: Untuk mengetahui hubungan antara praktik pemberian ASI eksklusif dan stunting pada anak usia 6 – 23 bulan di Indonesia.

Metode: Desain penelitian ini adalah cross-sectional. Data didapatkan dari hasil riset kesehatan dasar (Riskesdas) 2013. Teknik pengambilan sampel pada Riskesdas 2013 adalah multistage cluster sampling. Subjek pada penelitian ini berjumlah 6.956 anak usia 6 – 23 bulan di Indonesia yang dipilih secara purposive. Data dianalisis dengan menggunakan analisis deskriptif, chi-square dan regresi logistik berganda dengan mempertimbangkan sampling weight untuk analisis survei.

Hasil: ASI eksklusif bersifat protektif terhadap kejadian stunting pada anak, namun hasilnya tidak signifikan, baik untuk ASI eksklusif >6 bulan (OR=0,99, 95% CI 0,63–1,59) maupun ASI eksklusif 4-<6 bulan OR=0,93, 95% CI: 0,63–1,39). Anak yang lahir dengan berat badan lahir rendah (BBLR) memiliki risiko yang lebih tinggi untuk menjadi anak yang stunting (OR=1,77, 95% CI: 1,33–2,37). Status ekonomi rumah tangga sangat miskin (OR=1,96, 95% CI: 1,53–2,52), miskin (OR=1,62, 95% CI: 1,30–2,03) dan
menengah (OR=1,32, 95% CI: 1,06–1,64) masing-masing berkontribusi terhadap peningkatan risiko stunting pada anak.

Kesimpulan: ASI eksklusif bukanlah satu-satunya faktor yang berkontribusi terhadap kejadian stunting pada anak. Pemberian MPASI yang optimal juga harus diperhatikan. Perbaikan status gizi sejak masa prekonsepsi dan selama kehamilan, serta status ekonomi rumah tangga diharapkan mampu menurunkan kejadian stunting pada anak.

KATA KUNCI: stunting, ASI eksklusif, praktik makan, pertumbuhan

Keywords

stunting;exclusive breastfeeding;feeding practice;growth;ASI eksklusif;praktik makan;pertumbuhan

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References

Berkman DS, Lescano AG, Gilman RH, Lopez SL, Black M. Effect of stunting, diarrhoeal disease, and parasitic infection during infancy on cognition in late hildhood: a follow-up study.

Lancet. 2002;359:564–71.

Black R, Allen L, Bhutta Z, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional

exposures and health consequences. Lancet. 2008;371:243–60.

Black R, Victora C, Bhutta Z, Christian P, de Onis M, Ezzati M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013.

Santos I, Matijasevich A, Domingues M, Barros A, Victora C, Barros F. Late preterm birth is a risk factor for growth faltering in early childhood: a cohort study. BMC Pediatr. 2009;9:71.

Brennan L, McDonald J, Shlomowitz R. Infant feeding practices and chronic child malnutrition in the Indian States of Karnataka and Uttar Pradesh. Econ Hum Biol. 2004;2:139–58.

Caufield et al. Disease control priorities in developing countries 2nd edition (stunting, wasting and micronutrient defi ciency disorder chapter 28) Jamison et al Ed. Washington DC:

World Bank; 2006.

Martorell R, Young M. Patterns of stunting and wasting: potential explanatory factors. Adv Nutr. 2012;3:227–33.

Victora C, Adair L, Fal l C, Hallal P, Martorell R. Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008;371:340–57.

Victora C, Barreto M, do Carmo Leal, M Monteiro C, Schmidt M, Paim J, Bastos F, et al. Lancet Brazil series working group health conditions and health-policy innovations in Brazil: the way

forward. Lancet. 2011;377:2042–53.

United Nations Children’s Fund (UNICEF). Improving child nutrition. New York: United Nations Children’s Fund (UNICEF).

Gupta A, Dadhich J, Faridi M. Breastfeeding and complementary feeding as a public health intervention for child survival in India. Symposium on Child Survival in India: Part II. India: Indian Journal of Pediatric; 2010.

Marriott B, White A, Hadden L, Davies J, Wallingford J. How well are infant and young child World Health Organization (WHO) feeding indicators associated with growth outcomes?

an example from Cambodia. Matern Child Nutr. 2010;6(4):358–73.

Zhou H, Wang X, Ye F, Zeng X. Relationship between child feeding practices and malnutrition in 7 remote and poor counties, P R China. Asia Pac J Clin Nutr. 2012;21(2):234–40.

Agrasada G, Ewald U, Kyllberg E. Exclusive breastfeeding of low birth weight infants for the first six months: infant morbidity and maternal and infant anthropometry. Asia Pac J Clin Nutr.

;20(1):62–8.

Rehman A, Gladstone B, Verghese V, Muliyil J, Jaffar S, Kang G. Chronic growth faltering amongst a birth cohort of indian children begins prior to weaning and is highly prevalent at three

years of age. Nutr J. 2009;8:44.

Jones A, Ickes S, Smith L, Mbuya M, Chasekwa B, Heidkamp R, et al. . World health organization infant and young child feeding indicators and their associations with child anthropometry: a synthesis of recent fi ndings. Matern Child Nutr. 2014;10:1–17.

Dewey K, Adu-Afarwuah S. Systematic review of the effi cacy and effectiveness of compementary feeding interventions in developing countries. Matern Child Nutr. 2008;4:24–85.

Aerts D, Drachler M, Giugliani E. Determinants of growth retardation in Southern Brazil. Cad Saude Publica, Rio Janeiro. 2004;20(5):1182–90.

Vitolo M, Gama C, Bortolini G, Campagnolo P, Drachler M. Some risk factors associated with overweight, stunting and wasting among children under 5 years old. J Pediatr (Rio J).

;84(3):251–7.

Bove I, Miranda T, Campoy C, Uauy R, Napol M. Stunting, overweight and child development impairement go hand in hand as key problems of early infancy: Uruguayan case. Early Hum

Dev. 2012.

Andiani. Faktor determinan stunting pada anak usia 0-59 bulan di Indonesia [Internet]. 2013 [cited 2015 Jan 15]. Available from: http://repository.ipb.ac.id/handle/123456789/65706

Hambidge K, Mazariegos M, Kindem M, Wright L, Cristobal-Perez C, Juarez-Garcia L, et al. Infant stunting is associated with short maternal stature. J Pediatr Gastroenterol Nutr. 2012;54(1):117–9.

Nai H, Gunawan I, Nurwanti E. Praktik pemberian makanan pendamping ASI (MP-ASI) bukan faktor resiko kejadian stunting pada anak usia 6-23 bulan. J Giz dan Diet Indones. 2014; 2(3):

-49.

Kamal S. Socio-economic determinants of severe and moderate stunting among underfive children of Rural Bangladesh. Mal J Nut. 2011;17(1):105–18.

Ramakrishnan U, Aburto N, McCabe G, Martorell R. Multimicronutrient intervention but not vitamin a or iron intervention alone improve child growth: result of 3 meta-analysis. J Nutr. 2004;134:2592–602.

Aerts D, Regina E, Giugliani J. Determinants of growth retardation in Southern Brazil Determinantes do retardo no crescimento no Sul do Brasil. Cad Saude Publica. 2004;20(5):1182–90.

Bove I, Miranda T, Campoy C, Uauy R, Napol M. Stunting, overweight and child development impairment go hand in hand as key problems of early infancy: Uruguayan case. Early Hum Dev. 2012;88:747–51.

Amin N, Julia M. Faktor sosiodemografi dan tinggi badan orang tua serta hubungannya dengan kejadian stunting pada balita usia 6-23 bulan. J Giz dan Diet Indones. 2014; 2(3): 174-80.

Victora C, Aquino E, do carmo Leal M, Monteiro C, Barros F, Szwarcwald C. Maternal and child health in Brazil: progress and challenges. Lancet. 2011;377(9780):1863–76.

Mostafa Kamal S. Socio-economic determinants of severe and moderate stunting among underfive children of rural Bangladesh. Malays J Nutr. 2011;17(1):105–18.

Ramakrishnan U. Nutrition and low birth weight: from research to practice. Am J Clin Nutr. 2004;79(1):17–21.

DOI: http://dx.doi.org/10.21927/ijnd.2015.3(3).162-174