Praktik pemberian makanan pendamping ASI (MP-ASI) bukan faktor risiko kejadian stunting pada anak usia 6-23 bulan
DOI:
https://doi.org/10.21927/ijnd.2014.2(3).126-139Abstract
ABSTRACT
Background: Stunting reflects a process of failure to reach linear growth potential as a result of suboptimal health or nutrition conditions. One of causal factors of stunting is inadequate of quality and quantity of complementary foods.
Objectives: To identify complementary feeding practices such as introduction age of complementary foods, dietary diversity, and meal frequency as risk factors of stunting among children aged 6-23 months in Sedayu Subdistrict, Bantul, Yogyakarta.
Methods: Study design was case-control with ratio (1:1). The study used both quantitative methods as well as case control design and qualitative through interview. Cases were children aged 6-23 months who had length for age z-score <-2SD. Controls were children aged 6-23 months who had length for age z-score ≥-2SD who live adjacent to the case. Data were analyzed by using univariable (descriptive), bivariable (chi-square test), and multivariable analysis (multiple logistic regression).
Results: The result of bivariate analysis showed that introduction age of complementary foods (OR=1.07), dietary diversity (OR=1.17), and meal frequency (OR=1.69) were not risk factors of stunting. However, compared with high dietary diversity score, low dietary diversity score (≤2, 3, 4 food groups) associated with increased odds of being stunted among children aged 6-23 months (OR=2.24, 95% CI:1.00-5.01, OR=1.82, 95% CI:0.96-3.45, OR=1.66, 95% CI:0.81-3.46 respectively). The result of multivariate analysis showed that mother’s height (OR=1.86) and story of low birth weight (OR=3.23) were risk factors of stunting.
Conclusions: Complementary feeding practices such as age introduction of complementary foods, dietary diversity, and meal frequency were not risk factors of stunting among children aged 6-23 months. Mother’s height and story of low birth weight were risk factors of stunting among children aged 6-23 months.
KEYWORDS: stunting, nutritional intake, nutritional status, complementary foods
ABSTRAK
Latar belakang: Stunting merefleksikan kegagalan proses mencapai potensi pertumbuhan linear sebagai akibat dari kondisi kesehatan dan gizi yang tidak optimal. Salah satu penyebab kejadian stunting adalah kuantitas dan kualitas MP-ASI yang rendah.
Tujuan: Untuk mengidentifikasi risiko praktik pemberian MP-ASI seperti usia pengenalan MP-ASI, keragaman MP-ASI, dan frekuensi MP-ASI dengan kejadian stunting pada anak usia 6-23 bulan di Kecamatan Sedayu, Bantul, Yogyakarta.
Metode: Rancangan penelitian ini adalah kasus-kontrol dengan perbandingan 1:1 dan menggunakan pendekatan kuantitatif-kualitatif model concurrent embedded. Kasus adalah anak usia 6-23 bulan yang memiliki skor-z PB/U <-2SD. Kontrol adalah anak usia 6-23 bulan yang memiliki skor-z PB/U ≥-2SD yang tinggal berdekatan dengan kelompok kasus. Analisis data menggunakan analisis univariat (deskriptif), bivariat (uji chi-square) dan multivariat (uji regresi logistik berganda).
Hasil: Analisis bivariat menunjukkan usia pengenalan MP-ASI (OR=1,07), keragaman MP-ASI (OR=1,17), dan frekuensi pemberian MP-ASI (OR=1,69) bukan faktor risiko kejadian stunting (p>0,05). Skor keragaman MP-ASI yang lebih rendah (kelompok makanan ≤2, 3, 4) berhubungan dengan peningkatan risiko kejadian stunting berturut-turut OR=2,24, 95% CI:1,00-5,01; OR=1,82, 95% CI:0,96-3,45; OR=1,66, 95% CI:0,81-3,46. Analisis multivariat menunjukkan faktor risiko kejadian stunting adalah tinggi badan ibu (OR=1,86) dan riwayat berat badan lahir rendah (BBLR) (OR=3,23,).
Kesimpulan: Praktik pemberian MP-ASI seperti usia pengenalan, keragaman, dan frekuensi pemberian MP-ASI bukan merupakan faktor risiko kejadian stunting pada anak usia 6-23 bulan. Faktor risiko kejadian stunting pada anak usia 6-23 bulan yang bermakna adalah tinggi badan ibu dan riwayat BBLR.
KATA KUNCI: stunting, asupan makan, status gizi, MP-ASI
Downloads
References
UNICEF. Tracking progress on child and maternal nutrition: a survival and development priority. New York: UNICEF; 2009.
De Onis M, Blossner M, Borghi E. Prevalence and trends of stunting among pre-school children, 1999-2220. Public Health Nutr. 2011;32:1–7.
Allen LH, Gillespie SR. What works ? A review of the effi cacy and effectiveness of nutrition interventions. Manila: The Asian Development Bank; 2001.
Dewey KG, Begum K. Why stunting matters [Internet]. Alive&thrive technical brief. 2010 [cited 2013 Apr 25]. p. 1–7. Available from: http://www.aliveandthrive.org/sites/default/fi les/Brief 2Sept. 2010- Why stunting matters_1.pdf
Badham J, Sweet L. Stunting: an overview. Sight Life. 2010;3:40–7.
World Health Organization (WHO). Complementary feeding: report of the global consultation. Geneva; 2001.
Dewey K, Begum K. Long-term consequences of stunting in early life. Matern Child Nutr. 2011;7:5–18.
Reyes H, Perez-Cuevas R, Sandoval A, Castillo R, Santos J, Doubova S, et al. The family as a determinant of stunting in children living in conditions of extreme poverty: a case control
study. BMC Public Health. 2004;4:57.
Yulidasari F. MP-ASI sebagai faktor risiko kejadian stunting pada anak usia 6-24 bulan di Kota Yogyakarta. Universitas Gadjah Mada; 2013.
Paudel R, Pradhan B, Wagle RR, Pahari DP, Onta SR. Risk factors for stunting among children: a community based case control study in Nepal. Kathmandu Univ Med J (KUMJ).2011;10:18–24.
Kementerian Kesehatan Republik Indonesia. Petunjuk pelaksanaan surveilans gizi. Jakarta: Kementerian Kesehatan RI; 2012.
World Health Organization (WHO). Indicators for assessing infant and young child feeding practices. Washington DC: WHO; 2007.
Adriani M, Wiratjamadi B. Pengantar gizi masyarakat. Jakarta: Kencana Prenada Media Group; 2012.
Kramer MS, Kakuma R. Optimal duration of exclusive breastfeeding. Cochrane database of systematic reviews (Online). Geneva: WHO; 2001.
Gupta N, Gehri M, Stettler N. Early introduction of water and complementary feeding and nutritional status of children in Nothern Senegal. Public Health Nutr. 2007;10(11):1299–304.
Victora C, M de O, Hallal P, Blossner M, Shrimpton R. Worldwide timing of growth faltering: revisiting implications for interventions. Pediatrics. 2010; 125 (3): e473-80.
Marriot P, White A, Hadden L, Davies J, Wallingford J. World Health Organization (WHO) infant and young child feeding
indicators: association with growth measures in 14 low-income countries. Matern Child Nutr. 2011;8(3):354–70.
Rah J, Akhter N, Semba R, de Pee S, Bloem M, Campbell A, et al. Low diversity is a predictor of child stunting in Rural Bangladesh. Eur J Child Nutr. 2010;64:1393–8.
Arimond M, Ruel M. Dietary diversity is associated with child nutritional status: evidence from 11 demographic and health surveys. J Nutr. 2004;134:2579–85.
Onyango A, Koskia K, Tuckerb K. Food diversity versus breastfeeding choice in determining anthropometric status in rural Kenyan toddlers. Int J Epidemiol. 1997;27:484–9.
Steyn N, Nel J, Nantel G, Kennedy G, Labadarios D. Food variety and dietary diversity scores in children: are they good indicators of dietary adequacy? Public Health Nutr. 2005;9(5):644– 50.
Kennedy G, Pedro M, Seghieri C, Nantel G, Brouwer I. Dietary diversity score is a useful indicator of micronutrient intake in non-breast-feeding Filipino children. J Nutr.2007;137:472–7.
Moursi M, Arimond M, Dewey K, Tre`che S, Ruel M, Delpeuch F. Dietary diversity is a good predictor of the micronutrient density of the diet of 6- to 23-month-old children in Madagascar. J Nutr. 2007;138:2448–53.
Daniels M, Adair L, Popkin B, Truong Y. Dietary diversity scores can be improved through the use of portion requirements: an analysis in young Filipino children. Eur J Clin Nutr. 2009;63:199–208.
Sawadago P, Martin-Pre´ vel Y, Savy M, Kameli Y, Traissac P, Traore´An, et al. Infant and child feeding index is associated with the nutritional status of 6- to 23-month-old children in rural
Burkina Faso. J Nutr. 2006;136:656–63.
Umeta M, West C, Verhoef H, Haidar J, Hautvast J. Factors associated with stunting in infants aged 5 – 11 months in the Dodota-Sire district, rural Ethiopia. J Nutr. 2003;133:1064–9.
Soetjiningsih, Suandi I. Gizi untuk tumbuh kembang anak. Jakarta: Sagung Seto; 2008.
Dewey K, Adu-Afarwuah S. Systematic review of the efficacy and effectiveness of complementary feeding interventions in
developing countries. Matern Child Nutr. 2008;4:24–85.
Branca F, Ferrari M. Impact of micronutrient deficiencies on growth: the stunting syndrome.Ann Nutr Metab. 2002;46 Suppl 1:8–17.
Marquis G, Habicht J, Lanata C, Blacak R, Rasmusse K. Breastmilk or animalproductfoods improve linear growth of peruvian toddlers consuming marginal diets. Am J Clin Nutr. 1997;66:1102–9.
Amigo H, Buston P, Sun K, Akhter N, Bloem M. Is
there are relationship between parent’s short height and their children’s? social interclass epidemiologic study. Rev Med Chil. 1997;125(8): 863-8.
Barker D, Godfrey K. Gizi ibu, programming janin, dan penyakit kronis dewasa. Gizi kesehatan masyarakat. Jakarta: Penerbit Buku Kedokteran EGC; 2005. p. 372–90.
Downloads
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:
1. Authors retain copyright and grant the journal right of first publication, with the work [SPECIFY PERIOD OF TIME] after publication simultaneously licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.  that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Â
2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Â
3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
Â
IJND by http://ejournal.almaata.ac.id/index.php/IJND is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.Â
