Praktik pemberian makanan pendamping ASI (MP-ASI) bukan faktor risiko kejadian stunting pada anak usia 6-23 bulan

Hildagardis M.E Nai; I Made Alit Gunawan; Esti Nurwanti

doi:10.21927/ijnd.2014.2(3).126-139

Praktik pemberian makanan pendamping ASI (MP-ASI) bukan faktor risiko kejadian stunting pada anak usia 6-23 bulan

Hildagardis M.E Nai, I Made Alit Gunawan, Esti Nurwanti

Abstract

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

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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.

DOI: http://dx.doi.org/10.21927/ijnd.2014.2(3).126-139