Background: Neonatal hyperbilirubinemia is one of the most common conditions for neonate inpatients. Indonesia faces a major challenge in which different guidelines regarding the management of this condition were present. This study aimed to compare the existing guidelines regarding prevention, diagnosis, treatment and monitoring in order to create the best recommendation for a new hyperbilirubinemia guideline in Indonesia. Methods: Through an earlier survey regarding adherence to the neonatal hyperbilirubinemia guideline, we identified that three main guidelines are being used in Indonesia. These were developed by the Indonesian Pediatric Society (IPS), the Ministry of Health (MoH), and World Health Organization (WHO). In this study, we compared factors such as prevention, monitoring, methods for identifying, risk factors in the development of neonatal jaundice, risk factors that increase brain damage, and intervention treatment threshold in the existing guidelines to determine the best recommendations for a new guideline. Results: The MoH and WHO guidelines allow screening and treatment of hyperbilirubinemia based on visual examination (VE) only. Compared with the MoH and WHO guidelines, risk assessment is comprehensively discussed in the IPS guideline. The MoH guideline recommends further examination of an icteric baby to ensure that the mother has enough milk without measuring the bilirubin level. The MoH guideline recommends referring the baby when it looks yellow on the soles and palms. The WHO and IPS guidelines recommend combining VE with an objective measurement of transcutaneous or serum bilirubin. The threshold to begin phototherapy in the WHO guideline is lower than the IPS guideline while the exchange transfusion threshold in both guidelines are comparably equal. Conclusions: The MoH guideline is outdated. MoH and IPS guidelines are causing differences in approaches to the management hyperbilirubinemia. A new, uniform guideline is required.
ABSTRAK Latar Belakang: Hasil survei pendahuluan di Dusun Boro, Desa Sidodadi, 63% responden mengaku tidak mengetahui teknik menyusui yang benar dan sebanyak 60% responden menyatakan belum pernah mendapat informasi tentang ASI eksklusif. Tujuan: Mengidentifikasi hubungan pemberian ASI eksklusif dan pengetahuan ibu tentang cara menyusui bayi dengan stunting di Dusun Boro, Desa Sidodadi Kecamatan Lawang Kabupaten Malang tahun 2019. Metode: Analitik observasional dengan desain penelitian cross-sectional study. Teknik pengambilan sampel yang digunakan adalah teknik purposive. Pengambilan menggunakan kuesioner. Data yang didapatkan kemudian dianalisis menggunakan koefisien kontingensi menggunakan IBS SPSS Statistics 19 for windows. Hasil: Hubungan pengetahuan tentang cara menyusui dengan stunting tidak signifikan. Hubungan pemberian ASI eksklusif dengan stunting juga tidak signifikan. Simpulan: Tidak ada hubungan antara ASI dengan status gizi namun terdapat hubungan antara pengetahuan ibu tentang cara menyusui dengan status gizi. Kata Kunci: ASI eksklusif, tingkat pengetahuan, cara menyusui bayi, stunting ABSTRACT Background: Based on the preliminary survey’s result (primary data) in Sidodadi village, 63% of the respondents admitted that they don’t know about the right techniques of breastfeeding and 60% of the respondents claimed they had not been informed about exclusive breastfeeding. Aim: Identifying the correlation between exclusive breastfeeding and mother’s knowledge about how to breastfeed with nutritional status in toddlerhood in Boro Sidodadi Village Lawang Sub-District Malang Regency Year 2019. Method: The type of this research was an analytical observational study with a crosssectional design. This study used purposive sampling. This study collected data using questionnaires. The data obtained were analyzed using the contingency coefficient using IBS SPSS Statistics 19 for windows. Result: The results of this study indicate that the correlation between mother’s knowledge about how to breastfeed and nutritional status was not significant. The correlation between exclusive breastfeeding and nutritional status in toddlerhood also was not significant. Conclusion: There was no correlation found between breastfeeding and nutritional status. Yet there was a correlation between mother's knowledge about how to breastfeed and nutritional status. Keywords: Exclusive breastfeeding, Level of knowledge, How to breastfeed, Nutritional status of children
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