Latar belakang. Perkembangan dasar yang terjadi pada masa balita akan memengaruhi dan menentukan perkembangan anak selanjutnya. Status gizi dan stimulasi merupakan dua faktor yang memengaruhi tumbuh kembang balita. Tujuan. Penelitian ini bertujuan menganalisis hubungan status gizi dan stimulasi tumbuh kembang dengan perkembangan anak Balita di Provinsi Nusa Tenggara Barat (NTB).Metode. Jenis penelitian ini adalah studi penelitian analitik observasional dengan pendekatan cross-sectional. Penelitian ini dilaksanakan pada bulan Februari–April 2018. Sampel dipilih secara simple random sampling sebanyak 114 subjek penelitian. Teknik pengumpulan data menggunakan kuesioner dan dianalisis dengan regresi logistik.Hasil. Berdasarkan hasil analisis multivariat antara status gizi (TB/U) dan stimulasi tumbuh kembang dengan perkembangan didapatkan hasil (b=1,68; IK95%:1,10-2,57; p=0,016) untuk status gizi dan (b=3,48; IK95%:1,42-8,52; p=0,006) untuk stimulasi tumbuh kembang. Kesimpulan. Balita dengan perawakan normal memiliki peluang 1,6 kali mengalami perkembangan yang sesuai dibandingkan anak dengan perawakan pendek dan sangat pendek (stunting). Balita yang mendapatkan stimulasi tumbuh kembang sering memiliki peluang 3,4 kali mengalami perkembangan yang sesuai dibandingkan dengan anak yang mendapatkan stimulasi jarang.

AbstrakPemerintah Surakarta menyelenggarakan program kelompok pendukung ibu untuk meningkatkan cakupan ASI eksklusif. Penelitian cross sectional ini bertujuan menganalisis perbedaan pengetahuan, sikap, dan tindakan ASI eksklusif antara ibu-ibu yang mengikuti dan tidak mengikuti pada tahun 2014. Populasi penelitian adalah ibu-ibu yang memiliki bayi berusia 6-24 bulan. Besar sampel yaitu 384. Hasil uji Mann-Whitney menunjukkan bahwa pengetahuan dan sikap tentang ASI eksklusif pada ibu-ibu yang mengikuti program pendukung ibu lebih tinggi secara bermakna dibanding ibu-ibu yang tidak mengikuti (p=0,04 dan p=0,001). Uji Chi-Square menunjukkan bahwa tidak terdapat perbedaan tindakan yang bermakna pada kelompok tersebut (p=0,82). Regresi logistik dilanjutkan tes stratifikasi menunjukkan bahwa dukungan keluarga lain (selain suami) merupakan variabel perancu. Kesimpulannya yaitu ibu-ibu yang mengikuti program pendukung ibu memiliki pengetahuan dan sikap yang lebih tinggi secara bermakna dibanding yang tidak mengikuti. MOTHER SUPPORT GROUP PROGRAM EFFECTIVENESS IN CHANGING THE MOTHER BREASTFEEDING BEHAVIOUR

Background: Low birth weight (LBW) is one of the primary causes of infant mortality. It shares 27% of infant mortality rate (IMR). The Indonesian Demographic and Health Survey in 2007 reported that the IMR was 34 deaths per 1,000 live births. As much as 30.3% of this rate was accounted by LBW. As such LBW is an important global public health issue. Countries around the world have committed to overcome this problem. This study aimed to investigate the effects of maternal education, psychosocial stress, nutritional status at pregnancy, and family income, on birth weight. Subjects and Method:This was an observational analytic study with case control design. The study was conducted in Ngetos community health center, Nganjuk, East Java, from May to June, 2017. A total sample of 120 were selected for this study by fixed disease sampling, comprising 40 infants with low birth weight and 80 infants with normal birth weight. The dependent variable was birth weight. The independent variables were maternal education, psychosocial stress, nutritional status at pregnancy (middle-upper arm circumference, MUAC), maternal anemia, and family income. MUAC was measured by MUAC measuring tape. Hemoglobin concentration was measured by Sahli meter. Psychosocial stress was measured by Holmes and Rahe stress scale. The other variables were measured by a set of questionnaire. Path analysis was used for data analysis. Results: MUAC ≥23.5 cm(b= -0.80, SE= 0.57; p=0.064), hemoglobin concentration ≥11 g/dL (b= -120.16, SE= 45.14, p=0.008), and low psychosocial stress (b= -0.80, SE= 0.57, p=0.164)directly and negatively affected low birth weight. Maternal education ≥Senior High School(b= 1.28, SE = 0.056, p= 0.022), psychosocial stress (b= -0.001, SE<0.001, p=0.097), and family income (b= 0.97, SE= 0.46, p=0.036) positively affected MUAC. MUAC ≥23.5 cm positively affected hemoglobin concentration ≥11 g/dL (b= 0.19, SE = 20.84, p<0.001). Conclusion: MUAC, hemoglobin concentration, and low psychosocial stress directly and negatively affect low birth weight.

Background: In theory, infant massage is beneficial for improving sleep quality, gross and fine motor development. Infants aged 3-6 months are able to receive stimulation that may help develop gross and fine motor development. Massage may improve brain function and raise the release of growth hormone, and strengthen muscle. This study aimed to determine of the effect of massage on sleep quality, gross and fine motor development among infant aged 3-6 months. Subjects and Method: This was a randomized controlled trial, conducted in Magelang, Central Java, from 1 August to 16 September 2016. A total of 60 infants in Azza Momby Spa, Magelang was selected for this study by simple random sampling. This sample was then allocated at random into massage group (n1=30) and control group (n2=30). The independent variable was infant massage. The dependent variables were sleep quality, gross and fine motor development. The data was collected by using questionnaire. The difference of dependent variables between the two groups were tested by Mann-Whitney. Results: After intervention, infants in the massage group (median=2.00; SD=1.80) slept better than the control group (median<0.01; SD=0.95), and it was statistically significant (p<0.001). Infants in the massage group (median=0.00; SD=0.81) had better gross motor development than the control group (median<0.01; SD=0.72), and it was statistically significant (p=0.043). Infants in the massage group (median=0.00; SD=0.81) had better fine motor development than in the control group (median<0.01; SD=0.48), and it was statistically significant (p=0.018). Conclusion: Massage is effective to improve sleep quality, gross and fine motor development, in infants aged 3-6 months.

Background: The incidence of post-partum blues both in Indonesia and abroad has been quite high; the stress that post-partum mothers experience will inhibit breast milk production and, as a result, breastfeeding process should be stopped earlier. Hypnobreastfeeding relaxation and oxytocin massage have been a combination of therapy that might decrease the rate of Adenocorticotropic Hormon (ACTH) and that might assist hormone and prolactin secrection in order that breast milk production becomes fluent. This study then aimed at analyzing the optimization of the combination of oxytocin massage and hypnobreastfeeding in order to decrease anxiety and to improve breast milk production among post-partum mothers. Subjects and Method:This was an analytic experimental study with Randomized Control Trial (RCT) design. This study was conducted at Dr. Suradji Tirtonegoro Central General Hospital, Klaten, from January 25 th , 2017 until March 9 th , 2017. The population in this study was 200 postpartum mothers. A sample of 60 post-partum mothers was selected for this study and allocated into the intervention group (n1= 30) and the control group (n2= 30). The intervention group would be treated by the combination of oxytocin massage and hypnobreastfeeding. The dependent variables were anxiety and breast milk production. The independent variables were oxytocin massage and hypnobreastfeeding. The anxiety was measured by STAI scale. The breast milk production process was measured by checklist questionnaire. The breast milk production amount was measured by milking cups. The breast milk production between the two groups was tested by Mann-Whitney. Results: The anxiety scale in the intervention group was better and lower than that of the control group. The differences in terms of anxiety scale between the intervention group (median= 24.00; SD= 4.45) and the control group (median= 34.00; SD= 6.93) were statistically significant (p<0.001). Then, the differences in terms of breast milk production process between the intervention group (median= 9.00; SD= 1.66) and the control group (median= 8.00; SD= 1.56) were nearly significant (p<0.145). Furthermore, the differences in terms of breast milk production amount between the intervention group (median= 10.00; SD= 10.36) and the control group (median= 4.50; SD= 4.21) were statistically significant (p<0.001). Conclusion: Combination of oxytocin massage and hypnobreastfeeding can effectively decreasing anxiety and increasing breast milk production for post-partum mothers.

PurposeThe World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of a child's life. However, while the national coverage was 61.33%, the coverage in Sukoharjo was 39.33%. Effective intervention is needed to promote the importance of exclusive breastfeeding, and this requires knowledge of the barriers and support structures in place. This study analyzed the supports and barriers of exclusive breastfeeding in Sukoharjo, Central Java, Indonesia.Design/methodology/approachThis qualitative study used in-depth interviews conducted from December 2017 to March 2018. The population consisted of 33 informants (29 mothers with babies over six months of age, a pregnant mother, two midwives working in the community health center and a staff member in the district health department).FindingsThere were barriers to and support for exclusive breastfeeding in Sukoharjo, Central Java province, Indonesia. The district already has support systems in place, while the barriers emerge from society, the baby's condition, environmental and other sources. The government has tried to overcome the barriers.Research limitations/implicationsThe limitation of this study was that the triangulation method was not utilized. However, the use of various informants strengthened the findings.Practical implicationsThe district government, especially the health department, needs to establish a program to evaluate existing exclusive breastfeeding support programs thoroughly. Smarter and more comprehensive interventions may be needed, for example, by integrating various supports into one activity. For researchers, the findings of this study imply that they can conduct experimental community research using the framework of the two aforementioned theories of behavior change. For example, investigation of combining the support of trained peers with the presence of family members such as the grandmothers of the babies. If both types of support are conducted concurrently, it may strengthen support and reduce barriers from either inside or outside the home.Social implicationsThe district government, especially the health department, needs to establish a program to evaluate existing exclusive breastfeeding support programs thoroughly. Smarter and more comprehensive interventions may be needed, for example, by integrating various supports into one activity. For researchers, the findings of this study imply that they can conduct experimental community research using the framework of the two aforementioned theories of behavior change. For example, investigation of combining the support of trained peers with the presence of family members such as the grandmothers of the babies. If both types of support are conducted concurrently, it may strengthen support and reduce barriers from either inside or outside the home.Originality/valueThere are barriers to exclusive breastfeeding in Sukoharjo, but the government has made effective attempts to overcome them. The support systems in place were in line with the theory of planned behavior (TPB) and social cognitive theory (SCT).

Background: Post partum period is condition of a time that very influential on the psychological and social conditions for women after giving birth. The incidence of post partum blues increased in this period of time with a prevalence of 30% to 75%. Post partum blues give effect to the early cessation of breastfeeding process which is contribute to child mortality under 5 years of 11.6%. This is associated with the practice of exclusive breastfeeding that are not optimal as a result of post partum blues experienced by woman after giving birth. The purpose is to analyze the anxiety in the group given the Hypnobreastfeeding intervention treatment and which is not given the intervention treatment, held at RSUP Dr. Suradji Tirtonegoro, Klaten. Method: Research is experimental design with randomized control trial. The population is all pregnant women in Puskesmas Jogonalan I area of Klaten. A total of 60 post partum object was selected for this study by simple random sampling. This was a randomized controlled trial, conducted at RSUP Dr. Suradji Tirtonegoro, Klaten. Results: The difference of dependent variables between the two groups were tested by Mann-Whitney. Conclusion: There is a differences and significance level of result of degree of anxiety between both treatment result with p=0.002. Hypnobreastfeeding intervention treatment can relief anxiety level for post-partum mother

Background:The interaction between infections and malnutrition has been recognized as a vicious cycle. Repeated diarrhoeal illnesses as well as other common childhood infections progressively altered the normal growth trajectories of children. This study aimed to analyze the effects of diarrhea and lifelong determinants on the incidence of stunting in children under two years in Kupang. Subjects and Method: This was a case control study conducted in 25 integrated health posts in Alak and Oebobo Subdistricts, in Kupang, East Nusa Tenggara, from November December 2018. A sample of 200 children under two years was selected by multi-stage random sampling. The dependent variable was stunting. The independent variables were diarrhea, birth length, parental income, maternal education, exclusive breastfeeding, maternal height, maternal mid-upper arm circumference (MUAC), complementary feeding, maternal hygiene practice, and sanitation. The data were collected by questionnaire and analyzed by path analysis. Results: Stunting prevalence in Kupang was 30.5%. The risk of stunting was directly decreased by appropriate complementary feeding (b= -1.97; 95% CI= -3.55 to -0.39; p= 0.014), good hygiene practice (b= -4.38; 95% CI= -6.63 to -2.12; p<0.001), good sanitation (b= -2.32; 95% CI= -4.00 to -0.64; p= 0.007), and birth length ≥48 cm (b= -2.22; 95% CI= -3.74 to -0.69; p= 0.004). The risk of stunting was directly increased by diarrhea (b= 2.55; 95% CI= 1.01 to 4.09; p= 0.001). It was indirectly affected by parental income, maternal education, exclusive breastfeeding, maternal height, and maternal MUAC at pregnancy. Conclusion:The risk of stunting is directly decreased by appropriate complementary feeding, good hygiene practice, good sanitation, and birth length ≥48 cm. The risk of stunting is directly increased by diarrhea. It is indirectly affected by parental income, maternal education, exclusive breastfeeding, maternal height, and maternal MUAC at pregnancy.