BackgroundThis study investigated the infant feeding practices of participating mothers who were recruited into a research project aimed at improving the nutritional status of mildly wasted children (< -1.0 to ≥ -1.5 Weight-for-Height Z-scores) aged ≥ 6 to < 60 months on Nias Island, Indonesia.MethodsCross-sectional, questionnaire-based interview of mothers of the index children (n = 215) who were admitted to the community program for mildly wasted children in the study area. Four focus groups and twenty in-depth interviews were conducted to explore further information on infant feeding practices in the study area.ResultsRetrospective results indicated that 6% of the mothers never breastfed. Fifty two percent of mothers initiated breastfeeding within six hours of birth, but 17% discarded colostrum. Exclusive breastfeeding until 6 months of age was practiced by 12%. Seventy-four percent of the mothers offered supplementary liquids besides breast milk within the first 7 days of life, and 14% of infants received these supplementary liquids from 7 days onwards until 6 months of age. Moreover, 79% of the infants were given complementary foods (solid, semi-solid, or soft foods) before 6 months of age. About 9% of the children were breastfed at least two years. Less than one in five of the mildly wasted children (19%) were breastfed on admission to the community program. Qualitative assessments found that inappropriate infant feeding practices were strongly influenced by traditional beliefs of the mothers and paternal grandmothers in the study areas.ConclusionGenerally, suboptimal infant feeding was widely practiced among mothers of mildly wasted children in the study area on Nias Island, Indonesia. To promote breastfeeding practices among mothers on Nias Island, appropriate nutrition training for community workers and health-nutrition officers is needed to improve relevant counseling skills. In addition, encouraging public nutrition education that promotes breastfeeding, taking into account social-cultural factors such as the influence of paternal grandmothers on infant feeding practice, is needed.

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In comparison with NNE, the INE approach was significantly better in bringing about a positive change in knowledge and practice of caregivers of mildly wasted children in the study area.

The daily programs achieved better results for the implementing organization than the weekly programs; however, the weekly programs were preferred by the community because of the lower time constraints and the lower opportunity cost of time. The willingness of community and household members to invest their time in more intensive activities in the daily programs led to better program outcomes.

This study reports the outcomes of daily (semi-urban areas) and weekly (remote rural regions) programs for moderately wasted children supplemented with locally produced ready-to-use foods in the form of fortified cereal/nut/legume-based biscuits on Nias Island, Indonesia (RUF-Nias biscuit). Thirty-four children in daily and twenty children in weekly programs aged ≥6 to <60 months with weight-for-height z-score (WHZ) ≥ −3 to < −2 SD were recruited (October 2007–June 2008) on Nias and admitted into existing nutrition centers in the Church World Service project area. Individual discharge criterion was WHZ ≥ −1.5 SD. Weight gain of the children in daily and weekly programs was 3.9 ± 3.8 and 2.0 ± 2.0 g/kg/day, respectively. A higher proportion of children in daily than weekly programs reached target WHZ (76% vs. 35%, P = 0.004). Weight gain at program discharge/closure was highly predicted (R 2 = 0.228, P < 0.001) by compliance to RUF biscuits: high vs. low compliance resulted in a 1.33 (95% CI 0.16 to 1.53) g/kg/day higher weight gain. Compliance and admission in daily programs were significant factors in reducing the risk of not reaching the discharge criterion. However, mothers complained more frequently about time constraints in the daily relative to weekly programs.

Undernourishment is a threat to human health. The prevalence of undernourishment remains alarming, especially among children under five years old in many countries, including Indonesia. Nowadays, the handling of undernourishment has shifted to treatment outside the hospital, utilizing local nutrient-rich foods. At the national level, the utilization of local food resources is a part of the promotion of dietary diversification and the bioeconomy. Ready-to-use supplementary food (RUSF) refers to supplementary foods aimed at improving the nutrition of moderate acute malnutrition (MAM) children under five years old. RUSF biscuit recipes were made using local food resources available in Banten province, Indonesia. To optimize the nutritional profile of the developed RUSF, taro/talas banten were mixed with ground-nut/peanut (Arachis hypogaea L.) and mungbean (Vigna radiata) as protein and lipid sources and red rice (Oryza longistaminata) and maize (Zea mays) as carbohydrate sources, and enriched by the local banana Nangka (Musa textilia). Two formulations were selected for the pilot testing, namely the taro-peanut and taro-peanut/mungbean RUSF biscuits, made from taro Banten, cereal, peanut and/or mungbean, and local banana. The RUSF biscuit showed promising results, presenting a high level of acceptance and a macronutrient composition that meets the standards for MAM children. However, the RUSF biscuits should be fortified with micronutrient premix to fulfill the dietary requirement for the MAM children. The results of this study provide further development opportunities.

AbstrakSiswa sekolah dasar merupakan kelompok yang rentan terhadap keracunan makanan. Metode ceramah merupakan metode sederhana dan sering digunakan dalam pendidikan gizi, tetapi responden cenderung pasif, sedangkan metode Team Game Tournament (TGT) merupakan metode berbasis permainan menarik dan disukai anak SD. Tujuan penelitian ini adalah mengetahui perbedaan niat dan perilaku pemilihan jajanan sehat pada siswa kelas 5 SDN Tumpakrejo 1 dan 2 menggunakan metode ceramah dan metode TGT. Desain penelitian yang digunakan adalah quasy experimental study dengan pre-test and post-test design. Jumlah sampel adalah 42 orang, yang diambil dengan cara total sampling yaitu memilih seluruh siswa kelas 5B SDN Tumpakrejo 1 sebagai kelompok TGT dan seluruh siswa kelas 5 SDN Tumpakrejo 2 sebagai kelompok ceramah. Variabel yang diteliti adalah niat, perilaku di sekolah dan rumah terkait pemilihan jajanan pada kedua kelompok berdasarkan pengukuran sebelum dan sesudah perlakuan. Hasil penelitian menunjukkan bahwa terdapat peningkatan niat yang signifikan pada kedua kelompok (p<0,05) tetapi tidak ada perbedaan niat yang signifikan antara kedua kelompok setelah diberi pendidikan gizi. Perilaku di sekolah menunjukkan adanya perbedaan yang signifikan pada kedua kelompok dan juga antara kedua kelompok setelah diberi pendidikan gizi. Tidak terdapat perbedaan perilaku di rumah yang signifikan pada kedua kelompok dan juga antara kedua kelompok setelah diberi pendidikan gizi. Berdasarkan hasil penelitian dapat disimpulkan bahwa metode ceramah lebih baik dalam meningkatkan niat, sedangkan TGT lebih baik dalam meningkatkan perilaku di sekolah walaupun kedua metode tersebut cukup efektif meningkatkan niat dan perilaku di sekolah. Namun kedua metode kurang efektif dalam meningkatkan perilaku jajanan di rumah. Kata Kunci: pendidikan gizi, niat, perilaku, jajanan OPEN ACCESS 23

Central Java province plays the main role in the production of food for national stocks in Indonesia, in which Demak is one of the 35 Regencies. Demak Regency had the sixth highest rice productivity in 2013, but at the same time, the seventh highest percentage of child malnutrition. This paradox between high rice productivity and low nutritional status of children triggered an interest in analyzing the correlations between agricultural production of households in the Demak Regency and the prevalence of stunting of children underfive. In December 2014 to February 2015, a cross-sectional survey was carried out in three sub-districts in Demak (Karanganyar, Dempet and Gajah) having the highest rice production and at the same time poor nutritional status of under-five children. The oldest under-five children from farmer family backgrounds were selected. Data on general characteristics, anthropometry of the children, as well as household socio-economics, including agricultural characteristics were obtained. Of the 335 children, 31.9% of them were stunted. A higher proportion of households that grew rice solely or mainly for own consumption (62.4%) and had significantly smaller sized ricefields (p = 0.041) had stunted rather than non-stunted children. In total, rice production, farm income and agriculture diversity of families with non-stunted children were not significantly different from those of stunted children. However, yearly expenditure for improving family health and environmental conditions were significantly higher among non-stunted than stunted children (p = 0.044). Family decisions about what to spend money on also seemed to influence the nutritional status of the children, rather than nutritional diversity or revenue from agriculture itself. Therefore, improvement of agricultural production and diversity should be accompanied by education on household expenditure.