Public Health Perspectives Journal 4 (1) 2019 61 - 66

Public Health Perspectives Journal

http://journal.unnes.ac.id/sju/index.php/phpj

The Quality, Quantity and Age of Giving Breastfeeding for Toddlers in

Relation with Nutritional Status

A'idah Nur Syarifah , Dyah Rini Indriyanti

Universitas Negeri Semarang, Indonesia

Info articles Abstract
________________
History of Article : Malnutrition is one of the main causes of malnutrition. Globally, poor
Accepted 28 January nutritional status is one of the causes of under-five mortality. The purpose of
2019 this study was to analyze the effect of the quality, quantity and age of providing
Approved 12 April
complementary food for breast milk in relation to the nutritional status of
2019
children.This study was an observational study with a cross sectional study
Published 20 April
2019 design. The population of toddlers aged 7-24 months is 344 toddlers, a sample
_________________ of 77 toddlers. Data retrieval is using simple random sampling technique using
Keywords: Slovin formula.The results are showed that the three independent variables
AKG; Toddlers; affected the nutritional status of children. The obtained is p-value (0.001)
Breastfeeding quality, (0,000) quantity and age (0,000).Based on the results of the study, it can
be concluded that there is a relationship between the quality of complementary
food for breast milk to the nutritional status of children with ap value of 0.001 (p
<0.05), there is a relationship between the quantity of complementary food for
the nutritional status of children with p value amounting to 0,000, and there is a
relationship between the age of providing complementary food for breast milk
to the nutritional status of children with ap value of 0.000. This research is
expected to benefit the community. For information on the program of
dissemination and counseling on the quality and quantity of complementary
feeding for mother's milk the which is good in the family and the impact the
caused by nutritional problems in infants.

© 2019 Universitas Negeri Semarang


Address correspondence: p-ISSN2528-5998
Unnes Campus Jl. Kelud Utara III, Semarang, 50237, e-ISSN 2540-7945
Indonesia
E-mail: ifahbae@yahoo.com
 A'idah Nur Syarifah & Dyah Rini Indriyanti/ Public Health Perspectives Journal 4 (1) 2019 61 - 66

INTRODUCTION mothers only give breastfeeding in the baby

when the baby wants it.
Malnutrition becomes a health problem One of the main causes of malnutrition
generally occurs in young children because it is in children under five is ignorance about how
a vulnerable group of nutrition. Nutritional feeding (Kandowangko H et al., 2019).
status is influenced by several factors, including Another factor affecting the nutritional status of
the adequacy of the level of nutrition and food children is accompanying diseases, low birth
security (Natalia LD et al., 2013). One of the weight (LBW), the completeness of
direct causes of the child does not get balanced immunization and the provision of
nutrition, namely Complementary feeding breastfeeding (Complementary feeding) early
(MP-ASI) are not eligible at the age of 6-24 (Novitasari, 2012).
months (Setiawati, 2016). The provision of early breastfeeding in
Based on the results of Nutritional Status infants aged <6 months should not be done
Monitoring (PSG) Central Java province in because the food is not digested properly. This
2016 the nutritional status of children aged 0-23 can lead to digestive disorders, the incidence of
months based index of BB / U ie, cases of gas, and constipation (Genting et al., 2010).
malnutrition of 10.5%, 2.7% severe This study aimed to analyze the
malnutrition (MoH, 2016). influence of the quality, quantity and age giving
Based on the indicators Weight Loss by breastfeeding relation to the nutritional status
Height (W / H, Z-score) the prevalence of of children in Puskesmas Tirta Pekalongan.
underweight toddlers and very thin in 2018 in
Indonesia by 10.2% ,. This has included a METHODS
serious public health problem by the WHO in
2018. Observational study with cross sectional
Infant Mortality Rate (IMR) in design. The population of children aged 7-24
Indonesia reached 34 / 1,000 live births. IMR months a number of 344 infants. Sample of 77
in Central Java province in 2015 as much as toddlers using simple random sampling
10/1000 live births. IMR in Pekalongan City in technique. Primary data were obtained from
2016 as many as 12.36 / 1,000 live births. Data mothers of infants to determine the age of the
Riskesdas 2013, the prevalence of children provision of breastfeeding. Nutritional status
malnutrition and undernourishment in index (W / A) was measured using the
Indonesia reached 19.6%. This figure increased steelyard. The quality and quantity of
in comparison with the data Riskesdas 2010 breastfeeding was obtained from questionnaire
amounted to 17.9% and Riskesdas 2007 includes 24-hour food recall includes the
(18.4%). Malnutrition children in the province consumption of energy, protein, fat and
of Central Java in 2015 as many as 922 cases. carbohydrates. Interviews quality
The incidence of malnutrition in Pekalongan complementary feeding is used to determine
by indicators BB / U 2016 also increased from what foods consumed by infants in the last 24
the previous year of 355 (1.60%) in 2016 and hours, while the quantity of MP-ASI interview
377 (1.72%) in 2017. in use laneways know how many meals in a
Based on the phenomenon in the field, 6 day and how many doses every meal.
of the 10 mothers of children aged 7-24 months Secondary data were obtained from monthly
give breastfeeding in infants aged less than six reports SKDN, IHC, and malnutrition in 2018
months. The results of the initial survey of 10 to determine the number of children aged 7-24
mothers of infants aged 7-24 months, there are months. Analysis of the data in this study using
3 babies with poor nutritional status with the Chi Square test.
quantity giving breastfeeding poorly, where

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RESULTS AND DISCUSSION and porridge are carbohydrates that are often
consumed by babies and toddlers. Diverse food
The study, of 77 respondents describe consumption can reduce the risk of shortage of
characteristics of data, including quality, certain nutrients to a person. Pahlavi (2012)
quantity and age giving breastfeeding relation also says the level of energy and protein intake
to the nutritional status of children. affects the nutritional status.

Table 1. Relationship quality complementary Table 2. Relations quantity of breastfeeding

feeding with infant nutritional status. with infant nutritional status.
Quality Toddler Nutritional Status Quantity Toddler Nutritional Status
Breastfeedi Less Well Total p-value breastfee Less Well Total p-value
ng f % f % f % ding f % F % F %
Not 16 42.1 4 10.3 20 26.0 0.001 Not 30 79.8 7 10.3 37 26.0 0.000
as needed suitable
According 22 57.9 35 89.7 57 74.0 AKG 8 21.1 32 82.1 40 74.0
to the eeds In
accordan
Total 38 100 39 100 77 100
ce AKG
Total 38 100 39 100 77 100
Based on the results in Table 1 shows the
majority of respondents to the quality of
breastfeeding as needed have good nutritional Table 2 shows the majority of
status a total of 35 infants (89.7%), whereas respondents to the quantity of breastfeeding is
respondents with the quality of breastfeeding not appropriate AKG (Nutrition Adequacy
that do not fit their needs and have a good Score) had malnutrition as many as 30 infants
nutritional status as much as 4 toddler ( 10.3%). (79.8%) on the contrary respondents with
Results obtained chi square test p- appropriate complementary feeding quantity
value of 0.001 (p <0.05), which means that the AKG have malnutrition as much as 8 toddlers
quality of breastfeeding associated with infant (21 , 1%).
nutritional status in Puskesmas Tirta Kota Results obtained chi square test p value
Pekalongan. Based upon the findings in the of 0.000 (p <0.05), which means that the
field, some mothers or caregivers only provide quantity of breastfeeding associated with infant
breastfeeding in infants regardless of the type or nutritional status in Puskesmas Tirta
variety of food needed. A healthy snack such as Pekalongan. Based on the findings in the field
fruit and biscuits are also rarely given. Toddlers the majority of mothers breastfeeding in infants
often eat sugary foods before the age of 1 in accordance with the needs of children with a
year,such as crackers and a light snack or ciki. frequency of providing food 3-4 times a day,
The quality of a good breastfeeding containing but do not pay attention to the amount of
nutrients such as energy, protein, fats, and dosage as needed toddlers. Children prefer to
carbohydrates. eat snacks that do not meet the RDA
In line with the research Sulistyorini nutritional value. The quantity of breastfeeding
(2015) children who get breastfeeding is not that do not fit the AKG may result in
according to age are at risk of having poor malnutrition.
nutritional status. According to the study (Rini Infant feeding is done generally with a
et al., 2017) lack of energy and protein intake in frequency of between 2 to 3 times per day
children can be caused by eating a little toddler. (Jumirah et al., 2018). According to (Listiowati
Research (Adani V et al., 2016) says rice, bread & Agustina, 2012) the frequency of
breastfeeding are effective and in accordance
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with the child's condition will give an This study was supported by research
uncontrolled impact the nutritional status of kalsum (2015) stating that there is a
children. The more frequent administration of relationship between the first administration
breastfeeding given will affect the nutritional breastfeeding and nutritional status of children
status and improve the child's weight. aged 7-36 months with a p-value = 0.005.
Multivariate analysis with logistic
Table 3. Relations Award age breastfeeding regression test, which is to see the relationship
with infant nutritional status between the dependent variable and all
administra Toddler Nutritional Status independent variables.
tion Less Well Total p-
Breastfeedi % value Table 4. Influence the quality, quantity and age
f % f f %
ng provision of breastfeeding on infant nutritional
Not 31 81.6 13 33.3 44 57.1 0,000 status
exactly 7 18.4 26 66.7 33 42.9 variables P-value Sig.
Right Quality 0.001 0003
Total 38 100 39 100 77 100 breastfeeding 0.000 0001
Quantity 0.000 0032
breastfeeding
Based on Table 3 shows the majority of
Age Award
respondents to the provision of breastfeeding
breastfeeding
age who do not exactly have malnutrition as
many as 31 infants (81.6%), whereas
respondents with age appropriate provision has The results in Table 4 show that the
good nutritional status were 7 infants (18.4%). variable quality of breastfeeding has the most
Results obtained chi square test p-value dominant influence with sig (0003), followed
of 0.000 (p <0.05), which means that the age of by breastfeeding Quantity factor with sig
the provision of breastfeeding associated with (0.001) and age factors Giving breastfeeding
infant nutritional status in Puskesmas Tirta with sig (0032). Table 4 shows that the three
Pekalongan. Based on the findings in the field independent variables affect the nutritional
the majority of mothers breastfeeding in infants status of children.
with age not on time of less than 6 months. The lack of variety in food consumption
This is due to the mother or caregiver assumed is a problem which affects the nutritional status
that if children are given food from an early age of children (Roess A et al., 2018). Research
it will be faster fat and no fuss. Whereas the (Widiyawati et al., 2016) reported no
provision of breastfeeding is not timely impact significant relationship between the frequency
on the child's digestive development. Toddlers of breastfeeding and nutritional status of
given breastfeeding <6 months are likely to children. The frequency of breastfeeding
have malnutrition. enough that is 3 times or more to meet the
According to Maseko & Owaga (2012) consumption of food and nutrients required in
infant feeding to consider the timeliness of accordance with the age of the child (Depkes
administration, frequency, type and amount of RI., 2010).
food, and how to manufacture. Mukhopadhyay According to WHO the provision of
et al., (2013) the practice of giving breastfeeding breastfeeding at 6 months of age, the frequency
at age is not exactly common in children who of eating 2-3 times a day aged 6-8 months,
are malnourished. The provision of early increasing to 3-4 times a day ages 9-12 months
breastfeeding has health risks, causing the and 12-24 months. Extra snack or snacks
growth and development of infants being (snacks) nutritious (such as a piece of fruit or
distracted (Mulyani & Minarti 2013). bread) was administered 1-2 times per day. The

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frequency of breastfeeding infants should as REFERENCES

often as possible because a child can consume
foods little by little while the need for calories Adani V, Pangestuti D.R, Rahfiludin Z.M.
and other nutrients must be met (Widiyawati et 2016. Hubungan Asupan Makanan
al., 2016). This study is in line with the (Karbohidrat, Protein dan Lemak)
opinions Rohmani (2010) which says that the dengan Status Gizi Bayi dan Balita
MP-ASI type given to children should be (Studi pada Taman Penitipan Anak
phased in density according to age. Lusendra Kota Semarang Tahun 2016).
According to the study (Wahyu et al., Jurnal Kesehatan Masyarakat UNDIP.
2012) states that the cause of malnutrition is 4(3): 261-271.
not simply due to the amount of food that does Ciptaningtyas and Ratri. 2012. Evaluation on
not fit, but also because of the disease. Children Failure Weight Gain among Toddlers of
who get enough food intake but often suffer Low Economy Family After
from ill be malnourished. Complimentary Biscuits Feeding. Jurnal
According to the study (Lestari et al., Kesehatan Masyarakat Nasional. Vol 7(5);
2012) malnutrition in children aged 1-3 years is 227-232.
more common in children who were given Depkes RI. 2010. Pedoman Pemberian Makanan
early breastfeeding (33%). There was a Pendamping ASI (MP-ASI), Dirjen Bina
significant correlation between the age of early Kesehatan Masyarakat, Dirjen Bina Gizi
administration of breastfeeding and nutritional Masyarakat. Jakarta: Departemen
status of children aged 4-24 months Kesehatan.
(Ciptaningtyas et al., 2012). Jumirah, Siagian A, Lubis Z, Sibuea P. 2018.
Pengaruh Pemberian MP-ASI
Campuran Tepung Pisang Awak dan
CONCLUSIONS AND SUGGESTIONS
Beras Serta Kecambah Kedelai
Terhadap Asupan Zat Gizi Bayi. TM
Based on the research results, it can be
Conference Series. Volume 1(01): 189-196.
concluded there is a relationship between the
Listiowati E dan Agustina W. 2012. Hubungan
quality of breastfeeding on the nutritional status
Frekuensi Pemberian Makanan
of children with p value of 0.001 (p <0.05).
Pendamping Air Susu Ibu (MP-ASI)
There is a relationship between the quantity of
dengan Berat Badan Anak Usia di
breastfeeding on the nutritional status of
Bawah Dua Tahun. Universitas
children with p value of 0.000. There is a
Muhammadiyah Yogyakarta. Mutiara
relationship between age giving breastfeeding
medika. 12(02): 102-108.
on infant nutritional status with p value of
0.000.
Kalsum U. 2015. Hubungan Umur Pemberian
Mothers who have children aged 7-24
Pertama Makanan Pendamping ASI
months are expected to pay attention to
(MP-ASI) dengan Status Gizi Anak 7-36
breastfeeding given to the quality and quantity.
Bulan. Jambi Medical Journal (JMJ). 3(2):
Good breastfeeding containing energy, protein
85-99.
and fat suit Nutrition Adequacy Score (AKG).
Kandowangko H, Mayulu N, I Punuh M.
Health agencies recommended forming a cadre
2019. Hubungan Antara Pemberian
of breastfeeding and to cooperate with the
Makanan Pendamping Asi (MP-ASI)
health center to do counseling as needed
dengan Status Gizi Anak Usia 12-24
breastfeeding infants.
Bulan di 5 Puskesmas Kota Manado.
Jurnal KESMAS ejournalhealth. Volume 7
Nomor (4).

65
 A'idah Nur Syarifah & Dyah Rini Indriyanti/ Public Health Perspectives Journal 4 (1) 2019 61 - 66

Kemenkes. 2016. Pemantauan Status Gizi (PSG). Toddlers Study (FITS) 2016. The
Jakarta Journal of Nutrition. 148 (3): 1525-1535.
Listiowati E dan Agustina W. 2012. Hubungan Rohmani A. 2010. Pemberian Makanan
Frekuensi Pemberian Makanan Pendamping Asi (MP-ASI) pada Anak
Pendamping Air SusuIbu (MP-ASI) Usia 1-2 Tahun di Kelurahan Lamper
dengan Berat Badan Anak Usia di Tengah Kecamatan Semarang Selatan,
Bawah DuaTahun. Universitas Kota Semarang. http//Jurnal
Muhammadiyah Yogyakarta. Unimus.ac.id
Mutiaramedika. 12(02): 102-108. Setiawati. 2016. Hubungan Pemberian
Maseko & Owaga. 2012. Child Malnutrition Makanan Pendamping Asi (Mp-Asi)
and Mortality In Swaziland: Situation Dini dengan Status Gizi pada Bayi
Analysis of The Immediate, Underlying Umur 7-12 Bulan. Jurnal Kesehatan
And Basic Causes. African Journal of Holistik (The Journal of Holistic Healthcare).
Food, Agriculture, Nutrition and 10 (2): 1-4.
Development. 12(02): 5994-6006. Widyawati, Febry F, Destriatania S. 2016.
Mukhopadhyay, Dipta K, and Apurba S. 2013. Analisis Pemberian MP-ASI dengan
Association of Child Feeding Practices Status Gizi pada Anak Usia 12-24 Bulan
with Nutritional Status of Under-two Di Wilayah Kerja Puskesmas Lesung
Slum Dwelling Children: Acommunity- Batu, Empat Lawang. Jurnal Ilmu
based Study from West Bengal India. Kesehatan Masyarakat. Fakultas
Indian Journal of Public Health. 57(3). Kesehatan Masyarakat Universitas
Mulyani Y.E dan Minarti P.I. 2013. Hubungan Sriwijaya. 7(2): 139-149.
Usia Pemberian Mp-Asi dan Status Gizi
dengan Kejadian Diare pada Balita Usia
6-24 Bulan di Wilayah Kerja
Puskesmas Jati Warna Kota Bekasi
Tahun 2013. Fakultas Ilmu Kesehatan
Program Studi Ilmu Gizi Universitas
Esa Unggul. Jakarta. 6 (02): 140-167.
Natalia LD, P Rahayuning D, STP, M.Gizi.
dr. Fatimah Siti M.Kes. 2013.
Hubungan Ketahanan Pangan Tingkat
Keluarga dan Tingkat Kecukupan Zat
Gizi dengan Status Gizi Batita di Desa
Gondangwinangun Tahun 2012. Jurnal
Kesehatan Masyarakat UNDIP (e-Journal).
Volume 2 (2).
Rini I, Pangestuti D.R, Rahfifudin M.Z. 2017.
Pengaruh Pemberian Makanan
Tambahan Pemulihan (Pmt-P) Terhadap
Perubahan Status Gizi Balita Gizi Buruk
Tahun 2017 ( Studi di Rumah Gizi Kota
Semarang). JurnalKesehatan Masyarakat
UNDIP. 5(4): 698-705.
Roess AA, Jacquier EF, Catellier DJ, Carvalho
R et al. 2018. Food Consumption
Patterns of Infants and Toddlers:
Findings from the Feeding Infants and
66