PERBANDINGAN APLIKASI KOLOSTRUM DI MULUT TIAP 2 DAN 4 JAM DALAM TERCAPAINYA TROPHIC FEEDING PADA BAYI KURANG BULAN < 34 MINGGU

Astri Tantri Indriani, dr. Setya Wandita, M.Kes. Sp.AK; DR. dr. Ekawaty Lutfia Haksari, MPH, Sp.AK

2024 | Tesis-Subspesialis | SUBSPESIALIS ILMU KESEHATAN ANAK

Enteral feeding pada bayi kurang bulan dimulai dalam jumlah kecil ("trophic").
Trophic feeding adalah pemberian susu dalam jumlah kecil dimulai dari 10-25
ml/kg/hari yang diberikan melalui selang orogastrik. Kolostrum mengandung efek
protektif seperti anti inflamasi, imunodulasi, dan anti mikroba. Aplikasi kolostrum di
mulut merupakan terapi aman, efektif, dan ekonomis. Frekuensi aplikasi kolostrum di
mulut paling optimal belum konklusif. Tujuan penelitian ini untuk mengetahui
pengaruh frekuensi aplikasi kolostrum di mulut tiap 4 jam dan aplikasi tiap 2 jam dalam
tercapainya trophic feeding pada bayi kurang bulan.
Kami melakukan penelitian eksperimental menggunakan desain RCT
(randomized controlled trial) open label. Sampel penelitian adalah seluruh bayi kurang
bulan yang memenuhi kriteria inklusi dan dirawat di RSUP Dr. Sardjito pada bulan
Maret-Agustus 2023. Analisis data dilakukan menggunakan SPSS.
Penelitian ini dilakukan analisis pada 40 subjek yang mencapai trophic feeding
terdiri dari 20 subjek diberikan aplikasi kolostrum tiap 2 jam dan 20 subjek lainnya tiap
4 jam. Analisis bivariat variabel independen yakni aplikasi kolostrum, variabel luar
yakni enterokolitis nekrotikan, sepsis, hemodynamically significant Patent Ductus
Arteriosus (hsPDA), dan jenis kelamin dengan variabel dependen yakni tercapainya
trophic feeding. Hasil analisis ini menunjukkan bahwa hasil analisis bivariat, aplikasi
kolostrum tiap 4 jam 0,47 hari lebih cepat dibanding aplikasi kolostrum tiap 2 jam
dalam tercapainya trophic feeding dan secara statistika tidak memiliki perbedaan rerata
yang signifikan (p=0,703).
Kesimpulan dari penelitian ini bahwa frekuensi aplikasi kolostrum di mulut tiap
4 jam tidak memiliki perbedaan dengan frekuensi aplikasi kolostrum di mulut tiap 2
jam dalam tercapainya trophic feeding pada bayi kurang bulan <34>

Enteral feeding in preterm neonates starts with trophic feeding, which is the
practice of feeding minute volumes of enteral feeds (starting at 10-25mL/kg/day)
through an orogastric tube. Colostrum has protective effects, such as anti-
inflammatory, immunomodulatory, and antimicrobial effect. The oral colostrum
application is a safe, effective and economical therapy. However, the most optimal
frequency of the oral colostrum application is not yet conclusive. Therefore, this
research aims to evaluate the effects of applying colostrum orally every 4 and 2 hours
in order to achieve trophic feeding in preterm infants.
We conducted the experimental study applying the RCT (randomized
controlled trial) open label design. The study samples were all very-low-birth-weight
neonates admitted to RSUP Dr. Sardjito from March to August 2023 who fulfilled the
inclusive criteria. The data analysis was performed with SPSS.
Among 40 subjects who achieved trophic feeding, 20 received oral colostrum
application every 2 hours, and the other 20 subjects were fed every 4 hours. The
bivariate analysis of the independent variable was the colostrum application; the
extraneous variables were necrotizing enterocolitis, sepsis, hemodynamically
significant Patent Ductus Arteriosus (hsPDA) and gender; while the dependent variable
was the achievement of trophic feeding. This analysis showed the result of the bivariate
analysis, which was the colostrum application every 4 hours achieved the trophic
feeding 0.47 day faster than the colostrum application every 2 hours. Moreover, the
two feeding methods did not show a significant difference statistically (p=0.703).
To summarize, the result of this research stated that there is no significant
difference in achieving trophic feeding in preterm neonates (less than 34 weeks)
whether the colostrum was given every 2 or 4 hours.

Kata Kunci : colostrum, very low birth weight, trophic feeding