Pengaruh Konsumsi Susu Formula yang Disuplementasi Gabungan Strain Bifidobacteria (B. longum BB536, B. breve M-16V, dan B. longum subsp. infantis M-63) terhadap Tumbuh Kembang Anak Sehat Usia 1–3 Tahun diukur dengan Ages and Stages Questionnaires-Third Edition (ASQ-3)

Hervina Claudia Cahyaningtyas, dr. Dian Kesumapramudya Nurputra, M.Sc, Ph.D, Sp.A, Subs. Neuro(K); dr. Mawaddah Ar Rochmah, Ph.D, Sp.N; dr. Braghamandita Widya Indraswari, M.Sc, Sp.A(K)

2024 | Skripsi | PENDIDIKAN DOKTER

Latar belakang: Suplementasi probiotik Bifidobacteria diberikan dalam susu formula untuk menunjang tumbuh kembang anak, terutama pada periode emas yaitu usia 1–3 tahun. Parameter yang umum digunakan yaitu berat badan (BB), tinggi badan (TB) atau panjang badan (PB), dan lingkar kepala (LK) untuk pertumbuhan anak serta Ages and Stages Questionnaires-Third Edition (ASQ-3) sebagai alat penapisan perkembangan anak. Tujuan: Mengetahui pengaruh konsumsi susu formula yang disuplementasi gabungan strain Bifidobacteria (B. longum BB536, B. breve M-16V, dan B. longum subsp. infantis M-63) terhadap tumbuh kembang anak sehat usia 1–3 tahun diukur dengan Ages and Stages Questionnaires-Third Edition (ASQ-3). Metode: Dalam uji acak terkendali dengan metode buta berganda yang dikontrol plasebo di Yogyakarta, 102 anak usia 1–3 tahun terdaftar dan dialokasikan secara acak untuk menerima susu probiotik (n=51) atau susu plasebo (n=51). Setiap kelompok dibagi kembali berdasarkan usia (12–24 bulan dan 25–36 bulan) untuk analisis BB, TB/PB, LK. Susu probiotik mengandung tambahan tiga strain Bifidobacteria masing-masing 5 × 10? CFU/saji. Uji klinis dilakukan dengan periode baseline 14 hari dan intervensi selama 90 hari. Data diperoleh dari pengukuran BB, TB/PB, dan LK serta hasil kuisioner ASQ-3 pada awal dan akhir penelitian. Pengaruh intervensi dianalisis berdasarkan perbedaan kenaikan rata-rata dan interpretasi ASQ-3. Hasil: Karakteristik kedua kelompok studi serupa pada awal penelitian dengan kepatuhan tinggi (±89,5%). Hasil kenaikan BB, TB/PB, dan LK bermakna klinis pada usia 25–36 bulan. Dalam rentang usia tersebut, dibandingkan susu plasebo, konsumsi susu probiotik selama tiga bulan menghasilkan kenaikan yang lebih tinggi pada BB sebesar 0,12 kg (p=0,700), pada TB sebesar 0,33 cm (p=0,451), dan pada LK sebesar 0,20 cm (p=0,581). Kenaikan skor ASQ-3 lebih tinggi pada kelompok probiotik, terutama pada domain motorik halus sebesar 12% (p=0,647) yang hanya signifikan pada kelompok probiotik (p=0,022) dan tidak signifikan pada kelompok plasebo (p=0,157). Perbedaan skor domain ASQ-3 lainnya pada kedua kelompok tidak bermakna secara statistik, baik intragrup dan/atau antargrup. Kesimpulan: Konsumsi susu formula yang disuplementasi gabungan strain Bifidobacteria (B. longum BB536, B. breve M-16V, dan B. longum subsp. infantis M-63) mampu mempertahankan dan/atau mendukung tumbuh kembang anak sehat usia 1–3 tahun. Pada kelompok probiotik, rata-rata kenaikan BB, TB/PB, dan LK serta skor domain ASQ-3 lebih tinggi, terutama pada aspek motorik halus. Seluruh hasil uji statistik tidak bernilai signifikan.

Background: Supplementation of Bifidobacteria probiotics is included in infant formula to support child growth and development, especially during the golden period of 1–3 years. Common parameters used are body weight (BW), height (HT) or length (LG), and head circumference (HC) for child growth, as well as the Ages and Stages Questionnaires-Third Edition (ASQ-3) as a tool for screening child development. Objective: To determine the impact of consuming formula milk supplemented with a combination of Bifidobacteria strains (B. longum BB536, B. breve M-16V, and B. longum subsp. infantis M-63) on the growth and development of healthy children aged 1–3 years measured using the Ages and Stages Questionnaires-Third Edition (ASQ-3). Methods: In a double-blind, placebo-controlled randomized controlled trial in Yogyakarta, 102 children aged 1–3 years were enrolled and randomly allocated to receive probiotic milk (n=51) or placebo milk (n=51). Each group was further divided by age (12–24 months and 25–36 months) for analysis of BW, HT/LG, and HC. Probiotic milk contained an additional three strains of Bifidobacteria, each 5 × 10? CFU/serving. The clinical trial had a baseline period of 14 days and an intervention period of 90 days. Data was obtained from measurements of BW, HT/LG, and HC, as well as results of the ASQ-3 questionnaire at the beginning and end of the study. The effect of the intervention was analyzed based on the difference in mean increase and interpretation of ASQ-3. Results: The characteristics of the two study groups were similar at baseline with high compliance (±89.5%). The results of the increase in BW, HT/LG, and HC were only clinically significant at the age of 25–36 months. In this age range, compared to placebo milk, consumption of probiotic milk for three months resulted in a higher increase in BW by 0.12 kg (p=0.700), in HT by 0.33 cm (p=0.451), and in HC by 0.20 cm (p=0.581). The increase in ASQ-3 scores was higher in the probiotic group, especially in the fine motor domain by 12% (p=0.647), which was only significant in the probiotic group (p=0.022) and not significant in the placebo group (p=0.157). Differences in other ASQ-3 domain scores between the two groups were not statistically significant, both intragroup and/or intergroup. Conclusion: Consumption of formula milk supplemented with a combination of Bifidobacteria strains (B. longum BB536, B. breve M-16V, and B. longum subsp. infantis M-63) is able to maintain and/or support the growth and development of healthy children aged 1–3 years. Consumption of probiotics increased BW, HT/LG, HC, and ASQ-3 domain scores, especially in the fine motor aspect. All statistical results were not significant.

Kata Kunci : susu formula, suplementasi, Bifidobacteria, tumbuh kembang, anak