PENGARUH LAMA MENYUSU TERHADAP FUNGSI KOGNITIF ANAK DI KOTA YOGYAKARTA

LENNA MASYDIANASARI, dr. Madarina Julia, MPH., Ph.D, Sp.A(K)

2011 | Tesis | S2 Kesehatan Masyarakat/KIA

Latar Belakang: Fungsi kognitif anak dipengaruhi oleh faktor genetik dan lingkungan. Kondisi lingkungan yang menentukan perkembangan fungsi kognitif seseorang mencakup nutrisi, kesehatan, kualitas stimulasi, iklim emosional rumah, dan tipe umpan balik yang diperoleh melalui perilaku. Salah satu faktor nutrisi yang berperan dalam perkembangan fungsi kognitif anak adalah menyusu. Pengaruh lama menyusu terhadap fungsi kognitif anak masih banyak diperdebatkan. Median lama menyusu di Yogyakarta lebih tinggi dibandingkan nasional 22,6 bulan. Sedangkan di Kota Yogyakarta, cakupan ASI eksklusif paling rendah ditemukan di wilayah kerja Puskesmas Gondokusuman II sebesar 3,3%. Tujuan Penelitian: Untuk mengetahui pengaruh lama menyusu terhadap fungsi kognitif anak di Kota Yogyakarta. Metode Penelitian: Jenis penelitian analitik observasional dengan pendekatan kuantitatif menggunakan rancangan kohort retrospektif. Penelitian dilaksanakan di beberapa Sekolah Dasar (SD) di wilayah Puskesmas Gondokusuman II, Kota Yogyakarta. Populasi penelitian ini semua anak SD usia 7-8 tahun di wilayah Puskesmas Gondokusuman II. Teknik pemilihan sampel secara non probability sampling dengan menggunakan quota sampling. Penetapan besar sampel dihitung dengan software PASS (Power Analysis and Sample Size) dan besar sampel 90. Analisis data menggunakan univariabel, bivariabel, dan multivariabel menggunakan uji statistik t dan chi square, dan regresi linier serta regresi logistik dengan interval kepercayaan 95%. Hasil: Lama menyusu berpengaruh terhadap fungsi kognitif anak (p< 0,05). IQ anak menyusu ?? 6 bulan lebih tinggi 8,84 poin dibandingkan menyusu < 6 bulan. Dari hasil analisis chi square variabel fungsi kognitif anak dikategorikan normal (skor ?? 90) dan tidak normal (skor < 90) lama menyusu menjadi tidak berpengaruh terhadap fungsi kognitif anak. Ada hubungan antara fungsi kognitif orang tua dan kualitas stimulasi terhadap fungsi kognitif anak (p < 0,05). Hasil analisis multivariabel dengan analisis regresi linier sederhana menunjukkan bahwa lama menyusu tetap konsisten mempengaruhi fungsi kognitif anak. Kesimpulan: Hubungan lama menyusu dengan fungsi kognitif anak tidak dipengaruhi oleh oleh usia kehamilan saat persalinan, berat lahir anak, tingkat pendidikan orang tua dan jumlah penghasilan orang tua.

Background: Children’s cognitive functioning is affected by genetic and environmental factors. Environmental conditions that determine the development of a person's cognitive functioning includes nutrition, health, quality of stimulation, the emotional climate of the home, and the type of feedback obtained through behavior. One of the nutritional factors that play a role in the development of children's cognitive function is breastfeeding. Effect of duration breastfeeding on cognitive function of children are still much debated. Breastfeeding ?? 6 months is more likely to have higher IQs than those who are breastfed <6 months. Median time of breastfeeding in Jogjakarta is higher than the national 22.6 months. While in Yogyakarta Municipality, the lowest coverage of exclusive breastfeeding is found in the work area of Gondokusuman II Health Center 3.3%. Objective: To determine the effect of breastfeeding duration on children’s cognitive functioning in Yogyakarta Municipality. Methods: This was an observational analytic study with a quantitative approach using a retrospective cohort design. The study was conducted at several elementary schools (SD) in the Gondokusuman II health center area, Yogyakarta Municipality. The study population was all primary school children aged 7-8 years in the Gondokusuman II health center area. Sample selection technique used a non-probability sampling with a quota sampling. Determination of the sample size was calculated by the software PASS (Power Analysis and Sample Size) and sample size was 90. Analysis of data used univariable, bivariable, and multivariable with t test and chi-square statistic test, and linear regression with 95% confidence interval. Results: Breastfeeding duration affected a child's cognitive functioning (p <0.05). The IQ of Children having been breastfed ?? 6 months showed 8.84 points higher than those breastfed <6 months. From the results of chi square analysis, the variable of children's cognitive function was considered normal (score 90-169) and abnormal (score <90); breastfeeding duration no longer effected children’s cognitive functioning. There was a relationship between parents’ cognitive function and quality of stimulation on children's cognitive functioning (p <0.05). The results of multivariable analysis with simple linear regression analysis showed that breastfeeding duration remained consistently to affect a child's cognitive functioning. Conclusion: The relationship between breastfeeding duration and children’s cognitive functioning was not affected by the gestational age at delivery, children’s birth weight, parents’ educational level and parents’ income.

Kata Kunci : Lama menyusu, Fungsi kognitif