Faktor-Faktor Yang Berhubungan Dengan Lama Menyusu ASI Saja di Kabupaten Demak

Ardhiani dyah priamsari, dr. Mei Neni Sitaresmi, Ph.D, Sp.A(K).

2013 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang:Tingkat pelaksanaanASI Eksklusif yang masih rendah umumnya dipengaruhi oleh beberapa faktor yaitu; sistem kesehatan, dukungan dari tenaga kesehatan, penggunaan dan promosi susu formula di rumah sakit, Inisiasi Menyusu Dini (IMD) serta pelaksanaan rawat gabung. Tujuan:Mengetahui hubungan antara variabel IMD, promosi susu formula, konseling, rawat gabung, tenaga penolong persalinan, tempat lahir dan pendidikan ibu terhadap lamabayi menyusu ASI saja. Metode: Penelitian dengan desain penelitian cohort prospectivemenggunakandata sekunder. Lokasi penelitian terdapat di Kabupaten Demak, Lama menyusuASI sajadihitung dari bayi lahir sampai dengan 24 minggu.Dengan analisis survival, event dalam penelitian ini adalah bayi yang berhenti menyusu ASI sajaselama masa pengamatan penelitian berlangsung. Semua analisis dilakukan dengan tingkat kemaknaan p<0,05 dan interval kepercayaan 95%. Hasil:Sebanyak 80 % dari 160 subjek berhenti menyusu ASI saja sebelum 24 minggu. Secara statistik bivariabel, terdapat hubungan bermakna antara lama menyusu ASI saja dengan IMD, promosi susu formula, tenaga penolongpersalinan dan konseling (p<0,005). Hasil uji multivariat menunjukkan bahwa IMD dan promosi susu formula berkaitan dengan lama menyusu ASI saja (p < 0,05). Bayi yang diberikan IMD akan lebih lama menyusu ASI saja dari pada yang tidak diberikan IMD (HR=1,6 ; CI 95% : 1,09 - 2,36). Bayi yang ibunya tidak diberikan promosi susu formula gratis setelah persalinan akan lebih lama menyusu ASI saja dari pada yang mendapatkan promosi susu formula (HR=3,32 ; CI 95% : 2,13 - 5,16). Kesimpulan: Terdapat hubungan yang signifikan antara lama menyusu ASI saja dengan IMD dan promosi susu formula gratis saat persalinan.

Background: Poorpractice of exclusive breastfeeding is generally influenced by some factors such as health system, support from health staff, use and promotion of formulated milk in hospitals, early initiation of breastfeeding and the practice of integrated care. Objective: To identify association between variables of early initiation of breastfeeding, promotion of formulated milk, counseling, integrated care, child birth assistants, place of birth and education of mothers and duration of only breastfeeding. Method: The study used secondary data and prospective cohort design. Location of the study was District of Demak. Duration of only breastfeeding was calculated from birth until the baby was 24 weeks of age. Using survival analysis, event of the study were babies ceasing only breastfeeding during the observation of the study.All analysis was made at significance p<0.05 and confidence interval 95%. Result:As much as 80 % of 60 subjects ceased only breastfeeding before 24 weeks. The result of bivariate analysis showed there was a significant association between duration of only breastfeeding and early initiation of breastfeeding, promotion of formulated milk, child birth assistants and counseling (p < 0.05). The result of multivariate test showed that early initiation of breastfeeding and promotion of formulated milk were associated with duration of only breastfeeding(p < 0.05). Babies with early initiation of breastfeeding would have longer breastfeeding only than those without early initiation of breastfeeding(HR = 1.6; CI 95%: 1.09 – 2.36). Babies who did not receive promotion of free formulated milk would have longer breastfeeding only than those with promotion of formulated milk(HR = 3.32; CI 95%: 2.13 – 5.16). Conclusion: There was significant association between duration of only breastfeeding and early breastfeeding initiation and promotion of free formulated milk during child birth.

Kata Kunci : ASI, Menyusu, IMD, Promosi susu formula