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"ABSTRAKNama : Eleonora Mitaning ChristyProgram Studi : Ilmu Gizi, Peminatan Ilmu Gizi KlinikJudul : Hubungan Pola Menyusui dengan Status Gizi Bayi dan Kadar Sekretori Imunoglobulin A pada Saliva Bayi Usia 3 ndash;6 BulanPembimbing : Dr. Sri Sukmaniah, M.Sc, Sp.GK K DR. Dr. Rini Sekartini, Sp.A K Pola menyusui merupakan bentuk atau model perilaku ibu dalam memberikan ASI kepada bayinya meliputi apakah Ibu memberikan makanan dan minuman selain ASI, kapan diberikannya makanan dan minuman lain tersebut, bagaimana kontinuitas Ibu dalam memberikan ASI, serta cara Ibu memberikan ASI. ASI mendukung pertumbuhan dan perkembangan bayi. Parameter yang paling sering digunakan untuk mengevaluasi pertumbuhan adalah adalah berat badan dan panjang badan, keduanya dapat dinterpretasikan dalam penilaian status gizi. Imunoglobulin merupakan salah satu komponen dalam ASI yang mendukung daya tahan tubuh, dan imunoglobulin yang terbanyak dalam ASI, terutama pada fase awal menyusui, adalah sekretori imunoglobulin A sIgA . SIgA sering dikatakan sebagai pertahanan tubuh lini pertama, dan kadar sIgA dapat dilihat salah satunya melalui pemeriksaan sampel saliva. Penelitian dengan desain potong lintang ini dilakukan di poliklinik anak gedung Kiara Rumah Sakit Cipto Mangunkusumo, yang bertujuan untuk mengetahui hubungan antara pola menyusui dengan status gizi dan hubungan pola menyusui dengan kadar sekretori imunoglobulin A pada saliva bayi usia 3 ndash;6 bulan. Mayoritas dari total 54 subyek yang mengikuti penelitian ini berjenis kelamin laki-laki 61,1 , 57,4 subyek memiliki usia gestasi cukup bulan, dan 51 subyek dilahirkan melalui operasi caesar. Rata-rata berat lahir dari kesuluruhan subyek adalah 2707,83 584,39 gram. Sebagian besar Ibu subyek 64,8 berusia 20 ndash;30 tahun, 55,6 memiliki riwayat multipara, dan 79,6 tidak bekerja. Pada penelitian ini didapatkan 35,2 Ibu subyek memiliki pola menyusui yang baik. Subyek dengan status gizi normal didapatkan sebesar 85,2 , Nilai tengah kadar sIgA saliva untuk seluruh subyek penelitian adalah 56,2 2,5 ndash;536,4 g/ml. Hasil penelitian ini menunjukkan bahwa tidak ditemukan hubungan yang bermakna antara pola menyusui dengan status gizi subyek dan kadar SIgA saliva pada bayi usia 3 ndash;6 bulan. Kata Kunci: ASI, menyusui, ibu menyusui, pola menyusui, status gizi, sIgA saliva, Bayi.

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ABSTRACTName Eleonora Mitaning ChristyStudy Program Nutrition, Clinical NutritionTittle Breastfeeding pattern and its rsquo association with nutritional status and salivary secretory immunoglobulin A level in 3 to 6 month old infantsSupervisor Dr. Sri Sukmaniah, M.Sc, Sp.GK K DR. Dr. Rini Sekartini, Sp.A K Breastfeeding pattern is a form of mother 39 s behavior in giving breast milk to her baby including whether mother provides foods and drinks other than breast milk, when those foods and drinks are given to the baby, how rsquo s the continuity of the mother in giving breast milk, an also the way mother breastfeeds her baby. Breast milk supports the growth and development of the baby. Body weight and body length are used to evaluate the growth of the infant. Both can be interpreted into nutritional status. Immunoglobulin is one of many components in breast milk that supports immunity. The most common immunoglobulin in breast milk, especially in the early phases of breastfeeding, are secretory immunoglobulin A sIgA . SIgA often mentioned as the first line defense of the body immune system. SIgA levels can be evaluated, one of the ways, from saliva samples examination. The research with cross sectional design was conducted in Kiara Pediatric Polyclinic, Cipto Mangunkusomo Hospital, Jakarta to determine the breastfeeding pattern and its association with nutritional status and salivary secretory immunoglobulin A level in 3 to 6 month old infants. The study was conducted using 54 subjects where the majority of the subjects 61.1 were boys, 57.4 subjects had mature gestational age, and 51 of subjects were delivered by caesarean section. The mean of all subjects rsquo birth weight was 2707,83 584,39 gram. The study found that the majority of subjects rsquo mothers 64.8 were 20 to 30 year old age, 55.6 of subjects rsquo mothers were multiparas, and 79.6 were not working. The study also showed that 64.8 of subjects rsquo mothers had less good breastfeeding pattern, at the other side, 35.2 had good breastfeeding pattern. Subjects with normal nutritional status were 85.2 , while 14.9 found with abnormal nutritional status. The median of subjects rsquo salivary sIgA level was 56.2 2.5 ndash 536.4 g ml. The results of this study showed no significant association between breastfeeding pattern with nutritional status of the subjects and salivary sIgA level in 3 to 6 month old infants. Keywords Breast milk, breastfeeding pattern, nutritional status, salivary sIgA, infants."

"Ileostomi merupakan tindakan pembedahan pembuatan lubang (stoma) antaraileum dan dinding abdomen, bertujuan untuk pengalihan feses. Ileostomi umumnyadibuat pada pasien yang menjalani penanganan kanker kolorektal, neoplasmastadium lanjut dengan infiltrasi usus halus, maupun peradangan saluran cerna.Ileostomi high output (produksi stoma ileum >1500 mL/hari) dapat menyebabkangangguan keseimbangan cairan dan elektrolit, maupun malnutrisi pada pasien. Saatini belum ada pedoman tata laksana nutrisi komprehensif untuk pasien ileostomihigh output. Serial kasus ini bertujuan untuk mendukung terapi, mengatasimalnutrisi, menunjang perbaikan klinis, sehingga dapat menurunkan morbiditasdan mortalitas pasien ileostomi high output. Empat pasien ileostomi high outputdengan rentang usia 42 hingga 50 tahun mendapatkan terapi medik gizi selamaperawatan di rumah sakit. Tiga kasus merupakan kasus kronik dengan keganasan,sementara satu kasus lainnya merupakan kasus akut yaitu adhesi dan perforasiakibat hernia femoralis strangulata. Keempat kasus tersebut merupakan ileostomihigh output onset awal, yaitu yang terjadi kurang dari tiga minggu pasca pembuatanstoma. Berdasarkan kriteria malnutrisi American Society for Parenteral andEnteral Nutrition (ASPEN), keempat pasien ini tergolong malnutrisi berat. Terapimedik gizi diberikan dengan prinsip pemberian makanan dan minuman porsi kecilnamun sering, restriksi cairan hipotonik, pemberian minuman berupa larutanelektrolit-glukosa, pemberian medikasi anti motilitas, serta koreksi cairan danelektrolit menurut kebutuhan dan kondisi klinis pasien. Target asupan energi danprotein pada keempat pasien dapat tercapai selama perawatan. Selama pemantauan,keempat pasien mengalami penurunan output ileostomi, serta perbaikankeseimbangan cairan dan elektrolit darah. Satu pasien mengalami perburukan klinisdan meninggal akibat sepsis pada hari perawatan ke-18. Tiga pasien pulang dengankondisi klinis perbaikan. Satu pasien mengalami peningkatan output ileostomi saatperawatan di rumah, kemudian dirawat kembali sepuluh hari setelah pulang karenakomplikasi anemia gravis dan ketidakseimbangan elektrolit, dan pada akhirnyameninggal. Terapi medik gizi dapat menurunkan produksi stoma, memperbaikikadar elektrolit darah, serta memperbaiki keseimbangan cairan pada pasienileostomi high output.

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Ileostomy is a surgical procedure to divert the ileum onto an artificial opening inthe abdominal wall, aimed for fecal diversion. Ileostomy is commonly created inpatients undergoing treatment for colorectal cancer, advanced neoplasms withintestinal infiltration, or gastrointestinal inflammation. High output ileostomy(stoma output >1500 mL per day) can cause imbalance of fluid and electrolytes,and malnutrition in patients. At present, there is no comprehensive nutritionmanagement guideline for high output ileostomy patients. This case series aimedto support therapy, prevent malnutrition, improve clinical condition, as well as toreduce the morbidity and mortality of high output ileostomy patients. Four highoutput ileostomy patients, with a range of age 42 to 50 years old received medicalnutrition therapy during their hospital stay. Three cases were chronic cases inmalignancy, while the other case was an acute case of adhesion and perforation dueto strangulated femoral hernia. All four cases were early onset high outputileostomy, occurring in three weeks after stoma creation. Based on the AmericanSociety for Parenteral and Enteral Nutrition (ASPEN) malnutrition criteria, thesefour patients were classified as severe malnutrition. Medical nutrition therapy wasadministered according to a set of principles: small frequent feeding and drinking,hypotonic fluid restriction, oral electrolyte-glucose solution administration, antimotilitymedication administration, as well as fluid and serum electrolytecorrection, according to patients' needs and clinical conditions. The target of energyand protein intake in all patients were achieved during hospital stay. During hospitalmonitoring, decreased ileostomy output as well as improvement in fluid andelectrolyte balance were observed in all patients. One patient clinically worsenedand died due to sepsis on the 18th day of hospital stay. Three patients showedimprovement in clinical condition and were discharged. One patient experienced anincrease in ileostomy output at home, and then readmitted ten days after hospitaldischarge due to severe anemia and electrolyte imbalance and subsequently died.Medical nutrition therapy may decrease output as well as improve fluid andelectrolyte balance in patients with high output ileostomy."