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"Tumor otak sekunder dapat menyebabkan masalah nutrisi. Manifestasi klinis penurunan selera makan, gangguan menelan, mual, muntah, hemiparesis, kejang, gangguan fungsional dan kognitif dapat menurunkan asupan makanan dan berat badan sehingga berisiko malnutrisi. Perubahan metabolisme makronutrien dan mikronutrien yang terjadi juga memengaruhi terjadinya malnutrisi. Tatalaksana terapi medik gizi yang diberikan bertujuan mempertahankan atau memperbaiki status gizi sehingga meningkatkan kualitas hidup dan memperlama harapan hidupnya. Terapi medik gizi yang sesuai rekomendasi European Society of Clinical Nutrition and Metabolism (ESPEN) adalah diet seimbang yang meliputi makronutrien, mikronutrien, nutrien spesifik, dan edukasi. Pasien serial kasus ini adalah perempuan, berusia antara 48 sampai 59 tahun dengan diagnosis tumor otak sekunder. Tiga pasien memiliki tumor primer kanker payudara, sedangkan satu pasien dengan kanker endometrium. Skrining menggunakan malnutrition screening tool (MST) dilanjutkan asesmen gizi. Terapi medik gizi diberikan sesuai rekomendasi ESPEN dan toleransi pasien. Pemantauan gizi meliputi pemeriksaan fisik, antropometri, komposisi tubuh, kapasitas fungsional dan analisis asupan. Hasil menunjukkan semua pasien mencapai asupan makan sesuai target pemberian makronutrien, mikronutrien, dan nutrien spesifik. Status gizi berhasil dipertahankan dengan tiga pasien mengalami peningkatan BB. Kapasitas fungsional keempat pasien menunjukkan perbaikan dengan menggunakan Karnofski dan Eastern Cooperative Oncology Group (ECOG). Pemeriksaan handgrip hanya dapat dilakukan pada 3 pasien menunjukkan perbaikan.

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A secondary brain tumor may cause nutritional problems. Clinical manifestations such as decreased appetite, swallowing disorders, nausea, vomiting, hemiparesis, seizures, functional and cognitive disorders may reduce food intake and increase malnutrition. Also changes in metabolism can affect the malnutrition. The aim of the medical nutrition therapy to maintain nutritional status to improve the quality of life and life expectancy. Balance diet were recommended by European Society of Clinical Nutrition and Metabolism (ESPEN) includes macronutrients, micronutrients, specific nutrients with continuing nutrition education. Patients are females, aged 48 to 59 years, with secondary brain tumor. The primary tumor of three patients were breast cancer and one patient was endometrial cancer. Screening was done using the malnutrition screening tool (MST) and followed with nutritional assessment. Medical nutrition therapy were given based on ESPEN recommendations and patient tolerance. Nutrition monitoring includes physical examination, anthropometry, body composition, functional capacity and intake analysis. Patient’s monitoring showed that all patients achieved their intake targets. The body weight of three patient increased showed that the nutrition status was maintained well enough. Patient’s functional capacity were improved according to Karnofsky and Eastern Cooperative Oncology Group (ECOG). Handgrip examination were also improve when it was assesed on three patients."

"Tindakan bedah pankreatektomi dapat menyebabkan peningkatan morbiditas dan mortalitas pascabedah. Terapi medik gizi pra dan pasca-pankreatektomi dapat mempertahankan status gizi, mempercepat pemulihan kapasitas fungsional, dan memperbaiki kualitas hidup pasien. Empat pasien, yang terdiri atas tiga perempuan dan satu laki-laki dengan rentang usia 30‒65 tahun, menjalani pankreatikoduodenektomi sebagai terapi kanker ampula Vateri. Nutrisi prabedah diberikan secara oral dalam bentuk makanan biasa dengan atau tanpa oral nutrition supplement (ONS). Delapan jam prabedah semua pasien mendapat ONS yang mengandung 30 g karbohidrat dan tiga pasien diberikan nutrisi enteral dini <48 jam pascabedah. Dua pasien mengalami komplikasi postoperative pancreatic fistula grade A dan satu pasien dengan obes morbid mengalami delayed gastric emptying pascabedah. Terapi medik gizi pascabedah berupa pemberian energi, makronutrien, mikronutrien, dan edukasi nutrisi disesuaikan dengan kondisi klinis dan toleransi asupan pasien. Asupan energi keempat pasien saat pulang mencapai 76‒109% kebutuhan energi total. Semua pasien mengalami perbaikan keluhan klinis, komplikasi, toleransi asupan, kontrol glukosa darah, dan kapasitas fungsional, serta dapat mempertahankan bahkan meningkatkan berat badan perioperatif. Lama rawat menjadi lebih singkat dan semua pasien diizinkan rawat jalan. Terapi medik gizi yang adekuat pada pasien pankreatektomi dapat meningkatkan status gizi dan kapasitas fungsional, memperbaiki luaran klinis, menurunkan morbiditas, dan mempersingkat lama rawat.

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Pancreatectomy surgery can cause escalation in post-surgical morbidity and mortality. Nutrition therapy before and after pancreatectomy can help preserve nutritional status, accelerate recovery of functional capacity, and improve patient’s quality of life. Four patients, consisting of three women and one man whose age ranged between 30 – 65 years old, underwent pancreaticoduodenectomy as a therapy for ampulla of Vateri cancer. Pre-surgical nutrition was given through oral route in the form of normal food with or without oral nutritional supplement (ONS). Eight hours before surgery all patients received ONS containing 30 g of carbohydrate and three patients were given early enteral nutrition <48 hours post-surgery. Two patients experienced postoperative pancreatic fistula grade A and one patient with morbid obesity experienced delayed gastric emptying postoperatively. Post-surgical nutritional therapy includes supply of energy, macronutrients, micronutrients, and nutrition education adjusted to the patient’s clinical condition and intake tolerance. Energy intake of the four patients attained 76-109% of the total energy requirement. All patients experience improvement of clinical symptoms, complications, intake tolerance, glycemic control and functional capacity, and able to preserve and even increase their perioperative body weight. Length of stay was shorter and all patients were allowed to be discharged and treated in the outpatient clinic. Adequate medical nutrition therapy in pancreatectomy patients can enhance nutritional status and functional capacity, improve clinical outcome, reduce morbidity, and shorten length of stay."

"[ABSTRAKLatar belakang: Prevalensi Diabetes Melitus Tipe (DM) tipe 2 semakin meningkat setiap tahun. Kontrol glisemik yang buruk, hipertensi, dislipidemia, dan kebiasaan merokok serta menopause dapat meningkatkan risiko komplikasi penyakit kardiovaskular. Komplikasi kardiovaskular merupakan komplikasi paling sering ditemukan dengan angka mortalitas yang tinggi. Oleh karena itu, untuk menekan progresivitas komplikasi kardiovaskular diperlukan suatu terapi nutrisi medik yang adekuat sesuai dengan kondisi klinis dan edukasi dalam memodifikasi gaya hidup.Metode: Pasien pada serial kasus berusia 55-65 tahun. Tiga pasien didiagnosis DM tipe 2 dengan gagal jantung, satu pasien dengan penyakit jantung hipertensi. Semua pasien memiliki skor skrining malnutrition screening tools (MST) ≥ 2. Dua pasien mempunyai status gizi obesitas, satu pasien berat badan dan pasien lainnya dengan berat badan normal. Kebutuhan energi basal (KEB) berdasarkan rumus Harris-Benedict dengan faktor stress 1,3-1,4 tergantung kondisi klinis dan penyakit penyerta. Komposisi makronutrien sesuai dengan rekomendasi American Diabetes Association dan Dietary Approach to Stop Hypertension. Pemberian mikronutrien dan nutrient spesifik diberikan pada satu dua kasus. Pasien dipantau selama 5-17 hari, meliputi keluhan subyektif, hemodinamik, toleransi dan analisis asupan, antropometri, pemeriksaan laboratorium, imbang cairan, dan kapasitas fungsional.Hasil: Selama pemantauan di RS, keempat pasien menunjukkan perbaikan klinis yaitu tekanan darah turun dan kapasitas fungsional membaik. Satu pasien kadar glukosa darah dipertahankan < 200 mg/dL.Kesimpulan: Terapi nutrisi medik yang adekuat dapat memperbaiki kondisi klinis pasien DM tipe 2 dengan komplikasi sistem kardiovaskular.

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ABSTRACTBackground: The prevalence of type 2 diabetes mellitus (DM) is increasing every year. Poor glycemic control, hypertension, dyslipidemia, smooking and menopause increase the risk for cardiovascular complications. Cardiovascular complications is the most common complications in type 2 DM with a significant high mortality rate. Therefore, a medical nutrition therapy is required to decreased the progresitivity of the cardiovascular complication in DM, based on improvement of clinical conditions and lifestyle modifications.Method: Patients in this case series were between 55-65 years old. There of those patients were diagnosed heart failure and one with hypertension heart disease. All patients had a screening score ≥ 2 with malnutrition screening tools (MST). Two of patients had nutritional status of obesity, one patients was overweight, and another patients was normoweight. Basal calorie requirement were calculating using Harris-Benedict formula with stress factor 1,3-1,4 adjusment according to clinical conditions and comorbidities. Macronutriens were given recommendations by The American Diabetes Association and Dietary Approach to Stop Hypertension. Two patients received micronutrien and specific nutrients. Monitoring was done for 5-17 days included subjective complaints, hemodynamic, tolerance and intake analysis, anthropometric measurement, laboratory test, fluid balance and functional capacity.Results : All the patients showed the improvement of clinical conditions, blood control and functional capacity. Blood glucose levels of one patients was maintained to below 200 mg/dLConclusion: Medical nutrition therapy can improved clinical conditions of patients type 2 DM with cardiovascular complications., Background:The prevalence of type 2 diabetes mellitus (DM) is increasing every year. Poor glycemic control, hypertension, dyslipidemia, smooking and menopause increase the risk for cardiovascular complications. Cardiovascular complications is the most common complications in type 2 DM with a significant high mortality rate. Therefore, a medical nutrition therapy is required to decreased the progresitivity of the cardiovascular complication in DM, based on improvement of clinical conditions and lifestyle modifications.Method:Patients in this case series were between 55-65 years old. There of those patients were diagnosed heart failure and one with hypertension heart disease. All patients had a screening score ≥ 2 with malnutrition screening tools (MST). Two of patients had nutritional status of obesity, one patients was overweight, and another patients was normoweight. Basal calorie requirement were calculating using Harris-Benedict formula with stress factor 1,3-1,4 adjusment according to clinical conditions and comorbidities. Macronutriens were given recommendations by The American Diabetes Association and Dietary Approach to Stop Hypertension. Two patients received micronutrien and specific nutrients. Monitoring was done for 5-17 days included subjective complaints, hemodynamic, tolerance and intake analysis, anthropometric measurement, laboratory test, fluid balance and functional capacity.Results :All the patients showed the improvement of clinical conditions, blood control and functional capacity. Blood glucose levels of one patients was maintained to below 200 mg/dLConclusion:Medical nutrition therapy can improved clinical conditions of patients type 2 DM with cardiovascular complications.]"

"ABSTRAKLatar belakang: Sistektomi radikal dengan ileal conduit yang merupakan tata laksana utama karsinoma buli adalah prosedur pembedahan kompleks yang seringkali membutuhkan rawat inap yang lama dan menyebabkan berbagai komplikasi. Malnutrisi praoperatif merupakan kontributor penting terhadap tingginya morbiditas dan mortalitas pada sistektomi radikal. Dukungan nutrisi perioperatif yang adekuat bertujuan untuk menurunkan stres akibat pembedahan sehingga dapat mencegah komplikasi, menunjang outcome yang baik, dan memperpendek masa rawat inap pascaoperasi.Metode: Laporan serial kasus ini menyajikan empat kasus karsinoma buli, dengandua kasus termasuk kaheksia kanker dan dua kasus termasuk pra-kaheksia. Keempat pasien dilakukan sistektomi radikal dengan ileal conduit dan diberikan dukungan nutrisi perioperatif yang mencakup carbohydrate loading dan nutrisi enteral dini pascaoperasi serta pemberian nutrisi secara bertahap. Dilakukan pemantauan yang meliputi keluhan klinis, pemeriksaan fisik, antropometri, hasil laboratorium, dan analisis asupan.Hasil: Tiga pasien mengalami hiperglikemia yang berlangsung singkat tanpa membutuhkan terapi insulin. Dua pasien mengalami ileus paralitik pascaoperasi, namun dapat teratasi secara konservatif dalam waktu cepat. Dua pasien mencapai 70-80 target kalori dalam 5 hari pascaoperasi, sedangkan pasien yang mengalami ileus paralitik mencapai target kalori 60-70 dalam waktu 9 hari pascaoperasi. Masa rawat inap pascaoperasi bervariasi mulai dari 7 hingga 10 hari.Kesimpulan: Dukungan nutrisi perioperatif pada keempat pasien menunjang dalam mengontrol stres pembedahan yang terlihat dari hiperglikemia yang hanya berlangsung singkat, mencegah komplikasi, serta memperpendek masa rawat inap.

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ABSTRACT

Background Radical cystectomy and ileal conduit, a mainstay treatment of bladder carcinoma, is a complex surgery which not rarely requires a long hospital stay and has many complications. Preoperative malnutrition is on of important contributor to high morbidity and mortality in radical cystectomy. Adequate perioperative nutritional support aims to alleviate surgical stress, thus prevent complications, support good outcome, and shorten length of hospital stay after surgery.

Method This case series presenting 4 cases of bladder carcinoma, consists of 2 cases of cancer cachexia and 2 cases of pre cachexia. All of the patients had undergone radical cystectomy and ileal conduit, and was supported by perioperative nutrition including carbohydrate loading and postoperative early enteral nutrition. The monitoring included clinical complaints, physical examination, anthropometry, laboratory results, and intake analysis.

Result Three patients had hyperglycemia lasted only in short period and no insulin treatment needed. Two patients experienced postoperative paralytic ileus and was resolved only with conservative treatment. Two patients achieved 70 ndash 80 calorie target on 5 days after surgery, while the others who experienced paralytic ileus achieved 60 ndash 70 calorie target in 9 days postoperative. Length of stay in the hospital after surgery was varied between 7 to 10 days.

Conclusion Perioperative nutritional support on the above patients had contribution in controlling surgical stress, seen on the short period hyperglycemia, preventing complications, and shortening the hospital stays."

"Proses penuaan mengakibatkan perubahan fisiologis yang terkait dengan masalah kesehatan pada orang usia lanjut (usila). Penyakit degeneratif merupakan faktor risiko terjadinya gangguan kognitif pada orang usila. Terbentuknya akumulasi amyloid β (Aβ) merupakan hal utama terjadinya gangguan kognitif. Mineral seng memiliki peran penting sebagai antioksidan dan proses akumulasi Aβ. Penelitian ini dilakukan dengan desain potong lintang pada 58 orang usila di Kelurahan Kartini yang dilaksanakan pada bulan Januari 2019 untuk mengetahui korelasi kadar seng rambut dengan fungsi kognitif pada populasi usila. Pemeriksaan kadar seng rambut dengan inductively coupled plasma spectrometer (ICPS) dan fungsi kognitif dinilai dengan instrumen abbreviated mental test (AMT). Data dianalisis dengan menggunakan uji korelasi. Rerata usia subjek 65,4 ± 4,4 tahun. Nilai median asupan seng sebesar 5,65 (3,2-13,3) mg/hari. Rerata kadar seng rambut sebesar 123,23 ± 69,71 µg/gram rambut. Sebagian besar memiliki fungsi kognitif normal (91,4%). Hasil penelitian ini menunjukkan bahwa tidak terdapat korelasi asupan seng dengan kadar seng rambut (p=0,349 ; r= -0,125) serta tidak ditemukan adanya korelasi kadar seng rambut dengan fungsi kognitif pada populasi usila (p=0,871 ; r= -0,022). Kesimpulan penelitian ini adalah tidak terdapat korelasi antara kadar seng rambut dengan fungsi kognitif pada populasi usila.

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Aging process cause physiological changes related to health problems in elderly. Degenerative diseases are the risk factor for cognitive impairment in elderly. Amyloid β (Aβ) accumulation is the major cause of cognitive impairment. Zinc has an important role in antioxidant and Aβ accumulation process. A cross sectional study of 58 elderly subjects was done at Kartini Regency in January 2019 to evaluate the correlation between hair zinc level and cognitive function in elderly population. Hair zinc level was measured by inductively coupled plasma spectrometer (ICPS) and cognitive function assessed by abbreviated mental test (AMT). Data analysis was done by correlation test. The mean age was 65.4 ± 4.4 years. The median value of zinc intake was 5.65 (3.2 - 13.3) mg/day. The mean hair zinc level was 123.23 ± 69.71 µg/gram hairs. Almost all subjects had normal cognitive function (91.4%). The results of this study indicate that there was no correlation between zinc intake and hair zinc level (p=0.349 ; r= -0.125) and there was no correlation between hair zinc level and cognitive function in elderly population (p=0.871 ; r= -0.022). In conclusion, there was no correlation hair zinc level and cognitive function in elderly population. "

"Latar Belakang: Kolestasis adalah hambatan atau supresi sekresi empedu. Kolelitiasis dan obstruksi bilier akibat keganasan merupakan kasus kolestasis yang sering ditemui. Kolestasis dapat menyebabkan gangguan nutrisi dan berbagai komplikasi. Selain pembedahan, terapi nutrisi adalah pendekatan tata laksana pada pasien kolestasis untuk mempertahankan status nutrisi dan kapasitas fungsional. Kasus: Pasien dalam serial kasus ini terdiri atas tiga pasien laki-laki dan satu perempuan, berusia 36-55 tahun dengan diagnosis kolestasis akibat keganasan dan postcholecystectomy syndrome (PCS) dengan riwayat kolelitiasis. Satu pasien dengan keganasan dan dua pasien dengan PCS menjalani operasi bypass biliodigestif dan rekonstruksi, sedangkan satu pasien menjalani perbaikan kondisi klinis sebelum pembedahan. Terapi nutrisi yang diberikan meliputi diet tinggi protein dan rendah lemak dengan nutrien spesifik berupa MCT dan BCAA. Pada kasus pertama terapi nutrisi diberikan pascabedah. Selama perawatan ada kecurigaan leakage anastomosis, tetapi keluaran klinis membaik. Pasien kedua mendapat terapi nutrisi prabedah dan mengalami perbaikan kondisi klinis. Kedua pasien tidak mencapai target nutrisi walaupun toleransi makanan cair baik. Kasus ketiga dan keempat mendapat terapi nutrisi pra dan pascabedah dan pada akhir masa pemantauan, dapat mempertahankan status nutrisi. Pada keempat pasien, kapasitas fungsional dapat dipertahankan, bahkan mengalami perbaikan.Kesimpulan: Terapi nutrisi yang optimal dapat memberikan keluaran klinis yang baik pada pasien kolestasis. Pemberian nutrien spesifik berupa MCT dan BCAA diperlukan untuk meningkatkan toleransi asupan, mempertahankan status nutrisi, dan memperbaiki kapasitas fungsional pasien kolestasis.

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Background: Cholestatis is obstruction or suppression of bile secretion. Cholestasis may cause nutritional disturbance and other complication. Besides surgery, nutritional therapy is needed in cholestasis patient for maintaining nutritional status and functional capacity.

Cases: Four cases (three male and one female) of cholestasis with range of age between 36-55 years old are included in this case series. They were diagnosed with cholestasis because of cancer and post-cholecystectomy syndrome (PCS) with cholelithiasis history. One patient with cancer and two patients with PCS had the biliodigestive bypass surgery and reconstruction, while one patient was restoring her clinical condition before surgery. All patients were given high protein and low fat diet, with specific nutrient such as MCT and BCAA. The first patient received nutrition therapy during postoperative phase. During monitoring, he was suspected with leakage anastomosis, but in the end the outcome was good. Second patient got nutritional therapy in preoperative phase and got better clinical condition. Both patients couldnt reach the nutritional target although their tolerance of ONS was good. The third and the fourth patient got nutritional therapy in pre and postoperative phase and had maintained their nutritional status. In all patients, the functional capacity could be maintained and improved.

Conclusion: Optimal nutritional therapy is needed in cholestasis patients to get better clinical outcomes. Specific nutrients such as MCT and BCAA improve the nutritional tolerance, maintain the nutritional status, and improve the functional capacity."

"Gangguan psikiatri meningkatkan risiko penderitanya mengalami obesitas dan sindroma metabolik akibat interaksi faktor genetik, lingkungan, gejala penyakit psikiatri dan pengobatannya. Pengaturan asupan makan dan perubahan pola hidup tetap menjadi tatalaksana awal pada pasien dengan gangguan psikiatri. Penggunaan metformin telah disarankan dalam studi sebagai adjuvan dalam tatalaksana berat badan pada pasien gangguan psikiatri terutama yang menggunakan obat psikiatri dalam jangka panjang. Empat pasien rawat inap dengan gangguan psikiatri dipantau selama perawatan dan sebulan setelah rawat jalan dengan kontak per minggu. Dilakukan pencatatan masalah subjektif, objektif, riwayat peningkatan berat badan, riwayat pengobatan pola asupan serta pengukuran antropometri dan komposisi tubuh. Pola asupan harian dan 24 jam terakhir dikumpulkan dengan metode FFQ semi kuantitatif dan 24h dietary recall. Perencanaan terapi medik gizi dilakukan dengan restriksi kalori, peningkatan asupan protein, penyesuaian asupan karbohidrat, motivasi melakukan aktivitas fisik yang cukup dan pemberian metformin dengan dosis bertahap. Tiga pasien memiliki status gizi obes 2, 1 pasien memiliki status gizi obes morbid yang disertai massa lemak yang tinggi dan massa otot yang rendah. Seluruh pasien memiliki lingkar pinggang diatas normal, kadar kolesterol total, LDL yang tinggi dan HDL yang rendah. Tiga pasien tidak mematuhi preskripsi selama perawatan. Setelah rawat jalan, dua pasien memiliki caregiver yang memberikan pemantauan dan motivasi yang baik terhadap pasien selama sebulan dan terdapat penurunan berat badan, penurunan lingkar pinggang, dan perbaikan komposisi tubuh. Terapi medik gizi pada pasien dengan gangguan psikiatri membutuhkan kerjasama dengan caregiver agar dapat bermanfaat bagi pasien.

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Patients with psychiatric disorders experienced an increased risk of obesity and metabolic syndrome due to genetic, environmental, disease symptoms and medication factor. Diet and lifestyle modification remained the firstline modalities for management of obesity in patients with psychiatric disorders. Metformin as an adjuvant therapy is recommended for preventing weight gain in patients especially with long-time psychiatric medication usage. Four inpatients with various psychiatric disorders were monitored during hospital stay and one month after discharge with weekly contact for monitoring. Subjective symptoms and objective signs, including history of weight gain, psychiatric medication history, intake pattern, anthropometric and body composition measurements were recorded. Daily intake pattern and 24 hour food intake were recorded and analyzed with semi-quantitative FFQ method and 24h food recall, respectively. Energy restriction, adjustment of protein and carbohydrate intake, physical activity encouragement and oral metformin administration with increasing dose were implemented in all patients. Three patients were grade 2 obese, one patients was morbidly obese with high fat mass and low muscle mass. All patients showed an increased waist circumference, high total cholesterol and LDL level, and low HDL level. Three patients failed to comply with nutrition prescription. After discharge, two patients had a supportive caregivers that gave an adequate monitoring and encouragement. Weight loss, reduced waist circumference, and better body compositition were found in 2 patients with supportive caregivers. Medical nutrition therapy on patient with psychiatric disorder will benefit greatly from supportive caregiver to bring benefit for patients."

"Air Susu Ibu (ASI) merupakan sumber energi utama yang mencukupi untuk bayi sampai usia 6 bulan. Berbagai kendala dapat timbul dalam upaya memberikan ASI eksklusif, salah satunya adalah ibu merasa ASI tidak cukup untuk memenuhi kebutuhan bayi sehingga pertumbuhan bayi tidak optimal. Setiap ibu harus mengetahui pola menyusui bayi ASI secara optimal untuk mendukung keputusan menyusui dan menghindari pemberian asupan yang tidak sesuai. Energi ASI sebanyak 50% berasal dari lemak. Lemak merupakan komponen ASI yang sangat bervariasi dan dapat berubah tergantung asupan ibu, irama sirkardian, tingkat laktasi, antar payudara, paritas, umur, dan antar individu. Tujuan dari penelitian ini adalah untuk mengetahui korelasi antara kadar lemak dalam ASI dan pola menyusui dengan pertumbuhan bayi ASI eksklusif usia satu bulan. Penelitian potong lintang dilakukan di RSIA Budi Kemuliaan pada bulan September– November 2014. Sampling dilakukan secara consecutive. Kriteria inklusi adalah bayi aterm, berat lahir 2500 -4000 g, sehat. Lemak ASI diperiksa dengan pemeriksaan creamatocrit. Terdapat 50 ibu dan bayi yang masuk dalam penelitian. Bayi usia satu bulan memiliki pertumbuhan yang baik dengan indikator pertumbuhan untuk Z-scores BB/PB, BB/U PB/U dan LK/U sebagian besar berada pada kategori ≥-2 SD s/d ≤2 SD. Pola menyusui subjek tergolong baik dengan frekuensi menyusui 12 kali per hari (84%) dan durasi menyusui <20 menit (58%). Pada pemeriksaan creamatocit didapatkan rerata kadar lemak dalam ASI termasuk kategori tinggi (6,6±1,9 gram/dl). Korelasi lemak ASI dengan BB/U, PB/U, BB/TB adalah berkisar antara 0,03–0,013. BB/U, PB/U, BB/PB, LK/U mempunyai korelasi <0,2 dengan frekuensi dan durasi menyusui. Pertambahan BB, PB, LK per hari mempunyai korelasi <0,25 dengan frekuensi menyusui dan durasi menyusui. Penelitian ini menunjukkan tidak terdapat korelasi antara kadar lemak dalam ASI dan pola menyusui dengan pertumbuhan bayi usia satu bulan.

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Breast milk is the main source of energy that is sufficient for infant up to 6 months old. Various breastfeeding problems can come in providing exclusive breastfeeding, one of the problem is mother perceived of her ability to meet the infant’s needs for optimal growth. Every mother should know about the pattern of optimal breastfeeding infant to support breastfeeding decisions and avoid improper feeding. Lipid is providing 50% of total breastmilk energy. Lipid is a component of breast milk that highly variable, depending on maternal intake, circadian rhythm, level of lactation, between breasts, parity, age, and between individuals.

The purpose of this study is to correlate between the levels of lipid in breastmilk and breastfeeding pattern with growth of one month old infants. The study used a cross-sectional study design at RSIA Budi Kemuliaan from September to November 2014. Sampling was taken with consecutive. Inclusion criteria were full-term infant, birth weight 2500–4000 g, healthy. Breast milk lipid was estimated with creamatocrit procedure. There were 50 mothers and infants who entered the study.

This study showed that subjects one month old infants have normal growth. The majority result of growth indicators for WHZ, WAZ, HAZ and HCAZ are between ≥-2 SD until ≤2 SD. Breastfeeding patterns have good result with frequency 12 times per day (84%) and duration <20 minutes (58%). Creamatocit examination showed average levels of lipid in the breastmilk is high (6.6±1.9 g/dl). Correlation of breastmilk lipid with WHZ, WAZ, HAZ is ranged from 0.03–0.013. WHZ, WAZ, HAZ and HCAZ has a correlation <0.2 with the frequency and duration of breastfeeding. Weight, height and head circumference increment per day correlated <0.25 with breastfeeding frequency and duration of breastfeeding.This study conclude that there was no correlation between breastmilk lipid and breastfeeding patterns with growth of one month old infants."