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"Latar belakang: Keterampilan minum oral merupakan proses yang kompleks dalam perawatan bayi prematur di ruang perawatan intensif neonatus. Peningkatan keterampilan minum oral melibatkan peran serta ibu melalui pembentukan dyadic interaction untuk mengoptimalkan nutrisi bayi prematur Tujuan: Penelitian bertujuan menganalisis pengaruh Model Intervensi Keperawatan Berfokus Nutrisi terhadap keterampilan minum oral, grafik pertumbuhan bayi prematur, dyadic interaction, dan pengetahuan ibu. Metode: Penelitian mixed methods dengan pendekatan sekuensial eksploratori. Tahap I merupakan studi deskriptif kualitatif eksploratif pada 12 perawat neonatus. Tahap II adalah penyusunan model melalui analisis dan sintesis hasil penelitian tahap I dengan melibatkan tiga pakar. Tahap III adalah validasi model melalui penelitian kuasi eksperimen. Hasil: Teridentifikasi tujuh tema pada penelitian tahap I, yang selanjutnya dijadikan dasar menyusun tiga konsep model pada penelitian tahap II. Tiga konsep model tersebut meliputi: (1) Menciptakan lingkungan terapeutik untuk stimulasi keterampilan minum oral; (2) Membentuk interaksi ibu dengan bayi prematur untuk mengoptimalkan pemberian nutrisi; dan (3) Melibatkan peran serta ibu dan keluarga dalam persiapan perawatan bayi prematur dengan ketidakmampuan minum oral di rumah. Perangkat model yang dihasilkan adalah modul, buku kerja, dan selebaran. Analisis GLM Repeated Measure menunjukkan perbedaan keterampilan minum oral (p value < 0,001), berat badan (p value 0,64), panjang badan (p value 0,72), lingkar kepala (p value 0,28), dyadic interaction (p value < 0,001), pengetahuan ibu (p value < 0,001). Simpulan: Model Intervensi Keperawatan Berfokus Nutrisi efektif meningkatkan keterampilan minum oral, dyadic interaction, pengetahuan ibu, namun belum bermakna terhadap grafik pertumbuhan. Saran: Model Intervensi Keperawatan Berfokus Nutrisi dapat diimplementasikan di ruang perawatan intensif neonatus.

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Background: Oral feeding skills are a complex process in the care of premature infants in the neonatal intensive care unit. Improving oral feeding skills involves maternal participation through the formation of dyadic interaction to optimize optimize premature infant nutrition. Objective: The study aimed to analyse the impact of the Nutrition-Focused Nursing Intervention Model on oral feeding skills, growth charts of premature infants, dyadic interaction, and maternal knowledge. Method: This mixed-methods study used a sequential exploratory approach. Stage I was an exploratory descriptive qualitative study involving 12 neonatal nurses. Stage II involved developing a model through analysis and synthesis of the results from Stage I, with input from three experts. Stage III was a model validation through quasi-experimental research. Result: Seven themes were identified in Stage I, which became the basis for developing three model concepts in Stage II. The three model concepts included: (1) Creating a therapeutic environment for stimulating oral feeding skills; (2) Forming interactions between mothers and premature infants to optimize the nutrition; and (3) Involving mothers and families in preparing for the care of premature infants with oral feeding disabilities at home. The resulting model tools included a module, workbook, and leaflet. GLM Repeated Measures analysis showed differences in oral feeding skills (p-value < 0.001), body weight (p-value 0.64), body length (p-value 0.72), head circumference (p-value 0.28), dyadic interaction (p-value < 0.001), and maternal knowledge (p-value < 0.001). Conclusion: The Nutrition-Focused Nursing Intervention Model effectively improved oral feeding skills, dyadic interaction, and maternal knowledge, but did not significantly affect growth charts. Suggestion: The Nutrition-Focused Nursing Intervention Model can be implemented in neonatal intensive care units."

"Respiratory Distress Syndrome (RDS), Feeding Intolerance (FI), dan sepsis merupakan morbiditas yang sering dialami bayi prematur. Salah satu faktor yang memengaruhi morbiditas adalah defisiensi vitamin D. Kadar vitamin D berkorelasi dengan sel Treg pada penyakit inflamasi bayi baru lahir. Sel Treg berperan dalam keseimbangan mikrobiota di usus. Tujuan penelitian ini untuk mengetahui peran vitamin D dengan kejadian RDS, FI, dan sepsis pada bayi sangat prematur dan/atau BBLSR melalui jalur sel Treg dan disbiosis usus. Design penelitian ini adalah kohort prospektif pada bayi sangat prematur dan/atau BBLSR, dilakukan bulan November 2019–Januari 2021 di Unit Neonatal RSCM. Pemeriksaan kadar vitamin D ibu dan bayi menggunakan metode CLIA dan Treg dengan flow cytometry menggunakan Treg detection kit CD4+CD127lowCD25+. Penilaian mikrobiota dengan Real Time PCR dan enteropati dengan Alpha-1 Antitrypsin. Pada penelitian ini didapatkan sebesar 88,3 % ibu defisiensi vitamin D (rerata 12,23 ± 5,07 ng/mL) dan 53% bayi defisiensi vitamin D (rerata 15,79  6,9 ng/mL). Didapatkan korelasi antara kadar vitamin D ibu dan bayi (r = 0,76, p < 0,001). Kadar vitamin ibu dan bayi tidak berhubungan dengan dengan kejadian RDS, FI, dan sepsis. Terdapat hubungan bermakna antara disregulasi sel Treg dengan kejadian FI (p = 0,04) dan sepsis (p = 0,03). Semua bayi mengalami disbiosis. Tidak didapatkan perbedaan komposisi mikrobiota pada RDS, FI, dan sepsis. Terdapat hubungan bermakna antara enteropati dengan kejadian sepsis (p = 0,02). Simpulan : Ibu defisiensi vitamin D akan melahirkan bayi defisiensi vitamin D. Kadar vitamin D tidak berpengaruh terhadap kejadian RDS, FI, dan sepsis. Pada bayi dengan disregulasi sel Treg, kejadian FI dan sepsis lebih tinggi dibandingkan yang tidak. Bayi dengan kondisi disbiosis tidak berbeda untuk terjadinya RDS, FI, dan sepsis. Kondisi enteropati menyebabkan kejadian sepsis lebih tinggi.

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Respiratory distress syndrome, feeding intolerance, and sepsis are the most common morbidities found in premature babies. One of the factors affecting morbidity is vitamin D level. Vitamin D level is correlated with the role of Treg cells in inflammatory neonatal. Treg cells act in balancing microbiota in the intestines. This study aimed to determine the role of vitamin D in increasing the incidence of sepsis, feeding intolerance, and respiratory distress syndrome in very premature and/or very low birth weight babies through Treg cells and intestinal dysbiosis. This is a cohort study conducted on very premature (< 32 weeks) and/or very low birth weight (birth weight < 1,500 g) babies, from November 2019–January 2021 in the Neonatal Unit of RSCM. Vitamin D levels of the mothers and babies were measured using the CLIA and Treg methods with flow cytometry using the Treg detection kit CD4+CD127lowCD25+. Treg was tested from umbilical cords blood. The fecal examination was conducted to determine intestinal bacteria using realtime PCR and Alpha-1 Antitrypsin. Most mothers (88.3%) had vitamin D deficiency with a mean value of 12.33 ± 5.07 ng/mL. The vitamin D level of the umbilical cord was 15.79 ± 6.9 ng/mL. There was a significant correlation between the vitamin D level of mothers and babies (r = 0.76, p < 0.001). There were no difference between maternal and babies vitamin D serum levels with incidence of RDS, FI, and sepsis.There were a significant correlation between Treg cell dysregulation and the incidence of FI (p = 0.04) and sepsis (p = 0.03) but not in RDS. All subjects experienced dysbiosis. There was a significant correlation between enteropathy and the incidence of sepsis (p = 0.02) but not in RDS and FI. Conclusion: Mothers with vitamin D deficiency will give birth to babies with vitamin D deficiency. There were no correlation between vitamin D and the incidence of RDS, FI, and sepsis. In babies with Treg cell dysregulation, the incidence of feeding intolerance and sepsis will be higher. The composition of the microbiota did not affect the incidence of RDS, FI, sepsis. In babies with enteropathy, the incidence of sepsis will be higher."