Menurut studi deskriptif oleh Jelliffe (1978) dan Soysa (1981) terdapat perbedaan kejadian Infeksi Saluran Pernapasan Akut (ISPA) pada bayi, di mana lebih tinggi pada bayi-susu formula dibandingkan dengan bayi-ASI. Penelitian (analitik) oleh Sumargono (1989) dan Juliastuti (2000), masing-masing dengan pengamatan prospektif dan retrospektif- tidak berhasil membuktikan secara signifikan adanya hubungan antara variabel pemberian ASI dengan kejadian ISPA. Sebaliknya, penelitian Naim (2001)- menggunakan desain case control- berhasil membuktikan secara signifikan hubungan kedua variabel tersebut.Menurut Jason (1984) dalam Sutrisna (1993), kontroversi hasil penelitian tersebut, karena perbedaan teknik pengontrolan variabel (konfounding). Atas dasar kontroversi tersebut, penulis mereevaluasi hubungan kedua variabel tersebut- sesuai rumusan masalah penelitian yang dibuat. Sekaligus, mencoba menjawab pertanyaan penelitian : apakah pemberian ASI eksklusifyang direfleksikan dengan pemberian ASI cukup sesuai dengan definisi operasional lebih baik daripada ASI noneksklusif yang direfleksikan dengan pemberian ASI kurang sesuai dengan definisi operasional dilihat dari aspek kejadian ISPA pada bayi 0 -4 bulan ?Untuk maksud tersebut, penelitian ini memilih desain nested case control, di mana beberapa variable termasuk pemberian ASI diamati secara prospektif. Sedangkan variabel lainnya diamati secara retrospektif. Di samping itu dilakukan pula modifikasi definisi operasional pemberian ASI. Ternyata, hasilnya memperlihatkan hubungan signifikan kedua variabel tersebut dengan nilai p = 0,000; RI = 5,633 (IK 95% : 3,039 - 10,411) setelah dikontrol variabel BBL bayi dan letak dapur. Probabilitas adjusted seorang bayi umur 0 - 4 bulan untuk terserang ISPA 63,3% untuk bayi mendapat ASI kurang ; sedangkan bayi mendapat ASI cukup 23,5%. Jumlah sampel yang digunakan sebanyak 328; masing-masing 164 kasus, dan 164 kontrol.Sebagai simpulan penelitian ini : pemberian ASI cukup memberikan efek protektif 39,8% terhadap ISPA pada bayi umur 0 - 4 bulan. Untuk itu peneliti menganjurkan : untuk menurunkan kasus ISPA pada bayi umur 0-4 bulan yaitu dengan meningkatkan prevalensi ASI eksklusif di tengah-tengah masyarakat.Daftar Pustaka : 89 (1977 - 2002)

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The Influence of Breast Feeding to ARI at Infant Aged 0 - 4 Months Jelliffe (1978) and Soysa (1981) in a descriptive study, found that there was difference of incidence of Acute Respiratory Infection (ARI) between the infant who got breastfeeding and who were not. ARI cases are higher among infants who got bottle - feed. On the other hand, analytic study by Sumargono (1989) used prospective method found that, there was no a significant association of both variables. This result supported by Juliastuti (2000) who used retrospective method. However, Naim (2001) used case control design found that, there was a significant association between exclusive breastfeeding and nonexclusive breastfeeding in ARI cases.

Jason (1984) in Sutrisna (1993) wrote that a controversy of the study result caused by the variance of confounding control technique. Regarding with this argument, the researcher try to assess the association of both variables due to research statement problem. Moreover, the research question would be answered : does the exclusive breastfeeding --- reflected by enough breastfeeding as operational definition --- better than nonexclusive breastfeeding --- reflected by less breastfeeding as operational definition --- in ARI cases among infant aged 0 - 4 month ?

With regard to that point, this study chosen a nested case control design. Some variables ---including breastfeeding factor--- are observed using prospective method. Meanwhile, other variables are observed using retrospective method. In addition, the modification of operational definition term of breastfeeding was conducted. The result of the study showed that there is a statistical significant association of both variables. The significant of the test is p = 0,000; OR = 5.633 ( 95% CI : 3.039 - 10.411) after controlled the infant birth weight and kitchen site. The study also found the adjusted probability for ARI was 23.5% for enough breastfeeding and 63.3% for less breastfeeding. A total sample was 328, where 164 cases and 164 as controls.

The result of the study conclude that enough breastfeeding has protective influence 39.8% for infant aged 0-4 month. According to the result of study, the researcher recommend for decreasing ARI cases in infant aged 0-4 months by increasing the prevalence of exclusive breastfeeding in the community.

Reference list : 89 ( 1977 - 2002)