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Abstrak :
Metode kanguru telah terbukti mampu meningkatkan berat badan bayi dengan berat lahir rendah dan mempersingkat lama hari rawat, akan tetapi dua hal tersebut juga dipengaruhi oleh pemberian nutrisi yang optimal khususnya ASI. Penelitian ini bertujuan untuk mengetahui efektivitas perawatan metode kanguru terhadap kenaikan berat badan dan lama rawat bayi dengan berat lahir rendah yang disusui langsung dan tidak disusui langsung. Penelitian ini menggunakan crossover design dengan 32 BBLR di ruang Perinatologi pada tiga rumah sakit di Tangerang. Kriteria inklusi dalam penelitian ini adalah bayi berat badan < 2500 gram, bayi yang menerima nutrisi ASI maupun susu formula, bayi dapat menghisap walaupun masih lemah, tidak dipuasakan, tidak terdapat masalah pernafasan, dan bayi tidak mendapatkan produk penambah berat badan atau Human Milk Fortifier. Teknik pengambilan sampel dengan random sampling. Hasil penelitian menunjukkan tidak ada perbedaan signifikan pada berat badan bayi yang diberikan intervensi PMK dengan disusui langsung dan PMK tanpa disusui langsung (p=0,451, α<0,05). Hasil penelitian dari lama hari rawat menunjukkan tidak ada perbedaan signifikan pada kedua grup (p=0,096). Intervensi ini diharapkan dapat dilanjutkan di ruang rawat Perinatologi dengan durasi lebih dari 60 menit. ......The application of the kangaroo method has been shown to be able to weight gain for low birth weight infants and shorten the length of hospitalization, but these two things are also influenced by optimal nutrition, especially breast milk. This study aims to determine the effectiveness of the kangaroo method of care for weight gain and length of stay of infants with low birth weight who are breastfed directly and not directly breastfed. This study used a crossover design with 32 LBW in the Neonatology room at three hospitals in Tangerang. The inclusion criteria in this study were body weight <2500 grams, infants who received both breast milk and formula milk, babies could suck even though they were still weak, not fasted, no respiratory problems, and the baby's mother was willing to take part in the study. Sampling technique with random sampling. The results showed that there was no significant difference in the weight of infants who were given the FMD intervention with direct breastfeeding and FMD without direct breastfeeding (p=0.451, <0.05). The results of the study of length of stay showed that there was no significant difference between the two groups (p=0.096). This intervention is expected to be continued in the Neonatology ward with a duration of more than 60 minutes.

Abstrak :
Latar belakang Gagal tumbuh atau failure to thrive adalah kondisi keterlambatan pertumbuhan fisik pada anak, dimana terjadi kegagalan penambahan berat badan yang sesuai dengan grafik pertumbuhan normal, dibandingkan dengan tinggi badan. Beberapa kondisi menjadi faktor risiko terjadinya gangguan pertumbuhan terutama pada neonatus. Studi ini memberikan gambaran penerapan Model Adaptasi Roy dalam asuhan keperawatan pada lima kasus neonatus dengan risiko gangguan pertumbuhan. Presentasi kasus Kasus 1 neonatus laki-laki, dengan extremely preterm usia gestasi 27 minggu, berat badan lahir 870 gram, neonatus kurang bulan kecil masa kehamilan (NKB-KMK), RDS, TTN, septikemia, tersangka SNAD, neonatal jaundice, terpasang ventilator mode high frequency oscilation (HFO), terpasang orogastric (OGT), diet ASI 12x1 ml, TPN PG 2 dengan GIR 4,7, kebutuhan kalori kurang dari target, interpretasi kurva Fenton dibawah persentil 50, berat badan menurun, usia enam hari 860 gram. Kasus 2 perempuan, extremely preterm usia gestasi 26 minggu, berat badan lahir 744 gram, NKB-KMK, RDS, tersangka SNAD, PDA, neonatal jaundice. Terpasang ventilator, sementara puasa, grafik Fenton berada dibawah persentil 50, kebutuhan kalori kurang dari target. Kasus 3 dan 4 neonatus berjenis kelamin perempuan, lahir dengan extremely preterm dan very preterm, terpasang ventilator, kebutuhan kalori kurang dari target, sementara dipuasakan karena kondisi belum stabil. Kasus 5 perempuan, usia gestasi 37 minggu, BBL 2610 gram, berat badan saat dikaji 2340 gram. Diagnosis medis gastroschizis post tutup defek hari ke 27, terpasang non invasif ventilasi, sementara puasa produksi OGT kehijauan, BB/PB berada di -3SD s/d <-2 SD (gizi kurang). Evaluasi respons adaptif dari kelima pasien didapatkan kebutuhan kalori terpenuhi sesuai target. Kesimpulan Hasil pengkajian perilaku dan stimulus mode fisiologis-fisik kelima kasus didapatkan empat kasus berisiko mengalami gangguan pertumbuhan dari kondisi neonatus lahir prematur, terpasang ventilator, penundaan pemberian makan karena kondisi klinis, risiko infeksi/sepsis serta kondisi medis lain yang mempengaruhi. Satu neonatus aterm gagal tumbuh karena gastroschizis post tutup defek, dengan produksi OGT kehijauan. Nutrisi optimal baik enteral maupun parenteral diperlukan pada kondisi neonatus tersebut untuk meningkatkan respons adaptif. ...... Background Failure to thrive or failure to thrive is a condition of delayed physical growth in children, in which there is a failure to gain weight according to the normal growth chart, compared to height. Several conditions are risk factors for growth disorders, especially in neonates. This study provides an overview of the application of the Roy Adaptation Model in nursing care to five cases of neonates with a risk of growth retardation. Case presentation Case 1 male neonate, with extremely preterm gestational age 27 weeks, birth weight 870 gram, small preterm neonate for gestational age (NKB-KMK), RDS, TTN, septicemia, TSK SNAD, neonatal jaundice, put on ventilator mode high frequency oscillation (HFO), installed orogastric (OGT), diet ASI 12x1 ml, TPN PG 2 with GIR 4.7, caloric requirement less than target, interpretation of Fenton curve below 50th percentile, decreased body weight, age six days 860 gram. Cases of 2 women, extremely preterm, gestational age 26 weeks, birth weight 744 grams, NKB-KMK, RDS, suspected SNAD, PDA, neonatal jaundice. Installed on a ventilator, while fasting, the Fenton chart is below the 50th percentile, calorie needs are less than the target. Cases 3 and 4 female baby were born extremely preterm and very preterm, were attached to a ventilator, their caloric needs were less than the target, while they were fasted because their condition was not yet stable. Case 5 female, gestational age 37 weeks, BBL 2610 grams, body weight when studied 2340 grams. Medical diagnosis of gastroschizis post closed defect on day 27, installed non-invasive ventilation, while fasting green OGT production, BB/PB was in -3SD to <-2 SD (malnutrition). Evaluation of the adaptive response of the five patients found that the calorie needs were fulfilled according to the target. Conclusion The results of the assessment of the behavior and stimulus of the physiological-physical mode of five cases found that four cases were at risk of experiencing growth retardation from the condition of the neonate born prematurely, being placed on a ventilator, delaying feeding due to clinical conditions, risk of infection/sepsis and other affecting medical conditions. One term neonate failed to thrive because of a closed post gastroschizis defect, with greenish OGT production. Optimal nutrition, both enteral and parenteral, is needed in these neonatal conditions to increase adaptive responses.

Abstrak :
Latar belakang Gagal tumbuh atau failure to thrive adalah kondisi keterlambatan pertumbuhan fisik pada anak, dimana terjadi kegagalan penambahan berat badan yang sesuai dengan grafik pertumbuhan normal, dibandingkan dengan tinggi badan. Beberapa kondisi menjadi faktor risiko terjadinya gangguan pertumbuhan terutama pada neonatus. Studi ini memberikan gambaran penerapan Model Adaptasi Roy dalam asuhan keperawatan pada lima kasus neonatus dengan risiko gangguan pertumbuhan. Presentasi kasus Kasus 1 neonatus laki-laki, dengan extremely preterm usia gestasi 27 minggu, berat badan lahir 870 gram, neonatus kurang bulan kecil masa kehamilan (NKB-KMK), RDS, TTN, septikemia, tersangka SNAD, neonatal jaundice, terpasang ventilator mode high frequency oscilation (HFO), terpasang orogastric (OGT), diet ASI 12x1 ml, TPN PG 2 dengan GIR 4,7, kebutuhan kalori kurang dari target, interpretasi kurva Fenton dibawah persentil 50, berat badan menurun, usia enam hari 860 gram. Kasus 2 perempuan, extremely preterm usia gestasi 26 minggu, berat badan lahir 744 gram, NKB-KMK, RDS, tersangka SNAD, PDA, neonatal jaundice. Terpasang ventilator, sementara puasa, grafik Fenton berada dibawah persentil 50, kebutuhan kalori kurang dari target. Kasus 3 dan 4 neonatus berjenis kelamin perempuan, lahir dengan extremely preterm dan very preterm, terpasang ventilator, kebutuhan kalori kurang dari target, sementara dipuasakan karena kondisi belum stabil. Kasus 5 perempuan, usia gestasi 37 minggu, BBL 2610 gram, berat badan saat dikaji 2340 gram. Diagnosis medis gastroschizis post tutup defek hari ke 27, terpasang non invasif ventilasi, sementara puasa produksi OGT kehijauan, BB/PB berada di -3SD s/d <-2 SD (gizi kurang). Evaluasi respons adaptif dari kelima pasien didapatkan kebutuhan kalori terpenuhi sesuai target. Kesimpulan Hasil pengkajian perilaku dan stimulus mode fisiologis-fisik kelima kasus didapatkan empat kasus berisiko mengalami gangguan pertumbuhan dari kondisi neonatus lahir prematur, terpasang ventilator, penundaan pemberian makan karena kondisi klinis, risiko infeksi/sepsis serta kondisi medis lain yang mempengaruhi. Satu neonatus aterm gagal tumbuh karena gastroschizis post tutup defek, dengan produksi OGT kehijauan. Nutrisi optimal baik enteral maupun parenteral diperlukan pada kondisi neonatus tersebut untuk meningkatkan respons adaptif. ......Background Failure to thrive or failure to thrive is a condition of delayed physical growth in children, in which there is a failure to gain weight according to the normal growth chart, compared to height. Several conditions are risk factors for growth disorders, especially in neonates. This study provides an overview of the application of the Roy Adaptation Model in nursing care to five cases of neonates with a risk of growth retardation. Case presentation Case 1 male neonate, with extremely preterm gestational age 27 weeks, birth weight 870 gram, small preterm neonate for gestational age (NKB-KMK), RDS, TTN, septicemia, TSK SNAD, neonatal jaundice, put on ventilator mode high frequency oscillation (HFO), installed orogastric (OGT), diet ASI 12x1 ml, TPN PG 2 with GIR 4.7, caloric requirement less than target, interpretation of Fenton curve below 50th percentile, decreased body weight, age six days 860 gram. Cases of 2 women, extremely preterm, gestational age 26 weeks, birth weight 744 grams, NKB-KMK, RDS, suspected SNAD, PDA, neonatal jaundice. Installed on a ventilator, while fasting, the Fenton chart is below the 50th percentile, calorie needs are less than the target. Cases 3 and 4 female baby were born extremely preterm and very preterm, were attached to a ventilator, their caloric needs were less than the target, while they were fasted because their condition was not yet stable. Case 5 female, gestational age 37 weeks, BBL 2610 grams, body weight when studied 2340 grams. Medical diagnosis of gastroschizis post closed defect on day 27, installed non-invasive ventilation, while fasting green OGT production, BB/PB was in -3SD to <-2 SD (malnutrition). Evaluation of the adaptive response of the five patients found that the calorie needs were fulfilled according to the target. Conclusion The results of the assessment of the behavior and stimulus of the physiological-physical mode of five cases found that four cases were at risk of experiencing growth retardation from the condition of the neonate born prematurely, being placed on a ventilator, delaying feeding due to clinical conditions, risk of infection/sepsis and other affecting medical conditions. One term neonate failed to thrive because of a closed post gastroschizis defect, with greenish OGT production. Optimal nutrition, both enteral and parenteral, is needed in these neonatal conditions to increase adaptive responses.