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"ABSTRACTName : Yulia Novika JStudy Program: Magister Program in Public Heatlth ScienceTitle : Influence of Exclusive Breastfeeding on Linear Growth ofStunted Infants from Birth in Bandar Lampung CityGrowth assessment is an important part of health evaluation of children and as aglobal effort to improve early childhood growth. Exclusive breastfeeding is the onlyappropriate food for infant 0-6 months of age, an ideal nutrition for childdevelopment and growth. In the region of Bandar Lampung city, the prevalence ofstunting is stiil high compared to national data 22.4 ; 20.2 . This study aimedto know the effect of excelusive breasfeeding on linear growth infants with stuntingfrom birth in Bandar Lampung city. A quantitative study with prospective cohortdesign was carried out in Bandar Lampung city for 3 months since the babies were3 months of age. A number of 179 mother singleton baby coupled with stunted frombirth and exclusive breastfed from birth to six months of age were completed tofollow up. Exclusive breasfeeding in Bandar Lampung city is still low 45.8 .Proportion of stunted infants with exclusive breasfeeding achieving normal lineargrowth 97.6 up to six months of age. Linier growth of exclusively breast-fedinfants is higher than those who are not exclusively breastfed either on normalgrowth or in infants who remain stunting at 6 months of age and girls grew betterthan boys. Growth faltering occurred during 4 ndash; 5 months of age in those infantswho were not breastfed exclusively while those who breastfed exclusively at 5 ndash; 6months of age. Growth pattern throughout 3 ndash; 6 months of age were analyzed bylogistic regression and plotted in curves compared to WHO standard. Exclusivelybreastfed infants had 3,58 times better in linier growth compared to formula fedinfants. While partial breastfed infants had 1,6 times to achieve normal linier growthcompared to infants who were fed by formula after controlling infectious diseaseexposure, minimal weight gain standar, materbal occupation, maternal height, andearly complementary feeding. Thus, active role of health personnel to promoteexclusive breasfeeding and growth monitoring, especially linier growth during 0-72 months of age in every three month according to Minister of Health Permenkesnumber 66 year 2014 to monitor growth faltering, is required.Kata Kunci : exclusive breastfeeding, birth length, linier growth, stunting

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ABSTRACTName Yulia Novika JStudy Program Magister Program in Public Heatlth ScienceTitle Influence of Exclusive Breastfeeding on Linear Growth ofStunted Infants from Birth in Bandar Lampung CityGrowth assessment is an important part of health evaluation of children and as aglobal effort to improve early childhood growth. Exclusive breastfeeding is the onlyappropriate food for infant 0 6 months of age, an ideal nutrition for childdevelopment and growth. In the region of Bandar Lampung city, the prevalence ofstunting is stiil high compared to national data 22.4 20.2 . This study aimedto know the effect of excelusive breasfeeding on linear growth infants with stuntingfrom birth in Bandar Lampung city. A quantitative study with prospective cohortdesign was carried out in Bandar Lampung city for 3 months since the babies were3 months of age. A number of 179 mother singleton baby coupled with stunted frombirth and exclusive breastfed from birth to six months of age were completed tofollow up. Exclusive breasfeeding in Bandar Lampung city is still low 45.8 .Proportion of stunted infants with exclusive breasfeeding achieving normal lineargrowth 97.6 up to six months of age. Linier growth of exclusively breast fedinfants is higher than those who are not exclusively breastfed either on normalgrowth or in infants who remain stunting at 6 months of age and girls grew betterthan boys. Growth faltering occurred during 4 ndash 5 months of age in those infantswho were not breastfed exclusively while those who breastfed exclusively at 5 ndash 6months of age. Growth pattern throughout 3 ndash 6 months of age were analyzed bylogistic regression and plotted in curves compared to WHO standard. Exclusivelybreastfed infants had 3,58 times better in linier growth compared to formula fedinfants. While partial breastfed infants had 1,6 times to achieve normal linier growthcompared to infants who were fed by formula after controlling infectious diseaseexposure, minimal weight gain standar, materbal occupation, maternal height, andearly complementary feeding. Thus, active role of health personnel to promoteexclusive breasfeeding and growth monitoring, especially linier growth during 0 72 months of age in every three month according to Minister of Health Permenkesnumber 66 year 2014 to monitor growth faltering, is required.Kata Kunci exclusive breastfeeding, birth length, linier growth, stunting"

"Asam amino menjadi zat gizi baru yang diduga berhubungan dengan pertumbuhan linier ketika banyak penelitian menemukan bahwa asupan protein cukup dan intervensi zat gizi mikro menunjukkan hasil yang tidak memuaskan. Kondisi stunting terjadi bersamaan dengan wasting karena kemungkinan berbagi jalur yang sama. Oleh karena itu, studi mengenai stunting dapat memiliki hasil yang berlebihan ketika wasting tidak dijadikan pengecualian. Studi potong lintang komparatif 2 fase ini bertujuan untuk membandingkan asupan asam amino dan konsentrasinya dalam darah antara anak stunted non-wasted (SNW) dan non-stunted non-wasted (NSNW) yang berusia 12-23 bulan dan menggunakan hasil dari fase 1 untuk mengembangkan rekomendasi pemberian makan dan makanan campuran (MC) dengan menggunakan makanan yang tersedia secara lokal yang kurang dimanfaatkan. Stunting didefinisikan sebagai panjang badan menurut umur (PB/U) dalam Z skor <-2 SD sedangkan untuk non-stunting dengan PB/U ≥-1 SD. Kedua kelompok memiliki Z skor berat badan menurut panjang badan yang normal (BB/PB antara -2 SD hingga +1SD). Pemrograman linier digunakan untuk pengembangan rekomendasi pemberian rekomendasi pemberian makan (Optifood) dan CG (Nutrisurvey2004). Sebanyak 151 data dianalisis. Tidak ada perbedaan signifikan pada asam amino dan asupan gizi makro mikro kecuali proporsi protein yang berisiko kekurangan lebih tinggi pada kelompok SNW. Arginin merupakan satu-satunya konsentrasi darah yang berbeda antar kelompok. Histidin menjadi sebuah masalah gizi mutlak pada kelompok SNW dan NSNW, sedangkan riboflavin dan zink rendah dalam kelompok stunting tetapi cukup pada kelompok normal. Selain itu, zat gizi makro dan mikro lainya kurang dalam kedua kelompok kecuali protein dan vitamin A. Zat gizi yang kurang adalah Ca, Vit C, Thiamin, Riboflavin, Niasin, B6, Folat, B12, Besi, Zink, dan Histidin. Rekomendasi yang diusulkan dapat memenuhi Vit C, Riboflavin, Besi, dan Zink tetapi tidak dapat mencukupi Ca, Thiamin, Niasin, B6, Folat, B12, dan Histidin. Dengan memasukkan kacang tunggak, buncis batik, ikan wader, dan susu sapi dalam pengembangan CG, zat gizi yang sebelumnya kurang dapat tercukupi.

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Amino acids be the emerging nutrients that hypothesized to be associated with linear growth when many studies found that protein intake is considerably adequate and micronutrient intervention showed an unsatisfactory result. Stunting condition concurrently occurred with wasting as they may share similar pathways. Therefore, studies on stunting may have an exaggerated results when wasting was not an exclusion. This 2 phases comparative cross sectional study aimed to compare amino acid intake and its concentration in blood between stunted non-wasted (SNW) and non-stunted non-wasted (NSNW) children aged 12-23 months and using the results of phase 1 to develop a complementary feeding recommendation (CFR) and food multi-mix (FMM) by incorporating underutilized locally available foods. Stunted was defined as length for age z-score (LAZ) <-2 SD whereas for non-stunted with LAZ ≥-1 SD. Both groups have normal weight for length z-score (WLZ between -2 SD to +1SD). Linear programming was used for CFR (Optifood) and FMM development (Nutrisurvey 2004). A total of 151 data was analyzed. No significant different on the amino acid and macro micronutrients intake except the proportion protein at risk of inadequacy was significantly higher among SNW group. Arginine was the only blood concentration that significantly different between the groups. Histidine was an absolute problem nutrient in SNW and NSNW group, whereas riboflavin and zinc were inadequate among stunted group but adequate among normal group. In addition, other macro and micronutrients were inadequate in both groups except for protein and vitamin A. The inadequate nutrients were Ca, Vit C, Thiamin, Riboflavin, Niacin, B6, Folate, B12, Iron, Zinc and histidine. With the proposed recommendations, it can fulfil Vit C, Riboflavin, Iron and Zinc. But it cannot fulfil Ca, Thiamin, Niacin, B6, folate, B12 and histidine. With the incorporation of the selected underutilized cowpea, buncis batik, wader fish and cows’ milk in the FMM development, the nutrients that are challenging in CFR development, can be fulfilled."