45 http://sosains.greenvest.co.id

JURNAL

SOSAINS

JURNAL SOSIAL DAN SAINS

VOLUME 3 NOMOR 12 2023

P-ISSN 2774-7018, E-ISSN 2774-700X

THE RELATIONSHIP OF EARLY PROVIDING MPASI AND

RECURRENT INFECTIONAL DISEASES WITH STUNTING

INCIDENTS IN CHILDREN AGED 1-5 YEARS IN THE LAWAHING

PUBLIC HEALTH CARE WORKING AREA

Nurhayati Fitria Amin, Gadis Meinar Sari, Astika Gita Ningrum

Airlangga University, Indonesia

Email: nurhayati.fitria.amin[email protected], [email protected],

astikagitan@fkunair.ac.id

Keywords:

Stunting, infectious

diseases,

complementary

feeding, Early

MPASI

ABSTRACT

Background: Stunting which is a condition where there is failure to thrive in children

under five years old (under five years) caused by chronic malnutrition so that the child

is too short for his age. Providing complementary breast milk too early (less than 4

months) is an indirect factor causing stunting where early complementary breast milk

food can cause various kinds of infectious diseases in children

Purpose: to determine the relationship between giving early MPASI and recurrent

infectious diseases to the incidence of stunting in children aged 1-5 years in the working

area of the Lawahing Health Centre, Alor Regency, NTT

Method: This research is an observational analytical study with a cross sectional

approach. The sample from this study was 214 children aged 1-5 years who met the

inclusion and exclusion criteria.

Results: : research shows that there is a significant relationship between early

complementary feeding and recurrent infectious diseases and the incidence of stunting

in children aged 1-5 years (p value: <0.01).

Conclusion: there is a significant relationship between early complementary feeding

and recurrent infectious diseases with the incidence of stunting in children aged 1-5

years in the working area of the Lawahing Community Health Centre, Alor Regency,

East Nusa Tenggara.

INTRODUCTION

Babies are the stages of human development from 29 days to 12 months (WHO,

2014). During this growth period, babies really need proper nutrition for their growth and

development, one of which is exclusive breastfeeding and appropriate complementary

foods. Exclusive breastfeeding is only 52.5% or half of the 2.3 million babies aged less

than 6 months do not receive exclusive breastfeeding. This figure has decreased by 12%

from the figure in 2019. East Nusa Tenggara Province, the success rate for exclusive

The Relationship of Early Providing MPASI and

Recurrent Infectional Diseases with Stunting Incidents

in Children Aged 1-5 Years in the Lawahing Public

Health Care Working Area

2024

Nurhayati Fitria Amin, Gadis Meinar Sari, Astika Gita Ningrum

breastfeeding is only 57.8% (Kementerian Kesehatan RI., 2021). Babies aged less than 4

months who do not receive exclusive breast milk and who already receive complementary

breast milk food in the form of solid food is 43.2%. Lawahing Community Health Centre

with a total of 458 children aged 1-5 years, only 30% receive exclusive breast milk from

their mothers, and the other 70% have been given complementary foods since the age of 3

months. 15.5% of children who are given early complementary foods at posyandu every

month have difficulty gaining weight, height and are susceptible to infectious diseases

(Dany et al., 2020).

Early complementary food is giving babies additional food other than breast milk

before the age of 4 months. According to the guidelines of the Indonesian Paediatrician

Association, complementary foods should be given at the age of 6 months, but if breast

milk is insufficient, complementary foods can be given as early as 4 months (17 weeks)

(Lenja, Demissie, Yohannes, & Yohannis, 2016). The signs that a baby is ready to be fed

are that he can hold his head upright, sit without help, his tongue sticking out reflex is

reduced and he is interested when he sees people eating. Providing complementary foods

for breast milk under 4 months of age can indirectly cause stunting which is a condition

where there is failure to thrive in children under five (under five years) caused by chronic

malnutrition so that the child is too short for his age (Octaviana, Roslina, Trianingsih,

Marlina, & Indrasari, 2023). The condition of the baby's organs not being ready to receive

solid food other than breast milk can cause various health problems in the baby. Providing

solid food to babies aged less than 4 months will result in various kinds of health problems,

including the baby not having the right to receive exclusive breast milk and not getting

complete nutrition in breast milk, being susceptible to disease, the risk of diarrhoea,

problems with the baby's intestines and kidneys, the risk of obesity, the risk of allergies,

and the risk of malnutrition and resulting in stunting (Fadillah, Delima, Rahmadhani,

Haruna, & Manda, 2022). Based on the results of previous research in the Rowosari

Semarang Community Health Centre area, a significant relationship was found between

early complementary breastfeeding and the incidence of stunting (Pangestuti, Khomsan, &

Ekayanti, 2023)

Infectious diseases are diseases caused by pathogenic microbes and are very dynamic

(WHO). NTT Health Profile in 2021 data on diarrhoea in children aged 1-5 years in 2019

there were 66.5 cases, in 2020 54,260 cases and in 2021 it decreased to 4,603 cases(1).

ISPA cases in children aged 1-5 years in East Nusa Tenggara Province: 5137 (18.6%),

2020: 2779 (1%), 2021: 2115 (0.37%) cases, Lawahing Health Centre morbidity data for

children aged 1-5 years as of August 2022 is 17.75%(2)with diarrhea, ARI, worms, eczema,

etc.

Stunting Can be prevented through feeding babies which is focused on the first 1000

days of life (Kemenkes, 2017). Based on research results, optimal feeding can prevent

deaths in children under five by around 13% (Organization, 2009). Feeding babies aged 0-

4 months is sufficient with breast milk without any additions (exclusive breast milk).

Starting from the age of 4 months, complementary foods can be given to breast milk while

still assessing the baby's promotor readiness to receive solid food. Based on the results of

previous research, there is a significant relationship between giving early MPASI and

Volume 4, Nomor 1, Desember 2024

p-ISSN 2774-7018 ; e-ISSN 2774-700X

47 http://sosains.greenvest.co.id

stunting (Pangestuti et al., 2023). WHO stunting data in 2020 globally, 149.2 million

children under the age of 5 were stunted, 454 million were underweight and 38.9 million

were overweight. The prevalence of stunting in Indonesia in 2021 is 24.4% / 5.37 million

children under five with 2.5% very short children and 7.0% short children. The province

with the highest percentage of short and very short children is West Sulawesi, while the

province with the lowest percentage of very short and stunted toddlers is North Sulawesi,

East Nusa Tenggara Province is in second place with very short toddlers at 5.5% and

stunted toddlers at 15.7% (Kementerian Kesehatan RI., 2021). Alor Regency is in third

place with stunting of 11.7% of children under five, 7.5% of children under five are short

and 10.5% of children under five are very short, Lawahing Community Health Centre data

for stunting of children under five is 58.8%, children under five are very short 0 .59% and

short toddlers 11.04% (Dany et al., 2020). This figure still needs to be reduced to reach the

2024 national stunting standard, namely 14%.

METHOD

This type of research uses an observational research design with a cross-sectional

approach (Setia, 2016). The population is 458 children aged 1-5 years in 3 villages in the

working area of the Lawahing Health Centre, Alor Regency, East of Nusa Tenggara. The

sample in this research is 214 children aged 1-5 years to the inclusion criteria in this study

were all children aged 1-5 years in the work area of the Lawahing Community Health

Centre, Alor Regency, East Nusa Tenggara, mothers who were physically and mentally

healthy, mothers who were willing to be respondents. Exclusion criteria are children aged

1-5 years with genetic disorders or congenital diseases. The samples in this research used

random sampling and the analysis used chi-square test and multivariate analysis with the

logistic regression test.

RESULT AND DISCUSSION

Frequency distribution of respondents' demographics

Table 1 Frequency distribution of respondents' demographics

Characteristics

Category

Number (n)

Percentage (%)

Father's occupation

Work

214

100%

Doesn't work

Child Age

12-24 Months

36.9%

Based on Table 1, it shows that the highest age of mothers is in the group age 21-34

years (50.9%), the highest level of education of mothers is elementary school (55.14%),

the mothers number who doesnt work is greater (71.0%) of working mothers, the largest

number of children are aged 12-24 months (36.9%) and the smallest number are children

aged 49-60 months (14.0%), the largest gender is girls (50.5%), the birth order of most

children is > 3 (42.5%).

The relationship between giving early MPASI and the incidence of stunting in

children aged 1-5 years in the working area of Lawahing Community Health Centre,

Alor Regency, East Nusa Tenggara.

Table 2: The relationship between giving early MPASI and the incidence of stunting

in children aged 1-5 years in the working area of Lawahing Community Health

Centre, Alor Regency, East Nusa Tenggara.

Early provision of MPASI

Stunting

Total

Normal

Stunting

Yes

5.1%

132

61.7%

143

62.1%

32.7%

0.5%

37.9%

Total

214

100%

P value: <0.01

Based on statistical analysis tests using the Chi-Square test, it was found that the p

value was: <0.01, which means there is a significant relationship between giving early

MPASI and the incidence of stunting in children aged 1-5 years in the working area of the

Lawahing health Centre, Alor district, East Nusa Tenggara.

The relationship between recurrent infectious diseases and the incidence of stunting

in children aged 1-5 years in the working area of the Lawahing Community Health

Centre, Alor Regency, East Nusa Tenggara

Table 3. The Relationship between recurrent infectious diseases and the incidence of

stunting in children aged 1-5 years in the working area of the Lawahing Community

Health Centre, Alor Regency, East Nusa Tenggara

Recurrent infectious disease

Stunting

Total

Normal

Stunting

Yes

2.3%

125

54.8%

130

60.7%

35.5%

3.7%

39.3%

Total

214

100%

P value: <0.01

Based on statistical analysis tests using the Chi-Square test, it was found that the

p value was: <0.01, which means there is a significant relationship between recurrent

infectious diseases and the incidence of stunting in children aged 1-5 years in the

working area of the Lawahing health Centre, Alor district, NTT.

Volume 4, Nomor 1, Desember 2024

p-ISSN 2774-7018 ; e-ISSN 2774-700X

49 http://sosains.greenvest.co.id

The relationship between early complementary feeding and recurrent infectious

diseases with the incidence of stunting in children aged 1-5 years in the work area

Lawahing Community Health Centre, Alor Regency, East Nusa Tenggara

Table 4. The relationship between early complementary feeding and recurrent

infectious diseases with the incidence of stunting in children aged 1-5 years in the

work area Lawahing Community Health Centre, Alor Regency, East Nusa Tenggara

Variable

p-value

CI 95%

Lower

Upper

Early provision of MPASI

,000

,002

,000

.021

Recurrent Infectious Diseases

,000

.026

,005

.133

Using the regression test, the following results were obtained to the variable giving

early MPASI and recurrent infectious diseases has a p value: <0.01, which means there is

a significant relationship between giving early MPASI and recurrent infectious diseases

and the incidence of stunting in children aged 1-5 years in the working area of the Lawahing

Community Health Centre, Alor Regency, East of Nusa Tenggara.

Relationship between Early MPASI Provision and Stunting Incidents in Children

Aged 1-5 Years in the Lawahing Community Health Centre Working Area, Alor

Regency, East Nusa Tenggara

The results of research conducted by researchers using bivariate analysis with the

chi square test showed a significant relationship (p value: <0.01) between early

complementary feeding and the incidence of stunting in children aged 1-5 years in the

Lawahing Community Health Centre working area. Alor district, East Nusa Tenggara. The

habit of feeding children aged less than 4 months in the Lawahing Community Health

Centre working area has become a tradition passed down from generation to generation.

Children who cry are considered hungry and are immediately given food. This has become

a community habit and has been applied to previous children. The environment and family

are also the main supporting factors in providing early complementary foods for breast

milk. Children are given complementary foods in the form of mashed bananas and strained

porridge. This practice of providing food also does not pay attention to the cleanliness of

the tools and food ingredients used because access to clean water is difficult in this area.

The large number of working mothers also means that children are often left behind, they

do not get enough breast milk and the children are looked after by grandmothers or family,

this is what indirectly results in children aged 1-5 years suffering from stunting.

Based on the latest recommendations from the Indonesian Paediatrician Association

and national nutritionists, children can be fed after the age of 4 months provided that the

child has been breastfed properly and correctly but there is no increase in weight/height,

the baby has shown signs of being ready. eating, able to control his head upright, able to

sit upright on his own, reduced tongue sticking out reflex. This is in line with the research

conducted shows that there is a relationship between a history of breastfeeding and the

incidence of stunting. This is because the mother or grandmother who is caring for her

thinks that the baby is crying all the time because he is hungry. Apart from that, there were

also 7 children (46.7%) who received MPASI for ≥ 6 months but experienced stunting, this

was also caused by the behaviour of mothers who often persuaded their children with

snacks or snacks so that they would be left to work so that children would consume more

often. light foods rather than heavy foods such as porridge and others that fulfill children's

balanced nutrition. Research conducted Rosita, (2021)showed the results that the age of

toddlers when they first received complementary foods for breast milk had a significant

The Relationship of Early Providing MPASI and

Recurrent Infectional Diseases with Stunting Incidents

in Children Aged 1-5 Years in the Lawahing Public

Health Care Working Area

2024

Nurhayati Fitria Amin, Gadis Meinar Sari, Astika Gita Ningrum

relationship with stunting status in toddlers with a correlation of -0.182, meaning that the

more appropriate the age at which complementary foods were given to toddlers, the lower

the risk of stunting.

The Relationship between Recurrent Infectious Diseases and the Incident of Stunting

in Children Aged 1-5 Years in the Work Area of the Lawahing Community Health

Centre, Alor Regency, East Nusa Tenggara

The results of research conducted by researchers using bivariate analysis with the

chi square test showed a significant relationship (p value: <0.01) between recurrent

infectious diseases and the incidence of stunting in children aged 1-5 years in the working

area of the Lawahing Community Health Centre, Alor Regency. East Nusa Tenggara.

Children aged 1-5 years in the Lawahing Community Health Centre working area are

susceptible to infectious diseases including ISPA, diarrhoea, worms and eczema or skin

allergies. On average, this infectious disease is found in children aged 4 months and over.

With a frequency of more than 6 times in 6 months. The geographic location of the region

is mountainous with difficult access to clean water, where only rainwater is used which is

collected in Viber tubs and then used throughout the dry season to the rainy season.

Nutritional intake obtained from fish, meat and fresh vegetables is also difficult for people

to obtain. Due to economic factors and a geographical location that is difficult to reach, the

history of mothers during pregnancy is that many suffer from CED and anaemia, which is

one of the factors that make children vulnerable to disease and at risk of stunting, but

researchers did not research this due to limited time. .

This research is in line with the research results Wulandari, Rahayu, Darmawansyah,

& Akbar, (2023) This shows that there is a relationship between a history of infectious

disease and the incidence of stunting in the working area of the Kerkap Community Health

Centre, North Bengkulu district with a value of (p=0.000). Based on the results of research

conducted by Mishra & Bera, (2023) shows that infectious diseases are also a factor that

influences stunting in Cambodia, Myanmar, Indonesia, Laos, Thailand, and Malaysia.

Research conducted by (Mentari & Hermansyah, 2019). The results of the study showed

that there was a relationship between infection (p = 0.004) and the stunting status of

children aged 24-59 months.

The Relationship between Early MPASI Provision and Recurrent Infectious Diseases

with the Incident of Stunting in Children Aged 1-5 Years in the Lawahing Community

Health Centre Working Area, Alor Regency, East of Nusa Tenggara

The results of the research conducted by researchers were analysed using

multivariate analysis with regression tests and found a significant relationship (p value:

<0.01) between early complementary feeding and recurrent infectious diseases and the

incidence of stunting in children aged 1-5 years in the region. work at the Lawahing

Community Health Centre, Alor Regency, NTT. The practice of giving early MPASI has

been carried out since ancient times, generally starting from the previous child and this is

common in society. A crying baby is considered hungry, this is what encourages the mother

or family to give MPASI too early. Giving early MPASI generally receives support from

the family without knowing the risks to the baby. Mothers who give MPASI early tend not

to routinely give breast milk to their babies for various reasons. This practice of providing

MPASI is also carried out without prioritizing hygiene factors, the environment and

difficult access to clean water being one of the causes. These children then tend to

experience illnesses such as acute respiratory infections, diarrhoea, worms, and other

infectious diseases so that ultimately their growth and development process, both physical

and cognitive, is disrupted.

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In line with research (Fufa, 2022). Which says that children who are given MPASI

too early can cause infectious diseases such as diarrhoea, acute respiratory infections, and

worms so that children experience stunting (resulting in children not growing according to

their age, experiencing delays in thinking, and not focusing at school.

According to a journal published in the Aceh Nutrition Journal, early MPASI does

not have a direct relationship with stunting, but giving MPASI too quickly (> 4 months)

makes babies susceptible to diarrhoea and digestive tract infections. If this is frequently

experienced by children, it will result in disruption to growth and development and

increases the risk of stunting.

CONCLUSION

The conclusions of this research are There is a relationship between early

complementary breastfeeding and the incidence of stunting in children aged 1-5 years in

the work area of the Lawahing Health Centre, Alor Regency, East Nusa Tenggara. There

is a relationship between recurrent infectious diseases and the incidence of stunting in

children aged 1-5 years in the work area of the health centre. Lawahing, Alor district, East

Nusa Tenggara, there is a relationship between early MPASI and recurrent infectious

diseases and the incidence of stunting in children aged 1-5 years in the working area of the

Lawahing health centre, Alor district, NTT. Parents must understand the risks of giving

children complementary foods with early breast milk, both long term and short term, so

that the child becomes healthy and is not disturbed in the process of growth and

development.

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