Jakarta, IO – Malnutrition in children in the first thousand days of their lives will inflict generally irreversible negative impact to their lives, whether short-term or long-term. Child nutrition problems in Indonesia are known as “double-burden malnutrition”, wherein some of our children are over-nourished, while others are under-nourished. Either extreme will run the risk of insufficient micronutrient absorption, including enough iron.
Malnutrition most frequently occurs when babies are three to six months old, when they are given breast milk supplements, even though this may tamper with the baby’s nutritional intake – an extremely important need to ensure proper growth and development of the brain structure and bodily function at an early age.
“In practice, child malnutrition frequently occurs as a result of erroneous feeding patterns. When finally taken in for consultation, the child’s growth and development are usually already stunted. Doctors and other medical workers need to educate mothers on the correct breast milk supplement practice,” said pediatrician dr. Rini Andriani, Sp.A, during her online doctorate examination at the University of Indonesia Faculty of Medicine on Monday, 28 March 2022.
She expresses her regret that the complete, comprehensive Mother and Child’s Health guide (Kesehatan Ibu dan Anak – “KIA”) issued by the Ministry of Health is largely ignored instead of being used by families optimally. A recent study held on 119 mother in Yogyakarta shows that even though KIA reach is 100%, only 48.7% of the mothers actually use the book properly. It seems that they do not read KIA’s contents properly, simply because they are intimidated by its length and breadth. To be more specific, only 48.7% mothers read KIA content on breast milk supplements, and only 42.8% mothers read the child nutrition requirement content. Mothers only completely understand 68% of the entire book’s content, and only 22.7% actually implement KIA.
Live Photos, Not Cartoon Illustrations
Plenty of breast milk supplement education modules circulate among our people, whether complete books or brief articles in mother and child health magazines. “However, there are no science-based educational modules concerning breast milk supplements, which are based on scientific studies on the impact of breast milk supplement interventions by mothers for their babies. We sorely need education concerning proper breast milk supplement provision practices based on scientific evidence. In my study, the ABC’s of Breast Milk Supplements (“ABC-MPASI”) educational module was created thoroughly using several stages, which include discussions with experts from various disciplines and mothers as the audience target. The final results are the ABC-MPASI-Press text module and the ABC-MPASI-Vid video module. The innovations used by these modules show that mothers can understand them more easily, as they use simpler language and photos instead of cartoon illustrations,” dr. Rini said.
A study of 57 mother and baby couples show that both ABC-MPASI-Vid and ABC-MPASI-Press modules are proven to have improved mothers’ knowledge about breast milk supplement provision practices more effectively than the KIA booklet. The ABC-MPASI-Vid module is specifically more effective in promoting specific behaviors, and it is easier to understand by mothers with different educational backgrounds. “The improvement in mothers’ knowledge and behavior in turn causes babies to receive better nutrition in terms of improved Minimum Dietary Diversity (MDD), Minimum Meal Frequency (MMF), and Minimum Acceptable Diet (MAD) parameters. They are the indicators used by the WHO to assess the quality of a child’s feeding.”
The use of the ABC-MPASI-Vid module also improves baby’s breast milk supplement ingestion in terms of the amount of protein and energy obtained, as the composition of these supplements is improved with sufficient provision of fat and iron. They are a good guideline for mothers who want to provide breast milk supplements properly to their babies, and it can improve growth and development of babies 6-9 months old. Pediatrics specialists can also use it to educate mothers with babies in this age range. (est)