Hubungan Operasi Sesar dengan Inisiasi Menyusu Dini di Indonesia: Analisis Data SDKI 2017

The Relationship of Caesarean Section on Early Initiation of Breastfeeding in Indonesia: An Analysis of 2017 IDHS

  • Siti Masitoh Puslitbang Upaya Kesehatan Masyarakat, Badan Penelitian dan Pengembangan Kesehatan
  • Siti Nurokhmah Program Studi Ilmu Gizi, Fakultas Ilmu Kesehatan, Universitas Muhammadiyah Surakarta
  • Anissa Rizkianti Puslitbang Upaya Kesehatan Masyarakat, Badan Penelitian dan Pengembangan Kesehatan
  • Sugiharti Sugiharti Puslitbang Upaya Kesehatan Masyarakat, Badan Penelitian dan Pengembangan Kesehatan
Keywords: cesarean section delivery, early initiation of breastfeeding, new born nutrition, IDHS, operasi sesar, inisiasi menyusu dini, gizi anak bayi baru lahir, SDKI

Abstract

The prevalence of exclusive breastfeeding and early initiation of breastfeeding in Indonesia, is still low 37.3% and 58.2%, respectively. However, cesarean delivery increased from 12.3% in 2012 to 17.0% in 2017. Women who gave birth by cesarean section were less likely to breastfeed earlier. This study aimed to determine the relationship between cesarean delivery and early initiation of breastfeeding among women in Indonesia. This study was a further analysis of the 2017 IDHS data with a sample of the 6,877 last-born children in the two years preceding the survey. The dependent variable was early initiation of breastfeeding, while the main independent variable was cesarean delivery. Other covariate variables included age, education, occupation, place of residence, parity, history of antenatal care, place of delivery and wealth index. Data analysis used logistic regression to determine the relationship between cesarean delivery and early initiation of breastfeeding, showing as the Adjusted Odds Ratio among 95% confidence interval. The results of the study showed that eight out of ten (82.75%) women who gave birth by cesarean section did not experience early initiation of breastfeeding, compared to those who delivered vaginal delivery (62.75%). Women who gave birth by cesarean section were 7.16 times more likely to not practice early initiation of breastfeeding (AOR 7.16; 95% CI: 3.66-14.01) compared to those who delivered vaginal delivery. To improve early initiation of breastfeeding, pregnant women need to be encouraged to do antenatal care (ANC) to increase their knowledge and confidence about breast milk. In addition, health workers and health care providers need to provide support to women who give birth by cesarean section to breastfeed as early as possible through providing adequate information about breastfeeding, encouraging rooming-in and preventing the promotion of formula milk.

Abstrak

Prevalensi air susu ibu (ASI) eksklusif dan inisiasi menyusu dini (IMD) di Indonesia, masih rendah yaitu masing-masing 37,3% dan 58,2%. Di sisi lain, kelahiran melalui operasi sesar meningkat dari 12,3% pada 2012 menjadi 17,0% pada 2017. Wanita yang melahirkan dengan operasi sesar lebih kecil kemungkinannya untuk menyusui lebih awal. Studi ini bertujuan untuk mengetahui hubungan persalinan sesar dengan IMD pada wanita di Indonesia. Studi ini merupakan analisis lanjut data Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2017 dengan sampel 6.877 anak terakhir yang lahir dalam kurun waktu dua tahun sebelum survei. Variabel dependen adalah IMD, sedangkan variabel independen utama adalah persalinan sesar. Variabel kovariat lainnya antara lain usia, pendidikan, pekerjaan, tempat tinggal, paritas, riwayat antenatal care, tempat persalinan, dan indeks kekayaan. Analisis data menggunakan regresi logistik untuk mengetahui hubungan antara persalinan sesar dengan IMD, yang dilihat dari nilai Adjusted Odds Ratio dengan interval kepercayaan 95%. Hasil studi menunjukkan bahwa delapan dari sepuluh (82,75%) wanita yang melahirkan dengan operasi sesar tidak melakukan IMD, dibandingkan dengan yang melahirkan persalinan pervaginam (62,75%). Wanita yang melahirkan melalui operasi sesar memiliki kemungkinan 7,16 kali lebih tinggi untuk tidak melakukan IMD (AOR 7,16; 95% CI: 3,66-14,01) dibandingkan dengan mereka yang melahirkan secara pervaginam. Untuk meningkatkan praktik IMD, ibu hamil perlu didorong untuk melakukan pemeriksaan kehamilan (ANC) meningkatkan pengetahuan dan kepercayaan dirinya mengenai ASI. Selain itu, petugas kesehatan dan penyedia layanan kesehatan perlu memberikan dukungan kepada wanita yang melahirkan melalui operasi sesar untuk menyusui sedini mungkin melalui pemberian informasi mengenai ASI secara memadai, mendorong adanya rooming-in, serta mencegah pemberian promosi susu formula.

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Published
2021-03-31
Section
Articles