MAKALAH

ARIKEL PENGARUH PEMBERIAN ASI EKSKLUSIF DAN NON

EKSLUSIF TERHADAP MENTAL EMOSIONAL ANAK USIA 3-4
TAHUN

Oleh:
Syaiful Anwar R.H
144011.01.18.175

YAYASAN WAHANA BHAKTI KARYA HUSADA

PROGRAM STUDI DIPLOMA III KEPERAWATAN
AKADEMI KEPERAWATAN RS. MARTHEN INDEY
JAYAPURA
2019/2020
Pengaruh pemberian asi eksklusif dan non eksklusif terhadap mental
emosional anak usia 3-4 tahun

Abstrac
Background: Breastmilk is the best food contains all the elements of required
nutriants for infant aged 0-6 months, and the attachment of the breastfeeding process give
better of growth and mental emotional development of the infant. Less attachment
between mother and infant caused mental emotional disorders, that affect to the next
period of child’s development..

Objective : The objective of this research was to analyze the differences of influence
of exclusive breastfeeding and non exclusive brestfeeding history on child’s emotional
mental age of 3-4 years as well as analyze the most dominant variables.

Method: This was an observational analitic research with cross sectional approach.
The subjects consisted of 84 children aged 3-4 years, living Banyumanik subdistrict
Semarang, taken by purposive sampling and grouped into exclusive and non-exclusive
breastfeeding. The data was collected by questionnaire, and the analysis using chi square
and logistic regression.

Result: The study showed that most of children with exclusively breastfed had good
mental emotional (76.2%), while children who did not get exclusively breastfed had a
mental emotional problem (64.3%). There were relations between breastfeeding
(p=0,001), mother’s knowledge (p=0,001), mother’s attitude (p=0,001), and mother’s
education level (p=0,029) to children’s mental emotional. Education level of mother was
 the most influence variable for child’s emotional mental after addjusted with mother’s
knowledge, mother’s attitude, mother’s education level, and birth weight of children.

Conclusion: Breastfeeding history, mother’s knowledge, mother’s attitude, and

mother’s education level were factors that influencing to children’s mental emotional

Key words : exclusive breasfeeding; children; mental emotional disorder

Introduction

BREAST milk is the best food that contains all nutrients needed by infants aged 0-6
months. Breast milk also contains immune substances that will protect the baby from
various Infectious diseases, bacteria, viruses, parasites, and Jamur1, 2, 3 the breast milk
can influence the baby's flower, including emotional mental development through the
attachment formed by breastfeeding. Emotional mental conditions at an early age may
affect the period of child development at a later stage. Children with good emotional
mental at an early age will experience positive developments at a later stage, and in the
end thy will

Be the next generation of mentally emotionally healthy peoples. 4.5, 6In Contrast,
early childhood disrupted emotionality development was an early sign of evil in
adolescence such as alcohol consumption, nicotine addiction, abuse Lawlessness, and
free sex behaviour. 7.8 The incidence rate of emotional mental disorders that have been
reported in Indonesia through basic health Research (RISKESDAS) is the number of
emotional mental disorders at the age of ≥ 15 years. 9 The fact that occurs today, the
signs of the emergence of Emotional mental disorders, such as: Having antisocial
behavior, more aggressive, and having a poor relationship with a friend, start to happen
at elementary school age (SD). The Indonesian Children Protection Commission (KPAI)
stated that the crime rate of school-aged children (SD to SMA) tends to increase annually.
Criminal acts include theft, brawl, and sexual harassment. 10.11 There is a connection
between the length of exclusive BREAST feeding and the incidence of emotional mental
disorders. Kramer's research, Fombonne, et al suggests that adolescents who were
infiltrates for at least 4 months have a low risk of taking drugs and experiencing
emotional mental disorders. An observation by Niles Newton in 2008 showed that the
child who gained exclusive breast milk for 6 months had a more friendly attitude,
socializing and showed better development compared to Children who consume formula
milk since birth. 12 District Banyumanik is one of the districts that included urban areas
in Semarang and was built by 4 health centers. The exclusive breast milk coverage at 4
Puskesmas in 2010 and 2011 is still relatively low, ranging from 0.91%-29.28%. Early
detection activities on emotional mental problems in early childhood in Banyumanik sub-
district has never been done even though there are low coverage data of 2010 and 2011
are low. 13,14 based on the background above, it is necessary to Conducted studies on
mental emotional early childhood based on BREAST-feeding history. The purpose of
this research is to analyse the influence of exclusive and non-exclusive BREAST feeding
on children's emotional Age 3-4 years and analyze the most dominant factor of emotional
mentally influential children aged 3-4 years in the district of Banyumanik Semarang.
Materials And Hods

This type of research is analytical observational, with a cross sectional approach by

studying the influence of BREAST-feeding (exclusive or non-exclusive, maternal
knowledge, maternal attitude, maternal education level, working mother status,
gestational age, infant weight Birth, and IMD) against the child's emotional mentally.
This study was conducted from September to November 2013 in 4 health centers in
Banyumnaik subdistrict: Puskesmas Pudak Payung, Puskesmas Ngesrep, Puskesmas
Padangsari, and Srondol Puskesmas. The population in this study is all children aged 3-
4 years old in Banyumanik district. Sampling on this study was chosen by the Purposif
sampling method. Samples were obtained based on data from Posyandu cadres that have
been appointed by the Puskesmas and conducted interviews on the history of the feeding
of respondents. Samples of research used by 84 children are grouped into 2 namely:
children who consume exclusive breast milk and those who do not consume exclusive
breast milk. The minimum sample amount in each sample group is 42 samples. The
research instruments used in data collection are: BREAST-feeding questionnaires which
include: baby birth weight, gestational age, maternal education, working mother status,
mother's knowledge and attitudes and IMD and mental mental screening questionnaire
Emotional child using SDQ (Strenght and EBD quotionnare). Test the normality of data
using the Smirnov Kolmogorov test. All of the data on each sample group distribution is
abnormal (p < 0.05). Data analysis uses a different test between the two groups studied
with the Chi Square test (X2). The difference is considered meaningful if the value P is
< 0.05 and the binary logistical regression with the intention to see the influence of some
free variables (independent) against the bound the (dependent). Binary logistic regression
is used because of the scale of the binomial nominal variable.
Result 1.

Characteristics of respondents the results showed a group of respondents who

consumed the exclusive breast milk, the majority of the respondents were born with
normal weight (95.2%), born at the age of pregnancy 38 week (95.2%), experienced
IMD (59.6%), maternal knowledge value About ASI average (73.8%), the value of
mother attitude towards breast milk average (71.4%), higher maternal education level
(81%), mother

Respondents did not work (81.0%), and children were less likely to experience
emotional mental problems (76.2%). Respondents in the non-exclusive majority breast
milk group were also born with normal body weight (88.1%), born at the age of
pregnancy ≥ 38 weeks (90.5%), Mother's education is relatively high (66.7%), and the
status of majority mother Also does not work (64.3%). Respondents to non-exclusive
breast milk groups did not experience IMD (81.0%), the value of maternal knowledge
about breast milk < Rerata (69.0%), the value of the mother's attitude towards breast milk
< Rerata (66.7%), and the majority of respondents were emotional mental problems
(64.3%).

2. Effect of BREAST feeding on Mental emotional children test Bivariate indicates

that there is a BREAST-feeding relationship (P = 0.001.), maternal knowledge (p =
0.001), Mother's attitude (P = 0.001) and maternal education level (P = 0.029) on the
Mental Emotional child. BREAST feeding is the most dominant variable affecting the
child's emotional mental after being controlled by the mother's knowledge variables,
mother's attitude, education level, and child's birth weight.
Discussion

Lactation will make babies feel sticky and safe. The sense of security that the baby
has in the first and second year of life will affect the development of the next stage
including the emotional development of child 6.15, 16Research conducted Carlson,
Sroufe, et al in 2004 acquired the results that the baby Who have good attachment will
become more emotionally competent at the age of 4 years compared to other babies with
less good attachment. 6Another Study conducted by Kramer et al in 2008 showed that
juvenile-fed At least RESULT 1. Characteristics of respondents the results showed a
group of respondents who consumed the exclusive breast milk, the majority of the
respondents were born with normal weight (95.2%), born at the age of pregnancy 38
week (95.2%), experienced IMD (59.6%), maternal knowledge value About ASI
average (73.8%), the value of mother attitude towards breast milk average (71.4%),
higher maternal education level (81%), mother

Respondents did not work (81.0%), and children were less likely to experience
emotional mental problems (76.2%). Respondents in the non-exclusive majority breast
milk group were also born with normal body weight (88.1%), born at the age of
pregnancy ≥ 38 weeks (90.5%), Mother's education is relatively high (66.7%), and the
status of majority mother

Also does not work (64.3%). Respondents to non-exclusive breast milk groups did
not experience IMD (81.0%), the value of maternal knowledge about breast milk < Rerata
(69.0%), the value of the mother's attitude towards breast milk < Rerata (66.7%), and the
majority of respondents were emotional mental problems (64.3%).
 2. Effect of BREAST feeding on Mental emotional children test Bivariate indicates
that there is a BREAST-feeding relationship (P = 0.001.), maternal knowledge (p =
0.001), Mother's attitude (P = 0.001) and maternal education level (P = 0.029) on the
Mental

Emotional child. BREAST feeding is the most dominant variable affecting the child's

emotional mental after being controlled by the mother's knowledge variables, mother's
attitude, education level, and child's birth weight.

Discussion

Lactation will make babies feel sticky and safe. The sense of security that the baby
has in the first and second year of life will affect the development of the next stage
including the emotional development of child 6.15, 16Research conducted Carlson,
Sroufe, et al in 2004 acquired the results that the baby Who have good attachment will
become more emotionally competent at the age of 4 years compared to other babies with
less good attachment. 6Another Study conducted by Kramer et al in 2008 showed that
juvenile-fed At least

For 4 months have a low risk of consuming drugs and experiencing emotional mental
disorders. Other studies in Denmark have been obtained by the results that there is a link
between early agitation (2 weeks after birth) with an early alcohol consumption in adult
males. 12 knowledge of mothers about breast milk can affect mental emosinal children.
Knowledge will affect a person's actions including actions for breastfeeding. The
research conducted by Fauzie in 2006 gained the result that as much as 63% of mothers
whose knowledge of breast milk is good, managed to give the child an exclusive breast
milk. 17 mothers who have the knowledge

Good opportunity 2.75 times to give breast milk exclusively to her child compared to
mothers whose knowledge is lacking. Attitude variables also affect mothers in the
exclusive BREAST-feeding. Mothers who have a good attitude towards breast milk have
a chance of 2.3 breastfeeding exclusively compared to mothers who are negative. 18
maternal education is also closely related to exclusive BREAST-feeding. The mother of
a highly educated respondent the majority of her children did not experience emotional
mental problems (62.9), otherwise the mother of respondents was relatively educated,
her son had a majority of emotional mental problems (63.6%). The higher the level of
education a person then the more mature a person will take a decision. 19 The results of
Ida's research in 2012 gained the result that the proportion of mothers who successfully
completed a high school level of education to provide breast milk Larger exclusive
(28.7%) Compared to mothers who only completed junior high school education
(20.3%). 20Mothers with good knowledge and attitudes are highly educated and have an
influence on the giving of exclusive breast milk. The exclusive provision of breast milk
will lead to the attachment of mother and child and can affect the child's emotional
mental.

Maternal Status work does not affect the emotional mental child because mothers still
allow it to give breast milk exclusively. One of the factors that affect the success of
exclusive breastfeeding in working mothers is the support provided by the leadership of
the workplace to the mother to be able to breastfeed exclusively. Leadership support for
nursing mothers can be a flexible working hour, a lighter workload, and not assigning
the relevant outside of the city for a few days. 21Emotional mental Problems in children
with working mothers occur because Lack of closeness with mother. The study
conducted by Vandel in 2004 gained the results that, when the child spent more time in
daycare at an early age, the child would experience less sensitive interactions with his
mother.

The child will have behavioural problems. 6 Other factors that allow lack of
attachment between mother and child in the working mother is the administration of
formula milk or other foods besides BREAST-feeding before children aged 6 months.
Working mothers with high income have the opportunity to have high purchasing power
too, including purchasing power against formula milk. The 2003 Purnamawati research
gained results that the social economic level of mothers is the most dominant factor in
the giving of exclusive breast milk. Mothers with low economic level have an opportunity
of 4.6 times to breastfeed

Exclusively compared to mothers with high socio-economic level. 22 Child birth

weight and pregnancy age do not affect the emotional mental child, but thus the
percentage of of children born with body weight < 2500 gr and have problems More
emotional mental (71.4%) Compared to children born with weight (41.6%). The
Riksani states that a child born with less and premature weight is able to breastfeed the
mother despite not being strong. As children gain weight and age, the child will be
stronger to breastfeed the mother. 3 This opinion is not in line with Soetjiningsih.
Soetjiningsih stated that children who are born prematurely and less months will tend to
fuss so much more troublesome and cause a sense of discomfort. 23 anxiety will reduce
the production of breast milk and cause reluctance to breastfeed so that it will Reduce the
attachment between mothers and children. 25 IMD Implementation also has no effect on
the child's emotional mental. IMD children are born without the opportunity to have an
 exclusive chance to be fed. The factors that influence the IMD is the attitude of the Labor
helper. . The research results of Fikawati and Syafiq showed significant relationship
between midwives as helper copy with IMD. Midwives who have a positive attitude
towards IMD have a greater chance of doing IMD compared with midwives who have a
negative attitude toward IMD. 25 This research allows the bias of information on the
ability of respondents considering the circumstances When having an infant aged 3-4
years.

Resume :

1. Air Susu Ibu (ASI) merupakan makanan terbaik yang mengandung semua unsur zat
gizi yang dibutuhkan bayi usia 0-6 bulan. ASI juga mengandung zat kekebalan yang akan
melindungi bayi dari berbagai penyakit infeksi, bakteri, virus, parasit, dan jamur1,2,3
ASI dapat mempengaruhitumbuh kembang bayi, termasuk perkembangan mental
emosional melalui kelekatan yang terbentuk lewat menyusui.

2. Jenis penelitian ini adalah observasional analitik, dengan pendekatan cross sectional
dengan menelaah pengaruh pemberian ASI (eksklusif atau non eksklusif, pengetahuan
ibu, sikap ibu, tingkat pendidikan ibu, status ibu bekerja, umur kehamilan, berat bayi
lahir, dan IMD) terhadap mental emosional anak.

3. Hasil penelitian menunjukkan kelompok responden yang mengkonsumsi ASI

eksklusif, mayoritas responden lahir dengan berat badan normal (95,2%) , lahir pada
umur kehamilan 38 minggu (95,2%), mengalami IMD (59,6%), nilai pengetahuan ibu
tentang ASI rerata (73,8%), nilai sikap ibu terhadap ASI rerata (71,4%), tingkat
pendidikan ibu tinggi (81%), ibu responden tidak bekerja (81,0%), dan anak cenderung
tidak mengalami masalah mental emosional (76,2%).

4. Uji bivariat menunjukkan bahwa ada hubungan pemberian ASI (p=0,001.),

pengetahuan ibu (p=0,001), sikap ibu (p= 0,001) dan tingkat pendidikan ibu (p= 0,029)
terhadap mental emosional anak.
Kesimpulan :

Pemberian ASI, pengetahuan ibu, sikap ibu, dan tingkat pendidikan ibu merupakan
faktor yang berpengaruh terhadap mental emosional anak.Pemberian ASI merupakan
variabel yang paling berpengaruh terhadap mental emosional anak setelah dikontrol
oleh pengetahuan ibu, sikap ibu, tingkat pendidikan ibu, dan berat badan lahir anak.