Vol 1, No 5, May-, 2021
p-ISSN 2775-3735- e-ISSN 2775-3727
373 http://eduvest.greenvest.co.id
RELATIONSHIP ON EDUCATION LEVEL AND MOTHER'S
ATTITUDES ABOUT EXCLUSIVE ASSOCIATION WITH
NUTRITIONAL STATUS OF CHILDREN
Mulyadi
Jambi University
E-mail: [email protected]
Received:
May 10
th
,2021
Revised:
May, 16
th
, 2021
Approved:
May, 19
th
, 2021
Abstract
The magnitude of the problem of malnutrition in infants is a health
problem for citizens in Indonesia. This research aims to analyze
the relationship between knowledge and behavior of mothers about
breastfeeding and exclusive breastfeeding with the nutritional
status of infants aged 6- 24 months. This research used a
quantitative observational analytic method with a cross sectional
approach. The research population consisted of 98 mothers and
toddlers aged 6- 24 months in Kayu Raja Village, Keritang
Indragiri Hilir Subdistrict and 78 illustrations, using random
sampling method. The questionnaire instrument for information on
the level of learning, behavior and exclusive breastfeeding as well
as the baby's nutritional status used the BPJS Health Card
information. The results of the analysis show the bonding level of
learning (p = 0, 011 OR = 25, 196; 95% CI = 2, 087 to 304, 158),
behavior (p = 0, 044; OR = 21, 656; 95% CI = 1 , 081 to 434,
028) and exclusive breastfeeding (p = 0, 029; OR = 19, 769; 95%
CI = 1, 361 to 287, 238) as well as all variables (Nagelkerger R
Square of 68.2% ). There is a significant positive relationship
between the level of learning and behavior of mothers about
breastfeeding and exclusive breastfeeding with the nutritional
status of infants aged 6- 24 months.
Keywords: Knowledge, Attitudes, Exclusive Breastfeeding,
Nutritional Status of Toddlers
This work is licensed under a Creative Commons
Attribution-ShareAlike 4.0 International
INTRODUCTION
Universally, the nutritional problem in Indonesia, especially KEP (Lack of
Protein Power), is still bigger than in other ASEAN countries (Mardisantosa, Huri, &
Edmaningsih, 2017). At the world level, it is said that there are at least 17.289 babies die
every day because of hunger and malnutrition with all the consequences it causes. There
is no country in the world like Indonesia which is rich and resourceful agriculture
naturally (perennial factor), however in the country of Indonesia is facing a crisis in the
fields of energy, food, health or natural energy sources (Rahman, 2018), which is caused
by several aspects, one of which is the action of citizens who exploit and use nature in
excess, so that many problems continue to arise, including poverty, food and nutrition
crises, which is a meaningful task for the government and citizens to solve these problems
(Mahyarni, 2016).
The triggers for nutritional problems are influenced by 2 aspects, namely direct
aspects and indirect aspects (Marut, 2007). The immediate trigger is the aspect of eating
and inflammatory diseases (Nihwan, 2019). The indirect trigger aspects are food security
in the family, parenting styles, health care and insufficient sanitation in the area. The four
Mulyadi
Relationship on education level and mother's attitudes about exclusive
association with nutritional status of children 374
indirect aspects relate to the mother's learning, knowledge, income and expertise (Salla,
2017). The results of the national census survey show that the percentage of well-
nourished babies was 71.88% in 2012 and in 2013 it fell to 69.59%. Infants with less /
less good nutrition were 25.82% in 2012 and increased to 28.17% in 2013 (Statistik,
2016). The national prevalence of very thin babies is still quite large, at 6.2%. This matter
means that the problem of being underweight in Indonesia is still a serious health problem
for citizens. Moreover, out of 34 provinces, 18 provinces are among the critical types
(wasting prevalence 15%), 12 provinces are in serious type (wasting prevalence is 10-
15%).
Results of Nutrition Status Monitoring (PSG) in 2013–2019 in Riau Province, the
prevalence of malnutrition faced a decrease along with the improvement of health service
facilities and a reduction in the incidence of inflammatory diseases. Intent, but the
depreciation is still not normal, it can be seen from the results of PSG in 2014 amounting
to: 0.22%, 2015: 0.46% and in 2016 amounted to 0.35% (Riau Provincial Health Office,
2017).
In the area of Kayu Raja Village in 2016, there were 7 babies with a malnutrition
status and in 2017 the number of malnourished was 4 people. The total number of babies
in this village is 366 children, of which babies aged 6- 24 months are some 98 children.
The settlement conditions for the local Village Midwives to this area are malnutrition and
lack of good nutrition. From this phenomenon, things that are important to observe are
the factors that are related to the nutritional status of the baby, such as the characteristics
of the mother, the characteristics of the toddler, the knowledge and behavior of mothers
regarding breastfeeding, the position of posyandu cadres and village midwives, data
media and history of breastfeeding. exclusive and non-ASI milk as well as breastfeeding
couple's meal.
This research aims to analyze the relationship between the level of learning and
the mother's behavior regarding breastfeeding and exclusive breastfeeding with the
nutritional status of babies aged 6- 24 months in Kayu Raja Village, Keritang District.
The lack of knowledge of mothers about breastfeeding is one of the obstacles to the
sustainability of breastfeeding. The level of education of mothers about exclusive
breastfeeding can be obtained from various data sources. Towards the end of pregnancy,
mothers need a variety of meaningful data that are usually provided by health services
and personnel (Arifeen, 2016). Mother's behavior is related to breastfeeding practice.
Mothers who think that breast milk is the best food for toddlers plans to share breast milk
for 6 months (Foo, 2016). Breast milk is a hygienic, inexpensive, easy-to-provide meal
that is available for toddlers. Breast milk is one of the foods that toddlers need during the
first 6 months of their life to become healthy toddlers.
Its dynamic composition that suits the needs of toddlers makes breast milk the
maximum nutritional consumption for toddlers. Breast milk and plasma have the same
ion concentration, so toddlers don't need fluids or bonus meals. Breast milk has all the
elements that meet the needs of toddlers for nutrition throughout the period close to 6
months, unless the mother is experiencing severe malnutrition or other health problems.
The composition of breast milk will change in line with the needs of toddlers (Fawtrell,
2017). The condition of malnutrition status will have broad consequences, including the
ease with which children face inflammation and problems with development and
development as well as constraints for the use of their body organs (Rodrigues, 2016).
One of the ways to know nutritional status is by using anthropometric procedures which
are divided into 2 types, namely measurement of development (body dimensions) and
measurement of body composition (Sarni, 2019). The hypothesis in this research is that
there is a link between the levels of mother's learning about breastfeeding and behavior
Mulyadi
Relationship on education level and mother's attitudes about exclusive
association with nutritional status of children 374
RESEARCH METHODS
This research will be conducted in Kayu Raja Village, Keritang District. This
research is an analytic observational quantitative study with a cross sectional approach.
The population in this study were all mothers whose toddlers aged 6- 24 months in Kayu
Raja Village, Keritang District, totaling 98 people. Data collection was carried out
directly to the research subjects with a questionnaire and recording the results of the
nutritional anthropometric measurements of children under five listed in the KMS. To
determine the relationship between the level of education and attitudes of mothers
regarding breastfeeding and the implementation of exclusive breastfeeding with the
nutritional status of children aged 6-24 months, the statistical analysis used in this study
was multiple logistic regression analysis to test hypotheses 1, 2, 3 and 4.
RESULTS AND DISCUSSION
The level of education of the interviewee is divided into two categories, namely
low education (SD-SMP) and higher education (SMA-Perguruan Tinggi). Among the
respondents with a low level of breastfeeding education, 11 (14.1%) had high attitudes,
and as many as 67 (85.9%) attitude respondents were divided into two categories, namely
low attitudes and high attitudes.
Table 1. Distribution of Respondents based on Mother's Attitude
Category Attitude
Frekuency
Percentage
Low
32
41,0
High
46
59,0
Total
78
100,0
Respondents with low attitudes were 32 respondents (41.0%), and those with
high attitudes were 46 respondents (59.0%). Exclusive breastfeeding data from the
informants is divided into several categories, namely mothers who are not exclusively
breastfed and exclusively breastfed. Respondents who did not provide exclusive
breastfeeding were 19 respondents (24.4%), and those who only gave exclusive
breastfeeding were 59 respondents (75.6%).
Table 2. Distribution of Respondents based on Exclusive Breastfeeding
Exclusive breastfeeding
Frekuency
Percentage
Tidak
19
24,4
Ya
59
75,6
Total
78
100,0
The nutritional status of children under five is divided into two categories,
namely the nutritional status of children under the Red Line (BGM) and not under the
Red Line. There were 8 respondents (10.3%) with nutritional status below the red line
(BGM), and 70 respondents (89.7%) with nutritional status not lower than the red line.
Table 3. Distribution of Respondents Based on Nutritional Status of Toddlers
Toddler Nutritional Status
Frekuency
Percentage
BGM
8
10,3
Tidak BGM
70
89,7
Total
78
100,0
Vol 1, No 5, May-, 2021
p-ISSN 2775-3735- e-ISSN 2775-3727
375 http://eduvest.greenvest.co.id
Table 4. Results of Multiple Logistic Regression Analysis of the relationship between
education level and attitudes of mothers about breastfeeding and exclusive breastfeeding
with nutritional status of children aged 6-24 months
Variable OR Signifikancy (p) Confidence
Interval 95%
Lower Limit Upper Limit
Mother's education level 25, 196 0,011 2,089 304,158
Mother's Attitude 21,656 0,044 1,081 434,028
Breastfeeding
Exclusive 19,769 0,0029 1,361 287,238
N Observasi= 78
-2 log likelihood= 21,093
Negelkerker R
2
= 66,9%
Figure 1. Relationship between mother's education level regarding breastfeeding and
nutritional status of children aged 6-24 months
As can be seen in the figure above, there is a tendency for children under five
with a lower level of breastfeeding education and mothers with a higher level of
breastfeeding education to have a better nutritional status. It can be seen that there are 6
respondents (7%, 7%) and 5 respondents (6%, 4%) whose nutritional status is below the
red line (7%, 7%) and 5 respondents (6%, 4%). Among 83.3% mothers with tertiary
education, the nutritional status of children under five is above the red line, while 2.6% of
children under five are below the red line ..
Through the results of the logistic regression test, it can be seen that the
significance value or p = 0.011 or less than 0.05, and it can be concluded that there is a
significant relationship between the education level of breastfeeding mothers and the
nutritional status of children under five. 6-24 months. And based on the OR value
obtained of 25,196, it can be concluded that the nutritional status of mothers with higher
education may be 25.196 times higher than uneducated mothers. There is a relationship
between mother's attitude towards breastfeeding and the nutritional status of children
aged 6-24 months. The relationship between mothers' attitudes about breast milk and
nutritional status of children aged 6-24 months can be seen in the following figure: