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BMC Pediatr. 2017 Dec 21;17(1):211. doi: 10.1186/s12887-017-0966-x.

Nutritional status, exclusive breastfeeding and management of acute respiratory illness and diarrhea in the first 6 months of life in infants from two regions of Indonesia.

Author information

1
Pediatrics Research Office, Child Health Department, Faculty of Medicine, Universitas Gadjah Mada/ DR Sardjito Hospital, Yogyakarta, Indonesia. vicka.oktaria@ugm.ac.id.
2
Department of Pediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia. vicka.oktaria@ugm.ac.id.
3
Murdoch Childrens Research Institute (MCRI), The Royal Children Hospital, Melbourne, Australia. vicka.oktaria@ugm.ac.id.
4
Department of Pediatrics, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia.
5
Murdoch Childrens Research Institute (MCRI), The Royal Children Hospital, Melbourne, Australia.
6
Pediatrics Research Office, Child Health Department, Faculty of Medicine, Universitas Gadjah Mada/ DR Sardjito Hospital, Yogyakarta, Indonesia.
7
Department of Pharmacology & Therapy, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.
8
Department of Microbiology, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.
9
Bill and Melinda Gates Foundation, Seattle, USA.

Abstract

BACKGROUND:

Infant morbidity and mortality rates remain high in Indonesia, with acute respiratory illnesses (ARI) and diarrhea the leading two health problems in children under 5 years. We aimed to describe the nutritional status, feeding practice and case management of ARI and diarrhea of infants from two regions of Indonesia during the first 6 months of life.

METHODS:

This study was an observational study conducted in parallel to an immunogenicity and efficacy trial of an oral rotavirus vaccine (RV3-BB) in the Klaten and Yogyakarta regions, Indonesia. Mothers were interviewed at 3 time points: within the first 6 days of their infant's life, and at 8-10 and 22-24 weeks of age. Questions asked included pregnancy history, infant nutritional status, feeding status and health of infants within up to 2 weeks prior to the assessment.

RESULTS:

Between February 2013 and January 2014, 233 mother-infant pairs were recruited. 60% (136/223) of infants were exclusively breastfed (EBF) until 6 months of age with the strongest support for EBF reported by mothers themselves 70% (101/223) and 25% (36/223) from their partners. At 6 months, 6% (14/223) of infants were underweight and severely underweight; 4% (8/ 223) wasted and severely wasted; and 12% (28/223) were stunted and severely stunted. Non-recommended medication use was high, with 54% (21/39) of infants with reported cough within 2 weeks of an assessment receiving cough medication, 70% (27 /39) an antihistamine, 26% (10/39) a mucolytic and 15% (6 /39) an oral bronchodilator. At age 22-24 week, infants with reported diarrhea within 2 weeks of an assessment had low use of oral rehydration solutions (ORS) (3/21;14%) and zinc therapy (2/ 21;10%).

CONCLUSION:

In this unique observational study, breastfeeding rates of 60% at 6 months were below the Indonesian national target of >75%. Adherence to WHO guidelines for management of ARI and diarrhea was poor, with high use of non-recommended cough medications and oral bronchodilators in the first 6 months of life and low use of ORS and zinc therapy. Ongoing education of primary health care workers and parents regarding management of common illness is needed in Indonesia.

KEYWORDS:

Acute respiratory illness; Breastfeeding; Case-management; Indonesian infants; Nutritional status

PMID:
29268732
PMCID:
PMC5740930
DOI:
10.1186/s12887-017-0966-x
[Indexed for MEDLINE]
Free PMC Article

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