1.Maternal postpartum weight loss and associated factors in Beji subdistrict Depok City, Indonesia
Sandra FIKAWATI ; Vina Giolisa Permata Sari
Malaysian Journal of Nutrition 2018;24(1):47-52
Introduction: Weight retention during postpartum period is generally not preferred by mothers. Mothers are known to reduce energy intake during lactation in order to lose weight. Additional energy is required during lactation to provide for breast milk production. This study aimed at investigating factors that influence postpartum weight loss. Methods: Data from a prospective cohort quasi experiment study conducted in Beji subdistrict, Depok City were used. This study had recruited lactating mothers from community health centres and they were followed up from delivery to six months postpartum. A total of 201 breastfeeding mothers determined by cohort sample size formula were included. The dependent variable was six months’ postpartum weight loss, while the independent variables included age, energy intake, education, working status, parity and exclusive breastfeeding practice. Bivariate analysis using independent t-test and multiple linear regression was used for statistical analysis. Results: Mean age of the mothers was 30.3 years (95% CI: 29.8-31.1 years). Majority of the mothers had senior high school education, were not working, multiparous and practising exclusive breastfeeding. Mean intake of energy was 1946 kcal/day (1897-1994 kcal/day). They experienced a mean weight loss of 3.79 kg during the study period (3.27-4.31 kg). Postpartum weight loss was associated with exclusive breastfeeding (p=0.004), and education status of the mothers (p=0.029). Conclusion: Exclusive breastfeeding for six months is the dominant factor associated with postpartum weight loss of the mother. Breastfeeding mothers should be supported on their intention to exclusively breastfeed and not be unduly concerned with gaining weight.
2.Energy and protein intakes are associated with stunting among preschool children in Central Jakarta, Indonesia: a case-control study
Sandra Fikawati ; Ahmad Syafiq ; Rienzy Kholifatur Ririyanti ; Syilga Cahya Gemily
Malaysian Journal of Nutrition 2021;27(No.1):81-91
Introduction: Stunting is a major nutritional problem in Indonesia. The prevalence
of stunting in DKI Jakarta province was relatively high at 27.5% in 2013 and 17.7%
in 2018. This study aims to describe nutrient intakes of children aged 25-30 months
and to determine the proportional differences in nutrient intakes between stunting
and normal children in Central Jakarta, Indonesia. Methods: A case-control study
with a total sample of 121 children aged 25-30 months was conducted in Gambir and
Sawah Besar sub-districts, Central Jakarta, where the prevalence of stunting was
high. All children were exclusively breastfed for at least four months and had similar
socio-economic levels. Data collected included height measurement, questionnairebased interview, and 24-hour food recall. T-test and chi-square test were used to
investigate the differences between two groups and logistic regression was used in
multivariate analysis. Results: Factors associated with stunting were energy intake
(AOR=6.0; 95% CI=1.0-35.0) and protein intake (AOR=4.0; 95% CI=1.1-15.5) after
controlling for fat, carbohydrate, vitamin C, iron, and zinc intakes. The percentage of
children with energy intake below the recommendation was much higher in stunted
children (86.1%) compared to normal children (43.5%). Similarly, the percentage
of children with protein intake below the recommendation was very much higher
among stunted children (30.6%) compared to 8.2% in normal children. Conclusion:
Children who lacked energy and protein intakes were at a higher risk of stunting
than children who had sufficient intakes. Macronutrient intakes are important and
should be consumed in sufficient quantities every day to prevent stunting.
3.Milk supplementation increases mid-upper arm circumference and haemoglobin level among pregnant women in Kupang, Indonesia: Evidence from a regression discontinuity design
Ahmad Syafiq ; Sandra Fikawati ; Nindhita Priscillia Muharrani ; Mardatillah
Malaysian Journal of Nutrition 2022;28(No.2):191-202
Introduction: The high prevalence of chronic energy deficiency (CED) and anaemia
among pregnant women in Indonesia is worrying. Nusa Tenggara Timur (NTT) is one
of the provinces in Indonesia with the highest prevalence of CED. This study aimed to
determine the effect of fortified milk supplementation on changes in mid-upper arm
circumference (MUAC) and haemoglobin level among pregnant women. Methods:
This quasi-experimental study was conducted in three locations of Community
Health Centers in NTT from May to August 2019. Purposive sampling was used to
recruit 69 pregnant women who were divided into two groups based on haemoglobin
levels; the intervention group consisted of 31 pregnant women with haemoglobin
levels below 11 g/dL, and control group consisted of 38 pregnant women with
haemoglobin levels above 11 g/dL. Intervention group was provided with fortified
milk supplementation, while control group received education about prevention of
CED and anaemia. Data were analysed using regression discontinuity design with
haemoglobin of 11 g/dL as cut-off. Results: Using regression discontinuity method,
we were able to determine the effect of milk supplementation based on haemoglobin
levels and confirm the result that milk supplementation significantly increased
MUAC by 4.69 cm. Despite no discontinuity found, a positive increase of 0.98 g/dL
in haemoglobin level was important to note. Conclusion: Milk supplementation of
300 kcal/day for three months significantly increased MUAC and to some extent,
increased haemoglobin level. Thus, it should be considered when planning nutrition
programmes to improve the nutritional status of pregnant women.