kuliah makan bayi.pdf

PEMBERIAN MAKAN PADA BAYI

Dr. Julius Anzar, Sp.A(K)Divisi Nutrisi dan Penyakit Metabolik

Bagian IKA FK Unsri / RSMH Palembang2013

Makanan bayi

1. ASI (0 24 bulan)

2. MP-ASI ( 6 24 bulan)

Mengapa ASI?

Susu formula tidak mungkin menyamai ASI

Mengapa harus diberikan MP-ASI

pada usia 6 bulan?

Disusun oleh: Mexitalia dan Yoga D; UKK NPM-IDAI

Kandungan Protektif pada ASI

Perbandingan Komposisi

Kapan ASI?

Bayi kembar Operasi Caesar

Segera setelah lahir (IMD) hingga 1 - 2 tahun

Bagaimana Caranya?

LA

T

C

H

I

N

G

O

N

CARA MENYUSUI

Dianjurkan menggunakan minimal 3 posisi bergantian

Semua duktus laktiferus dapat dikosongkan

Mencegah bagian tertentu puting menjadi worn-out karena lebih sering terpakai

Mencegah kelelahan/kram bagian tertentu tubuh ibu

Posisi

Buka mulut bayi dengan menyentuhkan puting ke bibir bawah bayi (rooting reflex)

Areola masuk sebanyak mungkin ke mulut bayi (2,5 3,7 cm)

Latch on

Terdengar bunyi menelan

Bayi baru lahir: 5 -10 menit/payudara; tiap 2 -3 jam 10-12 kali/hari

> 1 bulan: kapasitas lambung bertambah, menyusu lebih jarang tapi lebih lama, misalnya 20 menit/payudara, tiap 3-4 jam

6 bulan: 20 menit/payudara; 3-5 kali/hari

Lama menyusui

POSISI

Making sure that youre comfortable and relaxed Try to feed in a chair that offers good back support;

use cushions or pillows to prop up your arms; if necessary, rest your feet on a telephone book or footstool

Its also good to experiment with the different feeding positions

Telinga, bahu, paha dalam satu garis lurus: Dekat dengan ibu Disangga seluruh badan Menghadap payudara; hidung ke puting

Dikutip: Satgas ASI IDAI

POSISI

Disusun oleh: Mexitalia dan Yoga D; UKK NPM-IDAI

Bagaimana Menilai

Kecukupan ASI?

BAK 4-6 kali/hari

Kenaikan BB adekuat

Menyusu 8 kali sehari

Masa waktu

g/hari g/bulan

Trimester 1

25 30 750 - 900

Trimester 2

20 600

Trimester 15 450

Bila ASI tidak cukup?

Evaluasi

Apakah cara menyusui sudah benar?

Apakah anak sakit?

Apakah ibu sakit?

Suplementasi

Formula bila < 4 bulan

Formula/MPASI bila > 4 bulan (lihat kesiapan motorik & psikologik)

Complementary feeding(MP-ASI)

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The Window of Opportunity for Improving Nutrition is very smallpregnancy until 18-24

months of age

-2.00

-1.75

-1.50

-1.25

-1.00

-0.75

-0.50

-0.25

0.00

0.25

0.50

0 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60

Age (months)

Weig

ht

for

ag

e Z

-sco

re (

NC

HS

) Latin America and Caribbean

Africa

Asia

19

INFANT FEEDING PERIODs

Exclusive Breast Feeding (EBF)

EBF + Complementary Foods

Family Foods

22

Periode 2 : ASI + MP-ASI

24

Proses penyapihan (weaning) :

proses dimulainya pemberian makanan khusus selain ASI secara bertahap jenis, konsistensi,

tekstur, sampai seluruh kebutuhan nutrisi anakdipenuhi oleh makanan keluarga

Makanan khusus :

bentuk : cair, lunak, padat jenis : jus, biskuit, bubur susu, nasi tim pemberian bertahap : jenis, konsistensi, tekstur,

jumlah/kali dan frekuensi/hari

Pemenuhan kebutuhan nutrisi bayi

0 6 bulan :ASI Eksklusif

6 bulan :65 80% ASI, sisanya MP-ASI

12 bulan :65-80% MP-ASI, sisanya ASI

24 bulan : seluruhnya makanan keluarga

25

27

Kapan mulai diberikan MP-

ASI?

Kesiapanfisik

Refleks

ekstrusi

Dapatmenahan

kepalatetaptegak

Dapat

duduk

dgnsedikit

bantuan

Kesiapanpsikologis

Menunjuk

kan minat

terhadap

makanan

Membuka

mulut jika

diberi

sendok

Tanda

lapar/

kenyang

Memulai Makanan Padat

28

Tidak terlalu dini (

29

Umumnya : berupa buburtepung beras yang diperkaya zatbesi

Hanya 1 jenis (bukankombinasi), bergizi, teksturhalus dan konsistensi agak encer

Diberikan setelah minum ASI atau formula, kecuali bila bayi menolak berulang atautampak tidak berminat berikansebelumnya

Tes Makanan Pertama

PANDUAN DASAR

1. Urutan pemberian :

AAP : tidak ada urutan khusus

2. Tekstur :

halus dan konsistensi encer pada awalpemberian yang ditingkatkan bertahap

3. Besar porsi :

mulai dgn jumlah sedikit (1-2 sdk teh)

bertahap ditambah 1 sdm atau lebihsampai jumlah yang sesuai 30

PANDUAN DASAR

4. Jarak waktu antara pemberian makanan baru :

- makanan baru berjarak 4-7 hari (riwayat alergi +)

- perhatikan adanya reaksi simpang

- dicoba satu-persatu jenis makanan

- dicoba pada pagi hari, oleh ibu

5. Keamanan :

Cuci tangan dan semua peralatan Tidak menggunakan peralatan makan

bersama-sama, atau mengunyah makananterlebih dahulu

31

HATI HATI !!

32

Wortel, bit, bayam, sawi hijau dan lobak:

kandungan nitrat tinggi methemoglobinemia tidak boleh diberikan kpd bayi < 6 bulan

Madu:

tidak boleh diberikan pada bayi < 12 bulan

C. botulinum

Susu SAPI (Whole Milk, susu segar):

tidak boleh diberikan kpd bayi < 12 bulankandungan zat besi rendah, tinggi kadarNatrium, Kalium dan Chlor ( beban ginjal)

Bantu bayi untuk lebihmandiri: beri finger foods

minum dari cangkir sejakusia 6-8 bulan

memegang sendiri cangkir / botol susu

buat jadwal makansedemikian rupa sehingga

terjadi rasa lapar dan

kenyang yg teratur

33

34

Family Foods

Meals Frequency

35

Tujuan akhir praktek pemberian makan (periode 3)

Susu

Susu

(Susu)

36

Tahapan penyapihan :

R.hisapR.telan

R.ekstrusi

Infant Formula

Disusun oleh:Damayanti RS, UKK-NPM IDAI

Objectives

To reviews the history of infant formula

To reviews the health risks associated with infant formula

To know the the WHO/FAO Codex Alimentarius for Standard Composition of Infant Formula

To know the WHO/FAO recommendation of how to prepare formula for bottle feeding for food safety

To know International Code of Marketing of Breast-milk Substitutes (WHA 1981)


Definition

The term infant formula is defined asa food which intended to be or is represented for special dietary use solely as a food for infants by reason of its suitability as a complete or partial substitute for human milk.


History of Infant Formula

Mothers who could not (or chose not to) breastfeed their babies either employed the use of a wet nurse or, less frequently, prepared food for their babies, a process known as "dry nursing."

In Europe and America during the early 19th century, the prevalence of wet nursing began to decrease, while the practice of feeding babies mixtures based on animal milk rose in popularity.


Reasons for using infant formula

Lack of education: The mother believes that her breast milk is of low quality or

in low supply, or that breastfeeding will decrease her energy, health, or attractiveness. The mother is not trained sufficiently to breastfeed without pain and to produce enough milk.

Financial pressures: Maternity leave is unpaid, insufficient, or lacking. The

mother's employment interferes with breastfeeding.

Societal structure: Breastfeeding is difficult or forbidden at the mother's job,

school, place of worship or while commuting. The mother feels infant formula is socially preferable.


Reasons for using infant formula

Personal beliefs: The mother feels that breasts are too sexual for a baby or

feels uncomfortable breastfeeding around other people. Nursing by a relative or paid wet-nurse is socially

unsupported, believed to be unhygienic, or too expensive. Also, the mother does not want to breastfeed or prefers to

use both breast milk and infant formula.

Dietary concerns: The contents of breastmilk are influenced by the dietary

habits of the mother. If the mother consumes a food that contains an allergen

breastfeeding may, for a brief period after consumption, provoke an allergic reaction in the infant.


Acceptable medical reasons for using infant formula

The mother's health: The mother is infected with HIV or tuberculosis. The mother is extremely ill HSV type 1 lesions direct contact lesion on the mother

breast. Maternal medication

Taking any kind of drug that could harm the baby, or drinks unsafe levels of alcohol.

The baby is unable to breastfeed: The child has a birth defect or inborn error of metabolism

such as galactosemia that makes breastfeeding difficult or impossible.


Acceptable medical reasons for using infant formula

Absence of the mother: The child is adopted, orphaned, or in the sole

custody of a man. The mother is separated from her child by being in

prison or a mental hospital. The mother has left the child in the care of

another person for an extended period of time, such as while traveling or working abroad.

The mother has abandoned the child. Family pressures:

Family members, such as mother's husband or boyfriend encourage use of infant formula.


Infant formula safety


How to Prepare Formula forBottle-Feeding at Home

(FAO & WHO 2006)

Powdered infant formula is not sterile. It may contain bacteria that can cause serious illness in infants.

By preparing and storing powdered infant formula correctly, you can reduce the risk of illness.


Cleaning


Sterilizing


Storing

Wash and dry your hands before handling sterilized equipment.

It is recommended that you use sterilized forceps for handling sterilized equipment.

If you remove feeding and preparation equipment from the sterilizer before you need it, keep it covered in a clean place.

Fully assemble feeding bottles if you remove them from the sterilizer before you need them.

This prevents the inside of the bottle, and the inside and outside of the teat becoming contaminated again.


How to prepare a bottle feed (1)


How to prepare a bottle feed (2)


Can I store bottle feeds to use later?

It is safest to prepare a fresh feed each time one is needed, and to consume immediately.

This is because prepared feeds provide ideal conditions for bacteria to grow - especially when kept at room temperature.

If you need to prepare feeds in advance for use later, they should be prepared in individual bottles, cooled quickly and placed in the refrigerator (no higher than 5C).

Throw away any refrigerated feed that has not been used within 24 hours.


How do I re-warm refrigerated bottle feeds?

Remove a bottle of feed from the refrigerator just before it is needed. Re-warm for no more than 15 minutes. Feeds can be re-warmed by

placing in a container of warm water, making sure the level of the water is below the top of the cup. Occasionally shake or swirl the bottle to make sure that it heats evenly

Check the temperature of the feed by dripping a little onto the inside of your wrist.It should feel lukewarm, not hot.

Throw away any re-warmed feed that has not been consumed within two hours.


Can I bring preprepared feeds when travelling?

Yes - but make sure the feed is cold before it is transported, and is kept cold during transport. This will slow down or stop the growth of harmful bacteria.

Prepare feeds as normal, cool quickly and place in the refrigerator (no warmer than 5C).

Immediately before you leave home, remove the cold feeds from the refrigerator and place in a cool bag with ice packs.

You can then place the feeds in a refrigerator at your destination,or re-warm a feed when you need one.

If your trip is longer than two hours, you may not be able to keep the pre-prepared feeds cold. In this case, you should prepare feeds as you need them. Bring individual portions of powdered formula with you in a cleaned and sterilized container, and prepare feeds as normal using boiled water that has been cooled to no less than 70C.


What if I do not have access to boiling water?

The safest way to prepare a feed is using water that has been boiled and cooled to no less than 70C.

If you do not have access to boiling water, you may wish to use sterile liquid infant formula.

Alternatively, you can prepare feeds using fresh, safe water at room temperature and consume immediately.

Feeds prepared with water cooler than 70C should not be stored for use later.

Throw away any left-over feed after two hours.


Breast is best

The World Health Organization (WHO) recommends that infants are exclusively breastfed for the first six months of life.

Babies who are exclusively breastfed will get the best start for growth, development and health.

Infants who are not breast fed need a suitable breast-milk substitute, for example, infant formula.

THANKYOU.

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