ABSTRACT
@#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.
ABSTRACT
The target of achieving exclusive breastfeeding for the first 6 months of life in Indonesia remains a challenge. Studies show a relationship between calorie intake of lactating mothers and success in 6 months of exclusive breastfeeding. This study aimed to compare the calories consumed between mothers who succeeded in 6 months of exclusive breastfeeding and those who did not and to investigate the effect of different types of supplementation. Methods: Three groups of lactating mothers (n=201) selected from cadres’ lists were followed for 6 months between June 2015 – July 2016. The first group was a control, the second group received milk (140 kcal/day), and the third group received milk and eggs (220 kcal/day). All food supplementation were given five days a week for as long as the mother was exclusively breastfeeding the infant. Cadres provided the mother supplements and ensured complete consumption. Each month, all groups were observed and measured on status of breastfeeding, anthropometry, and food consumption. Results: For all groups, calorie intake of those who succeeded in exclusive breastfeeding was significantly (p-value < 0.05) higher than those who failed. Calorie intake of lactating mothers is the most dominant factor (OR=5.6) for the success of 6 months of exclusive breastfeeding. The milk supplementation group had the highest calorie intake and highest percentage of mothers who were successful in providing 6 months of exclusive breastfeeding. Conclusion: Calories supplementation was found to be a significant factor in successfully achieving 6 months of exclusive breastfeeding. In this study, milk supplementation was more effective than milk and egg supplementation.