Selasa, 08 Desember 2015

Understanding Adolescent Definition According

Understanding Adolescents - Adolescence is a transition period between childhood - childhood and adulthood, which began at the time of sexual maturity, ie between the ages of 11 or 12 years up to 20 years is approaching young adulthood (Soetjiningsih. 2004: 45).

Definition adolescents according to experts - adolescent phase is a segment of people who are very important development, which begins with the maturation of the organ - the physical organs (sex) so as to reproduce (Syamsu Joseph. 2004: 184).

Adolescence is a period of transition from the child - the child to adulthood that includes mental maturity, emotional, social and physical (Hurlock, Elizabeth B. 1999: 206).

Stage - the stage of adolescence
Adolescence is classified into 3 phases:

Pre teen: 12-14 years
Ie the period of approximately less than 2 years before the onset of sexual ripening real but already there is a development-related physiological ripening several endocrine glands.
Early adolescence: 14-17 years
Ie the period in the range of developmental maturity where there is a tool - a tool of sexual and reproductive capacity is reached.
Late adolescence: 17-21 years
Means grew into adults that include mental maturity, emotional, social and physical (Hurlock, Elizabeth B. 1999: 206).

Traits - traits teen
Physical growth
Physical growth changes rapidly, faster than the time the child - the child and adulthood.
Sexual development
Sexual progressing sometimes - sometimes cause problems and be the cause of fights, suicide and so on.
The way of thinking
Causatif way of thinking is regarding causality. For example teenagers sitting in front of the door, then parents forbid it, saying "abstinence". If prohibited the little boy, surely he would obey their parents, but teenagers are banned it would question why he should not be sitting in front of the door.
Emotion - luap
Adolescent emotional state is still unstable because it is closely connected with the state of the hormone. One moment he can be sad, other times he could be angry.
Became interested in the opposite sex
In the adolescent social life, they are more interested in the opposite sex and start dating.
Draw attention to the environment
At this time a teenager began searching for environmental concern, trying to get status and roles such as through youth activities in the village - the village.
Tied with group
Teens interested in social life in the peer group so that it is not uncommon parents under-emphasized while the under-united group
(Zulkifli L. 2003: 65-67).
Understanding Adolescents

Developmental task of adolescence
Obtaining a number of norms - norms and values - values.
Learn social roles according to gender each - each.
Accept the physical reality and can use them effectively and feel satisfied with the situation.
Achieve freedom from dependence on parents and other adults.
Achieving economic freedom.
Prepare to determine an appropriate job with the talent and ability.
Obtain information about marriage and prepare.
Develop intellectual skills and concepts - concepts of social life.
Have a concept - the concept of social behavior that is necessary for social life
(Sofyan S. Willis. 2005: 8-15).

Early Initiation of Breastfeeding Journal article Objective Definition IMD

Understanding Early Initiation of Breastfeeding - Early Initiation of Breastfeeding is after birth with his own effort can suckle immediately within one hour after birth together with the baby skin contact on the mother's chest. Babies left at least 60 minutes in the mother's chest until she was nursing. (Utami, R, 2008).

Early Initiation of Breastfeeding Journal article, Purpose, Understanding IMD

Early Initiation of Breastfeeding advantage.

Advantages for baby skin with skin.

Optimizing hormonal keadan mother and baby.

Contacts ensure common behavior suckle on instinct and can be estimated to be able to stabilize breathing, controlling the temperature of the baby's body, improve / has a pattern of better sleep, encourage skills baby to suckle more quickly and effectively, improving weight gain (back to birth weight by more fast), improving the relationship between mother and baby, not too much crying during the first hour, maintaining the colonization of germs safety of mothers in the baby's stomach so as to provide protection against infection, bilirubin will be faster normal and pass meconium faster thus lowering the incidence ikhterus newborn, glucose levels and other biochemical parameters were better during the first few hours.

Advantages of skin to skin contact with the mother.

Stimulates the production of oxytocin and prolactin in the mother.

Oxytocin: help the uterine contractions that postpartum hemorrhage is lower, colostrum stimulate spending, it is important for the attachment relationship between mother and baby, mother calmer and more do not feel nyeripada time of delivery of the placenta and other postpartum procedures.

Prolactin: increase milk production, helping the mother cope with stress, encourage mothers to sleep danrelaksasi after the baby is finished breastfeeding, delaying ovulation.

Gains early breastfeeding for babies

Food quality and optimal order quantity of colostrum immediately come out that are tailored to the needs of the baby.

Giving the baby's health by providing immediate passive immunity to the baby.

Improve intelligence.

Improve the fabric of you- dear mother and baby.

Prevent heat loss.

Stimulate colostrum immediately exit.

Gains early breastfeeding for mother

Stimulates the production of oxytocin and prolactin.

Increase milk production success.

Improve the fabric of the baby mother's affection.

Will start early breastfeeding

Reduces 22% of infant mortality under the age of 28 days.

Improve the success of exclusive breastfeeding and increase the duration of breast-fed infants.

Stimulates milk production.

Strengthen the baby's sucking reflex, sucking reflex in infants beginning of the most robust in the first few hours after birth.

Early Initiation of Breastfeeding step in Neonatal Care

Step I: Deliver, dry, and do assessment in infants.

When a newborn note the time of birth.

Then put the baby below the mother's abdomen.

The business value of breath and movement what the baby needed resuscitation or (2 seconds).

After that, dry the baby. Once dry, a baby blanket with a dry cloth to wait 2 minutes before the umbilical cord is clamped. Dry the baby's body from the face, head and other body parts with smooth without cleaning vernik. Vernix will help warm the baby's body.

Avoid drying the baby's hands. The smell of amniotic fluid in the baby's hands also help him find the nipple mother smelled the same.

Mucus simply wipe with a clean cloth. Avoid suction mucus in the mouth or the mouth of the baby because the vacuum could damage the mucous membranes of the nose of infants and increases the risk of respiratory infections.

Perform rangasangan tactile by tapping or flicking the soles of the feet. Rubbing the back, abdomen, chest, or leg baby with the palm of the hand. This stimulation can start breathing the baby and helps the baby can breathe better

After one minute dry out and assess the baby, check the uterus to ensure there is no longer a baby in the uterus (single pregnant) and intra-muscular injections of 10 UI of oxytocin in the mother. Let the baby on a towel or clean cloth on the mother's abdomen.

Step II: Perform skin contact with the skin for at least one hour

After 2 minutes postpartum, perform clamping the umbilical cord with a clamp at about 3 cm from the baby's stomach wall. From the point of tongs, press the cord with two fingers, then push towards the mother's umbilical cord. Make a second clamping with a distance of 2 cm from the first pin on the mother's side. Cutting the umbilical cord delayed until the cord stops pulsing so that nutrients and oxygen to flow from the placenta to the baby's mother is more optimal.

Then cut the umbilical cord between the two clamps. One hand the foundation while protecting baby's umbilical cord, and the other hand to cut the umbilical cord between the two clamps.

Tie the umbilical stump with a distance of approximately 1 cm from the abdominal wall with a rope sterile baby. Wrap rope around the umbilical stump and tie for the second time with a knot in the opposite part.

Place the baby face down on the mother's chest. Align the shoulder so that the baby clinging to the mother's chest. The baby's head should be in antaa of breast mother, but lower than the nipple.

Then the blanket and mother with a warm cloth cap and plug in the baby's head

Let the baby still perform the skin-to-skin contact on the mother's chest mother of at least 1 hour. Ask the mother to hug and caress her baby. If necessary, place a pillow under the head of the mother to mempermudh visual contact between mother and baby. The bulk of the baby will successfully initiate early breastfeeding within 30 to 60 minutes.

Avoid wash or wipe breast before feeding the baby.

During the skin to skin contact, continue to step active management of the third stage of labor.

Step III: Let the baby seek and find the nipple and began to suckle

Let the baby seek and find the mother's nipple and began to suckle

Instruct the mother and others not to interrupt breastfeeding for example, move the baby from one breast to the other. The first feeding usually takes about 10- 15 minutes. Infant feeding from one breast

Suspend all normal newborn care more until the baby is finished nursing. Delay also bathing 6- 24 hours after birth to prevent hypothermia

Try to keep putting mothers and babies in the delivery room until the baby is finished nursing

As soon as the newborn is finished sucking, baby will stop swallowing and release the nipple. Baby and mother will feel sleepy. Baby then wrapped with a clean cloth and then do the weighing and measuring the baby, gave injections of vitamin K1, and applying antibiotic ointment in baby's eyes.

If the baby has not initiated early breastfeeding within 1 hour, position the baby closer to the nipple mother and let the skin contact with the skin for 30 to 60 minutes.

If the baby is still early breastfeeding initiation within 2 hours, transfer the mother to a recovery room with the baby still in the mother's chest. Continue newborn care and then return the baby to the mother to suckle.

Wear clothes on the baby or remain shrouded to maintain warmth. Still cover the baby's head with a hat during the first few days. A time when the baby's feet feel cold to the touch, open clothes then telungkupkan back in the mother's chest to warm baby back

An hour later, give the baby the first injection of Hepatitis B

Then place the mother and baby in the same room. Put the baby close to the mother so easily affordable and babies can suckle as often as his desire.

Early Initiation of Breastfeeding Articles

Five sequences of behavior while feeding the baby first

In the first 30 minutes: Stadium break / silent in idle state (rest / quit alerts stage). Baby still. Every now and then his eyes wide open to see his mother. Special quiet period is a transition adjustment of state in the womb to circumstances outside the womb. Bonding (relationship of affection) This is the basis for the growth of the baby in a safe atmosphere. This increases confidence in the ability of mothers to breastfeed and nurture her baby. Confidence father became part of the success of breast-feeding and educating children together mothers.

The initial steps happy family.

Between 30 to 40 minutes: Removing sound, mouth movements such as going to drink, kiss and lick the hand. Babies smell and taste of amniotic fluid in her hand. This odor similar to the smell of fluid removed breast. Smell and taste will guide the baby to find the breast and nipple of the mother.

Salivate - As I realized that there was food in the vicinity, the baby began to secrete saliva.

Babies begin to move toward the breast. Areola (prop breast) as the target, with the foot tapping the mother's abdomen. He was licking the mother's skin, tapping head to the mother's chest, turned to the right and to the left, as well as touching and squeezing the nipples and the surrounding area with small hands.

Find, licking, sucking nipples, open your mouth wide, and adheres well. (Tamirus, 2008)

Early Initiation of Breastfeeding inhibitors

Here are some opinions that inhibit the premature skin contact with the mother the baby's skin

The baby was cold - not really

The baby is in an unsafe temperature if skin contact with the mother. Amazing! Breast temperature increase of 0.5 degrees in two minutes if the baby is placed on the mother's chest Based on the results Niels Bergman (2005), found that mothers who gave birth to the chest temperature to 1 ° C. If the baby is cold, the temperature of the mother's chest to rise 2 ° C to warm the baby. So, the mother who gave birth chest is the best place for newborns compared beds "sophisticated" and expensive.

After giving birth, the mother is too tired to immediately breastfeed - not true

A mother rarely too tired to hug the baby immediately after birth. The release of oxytocin when skin to skin contact as well as when the baby early breastfeeding helps to calm a mother.

Medicals less available - no problem

When the baby on the mother's chest, birth attendant can continue its work. Babies can find their own breast. Involve the father or kin to keep the baby while giving support to the mother.

Delivery room or operating room is busy - no problem

With the baby in the mother's breast, the mother may be moved to a recovery room or treatment room. Give baby a chance to continue his efforts to achieve breast and early breastfeeding.

Mothers should be sewn - no problem

Looking breast crawl activity occurs in the breast area. Sewn is the lower part of the body of the mother.

Inject vitamin K and eye drops to prevent gonorrhea (gonorrhea) should be given immediately after birth - is not true according to the American colledge of Obstetricand Gynecology and the Academy of Breastfeeding Medicine (2007), preventive measures can be delayed for at least one hour until the baby feeds itself without harm baby.

Babies must be cleaned, washed, weighed, and measured - not true

Delaying bathing means to avoid the loss of the baby's body heat. In addition, the opportunity vernix pervasive, soften and protect the baby's skin is greater. Can be dried immediately after the baby is born. Weighing and measurement can be delayed until early feeding is completed.

Infants less idle - not true

Precisely in the first 1-2 hours of his birth, the baby is very alert (alert). After that, the baby slept in a long time. If the baby drowsy due to medicine diasup mother, skin to skin contact will be even more important because babies need more help to bonding.

Colostrum is not out or inadequate amount of colostrum necessitating another fluid (liquid pre laktal) - not really enough colostrum fed to the first newborn. Babies are born with the provision of water and sugar that can be used at the time.

Colostrum is not good, even dangerous for babies - not true

Colostrum is indispensable for the growth and development of infants. Aside from being the first immunization and reduce yellow in the newborn, colostrum and mature intestinal wall protecting the young. (Utami, R, 2008)

Understanding Malnutrition Causes Problems Articles

Understanding Malnutrition - Malnutrition is the most severe form of the occurrence of chronic malnutrition. Malnutrition is a condition of malnutrition caused by low consumption of energy and protein (KEP) in food daily (Admin 2008)

Nutritional classification - Definition of Malnutrition Causes, Problems, Articles
In determining the classification of nutritional status should be a standard measure that is commonly called a reference. Antopometri books are now used in Indonesia is WHO-NCHS with an index weight for age, height index according to age, body weight compared to height (Supariasa, 2002).

Factors causing nutritional problems
UNICEF (1988) has developed the concept of macro-framework as a strategy to address the problem of malnutrition. Within this framework demonstrated that the problem of malnutrition can be caused by:
Direct Causes
Food and diseases may directly lead to malnutrition. The incidence of malnutrition is not only due to the lack of food intake, but also diseases. Children who got quite a lot of food but often suffer from illness, may ultimately suffer from malnutrition. Similarly, children who do not get enough food, the body resistance will be weakened and will be susceptible to disease.
Indirect causes
There are three indirect causes that lead to nutritional problems, namely:
Family food security are inadequate.
Each family is expected to be able to meet the food needs of the whole family in the quantity and nutritional quality.
Inadequate parenting. Every family and community is expected to provide time, attention and support to children in order to grow and develop properly, both physically, mentally and socially.
Health care and inadequate environment. The existing health care system is expected to ensure the provision of clean water and basic health facilities (IHC) which is affordable by every family in need. (Supariasa, 2002)

Signs of malnutrition

Anthropometric measurements, if the weight for age (W / A) compared with the table Z-score, if they are less than - 3 SD positive malnutrition then matched with a z-score (TB / PB against BB) where also positive malnutrition means including Chronic malnutrition when the TB / B is not positive, including acute malnutrition, if no measuring instrument TB and PB can also be followed by measuring LILA left part of infants, if LILAnya less than 11.5 cm then the toddler from acute malnutrition.

Clinical signs can be divided into three, namely:
a. Marasmus with signs:
Children are very thin
Face as a parent.
Concave stomach
Wrinkled skin, very little fat tissue

b. Kwashiorkor
Edema throughout the body, especially on the face rounded and swollen, dull hair, easily removed.
c. Combined marasmus and kwashiorkor called kwashiorkor at KMS marasmic there is also the term BGM is a state where the location of body weight infants are below the red lines bada KMS Toddlers BGM is not necessarily bad but the nutritional status of malnourished children under five that certainly BGM. (Abdur 2008)

Management of Malnutrition
1. Household
Mother brought the child to be weighed at Posyandu regularly each month to determine the growth of body weight.
Mother give only breast milk to infants aged 0-4 months
Mothers still breastfeeding for children up to the age of 2 years.
Mother giving appropriate complementary feeding age and health condition of children as recommended feeding.
Mother immediately notify the health personnel / cadre when infants experience pain or

2. IHC
Kader do a child's weight every month at Posyandu and record weighing results at KMS.
For children with body weight does not rise ("T") is given a balanced nutrition counseling and PMT Extension.
Cadres give PMT-Recovery for underweight children do not go up 3 times ("3T") and weight below the red line (BGM).
Kader refer children to the clinic if found malnutrition and other comorbidities.

3. Nutritional Rehabilitation Centres (PPG)
PPG is a place nutrition services to the community in the village and can be developed from the Posyandu. Nutrition services at PPG focused on complementary feeding for infants KEP recovery. PPG handling carried out by a group of parents toddlers (5-9 children), assisted by a cadre for conducting PMT Recovery toddlers. Services that can be provided are:
Toddler severe PEM / malnutrition who are not suffering from other concomitant diseases can be served at PPG.
Kader provide nutrition counseling / health as well as the demonstration how to prepare food for children severe PEM / malnutrition.
Kader weigh children every two weeks to monitor changes in body weight and state of health record.
If the child's weight is in the yellow tape or below the red line (BGM) in KMS, cadres give PMT Recovery.
Food additives are given in the form of processed food and are given every day.
If the child's weight is in the yellow band on the KMS continue giving PMT recovery to 90 days.
If after 90 days, the weight of children not yet in the green color band on the KMS cadres refer the child to the clinic to look for other possible causes.
If the child's weight is in the green color band on KMS, cadres advocated the mother to follow the service in Posyandu each month and continue to implement nutrition and health advice that has been given.
Papers Malnutrition

4. Health Center
Puskesmas receive referral KEP Weight / malnutrition of Posyandu in its territory as well as patients from the inpatient hospital.
Selecting a way to reconsider the case and checked with Table W / Raw Median WHO-NCHS.
If it turns out the child's weight is below the red line (BGM) recommended a return to the PPG / Posyandu to obtain recovery PMT.
When children with severe PEM / malnutrition (weight <60% Table B / U Raw Median WHO-NCHS) without complications, the child can be treated in the clinic until his weight began to rise 0.5 Kg for 2 weeks and got PMT- P from PPG.
If after 2 weeks of weight does not go up, do the examination for evaluation of food intake and possible comorbidities, refer to the hospital to look for other causes.
KEP child weight / malnutrition with complications and no signs of emergency immediately referred to a public hospital
Actions that can be performed in the clinic in children severe PEM / malnutrition without complications
Provide nutrition counseling and dietary counseling severe PEM / malnutrition (done in a corner of malnutrition).
Perform a physical examination and treatment at least 1 time per week.
To evaluate the growth of children malnutrition weight every two weeks.
A demonstration of how to prepare food for weight PEM / malnutrition.
Do the recording and reporting of weight development and advancement of food intake