Healthy Tips for preventing Stunting

World Health Day was commemorated every April 7th. One of  world health topic that needs to be socialized is stunting. When I heard the term stunting for the first time, I think that it related with stuntman😜. Even though, it didn't relate one another. Ok, what is stunting? stunting  is a condition of abnormal growth of children, where child growth is hampered because of problems with malnutrition. But, there are also those who say the main cause is intestinal worms, so that the body cannot absorb nutrients from food which actually meets the requirements referred to as nutritious food .

What caused stunting?

1.  Malnutrition, both of baby and mom. It is the most common causative facto

2.  Wormy disease. The body cannot absorb nutrients from food, because of worm. So, worm suck it. Even though, the food consumed is proper and nutritious

3. Mental disorders. According to Teddy Hidayat, psychiatrist at Melinda 2 Hospital, Bandung, argues that stunting can also be caused by mental disorders that are suffered by depressed mothers (source: Pikiran Rakyat Newspaper on Sunday, September 16, 2018). How can? a pregnant woman who has a mental disorder such as depression will be trouble to think clearly, seek, and get good information, then take the best actions for mother her fetus healthcare, until born. In other words, a pregnant woman who was depressed will have problems in parenting. To overcome this, the key is early detection, there must be awareness of the closest people (family) to detect the symptoms of any small mental disorder. If there is a potential mental disorder, of course it must be reported immediately and taken to the nearest health service to get the best treatment

4. Prevent bad mother's attitude and lifestyle for herself and fetus health. Don't smoking, alcoholic drink, drugs, act harshly, and other negative deeds. It could affect fetal growth indirectly. 

Stunting is usually only detected when a child is 2 years old. Even though the symptoms of stunting can occur since the child is in the womb. Based on research, stunting is not only a matter of stunted growth, but also spreads to other problems, such as children easily sick, low achievement, decreased IQ, even when adults have a high probability of suffering from obesity, heart disease, diabetes, etc. (source: kompasiana.com/lbadriyah). So, all the chain effects begin from the growth of the fetus that is blocked, resulting in other organs being affected as well, so that the function also becomes problematic.

Source: penaulum.com

For more details, the following table from WHO in 2007 (source: https://hellosehat.com) about normal human height in general. If the height is less than that, it indicated stunting.

                       Little Girl until Teenager

 Age        Height (cm)           Age    Height (cm)
    1                   68,9                 10                 125,8 

    2                   80                    11                 131,7 

    3                   87,4                 12                 137,6 

    4                   94,1                 13                 142,5 
    5                 100,1                 14                 145,9 
    6                 104,9                 15                 147,9 
    7                 109,9                 16                 148,9
    8                 115                    17                  149,5
    9                 120,3                 18                 149,8 

                      Little Boy until Teenager
Age          Height (cm)          Age     Height (cm)
   1                    71                    10                 125    
   2                    81                    11                 129,7 
   3                    88,7                 12                 134,9 
   4                    94,9                 13                 141,2 
   5                  100,7                 14                 147,8 
   6                  106,1                 15                 153,4 
   7                  112,2                 16                 157,4 
   8                  116                    17                 159,9
   9                  120,5                 18                 161,2

  

Source: mommiesdaily.com

Stunting is different term form dwarfism and cretinism. All terms have the same meaning, dwarf. But the difference is the causative factor. According to Professor Dodik Briawan, if stunting is caused by child nutrition problem since fetus, dwarfism (called midgets) is caused by growth hormone and genetic disorders (source: www.haibunda.com). While cretinism occurs due to interference with thyroid hormones. This happens because the body lacks iodine (source: qeeyaaulia.blogspot.com). Usually this begins with the mother's mistake during pregnancy because of lack of attention to nutrition for herself, then influences the growth of her child.

Stunting Case Prevention Management

Management is an activity to manage and regulate something in order to achieve the desired and agreed upon goals. Well, Stunting cases need to be prevented as early as possible trough good management, so that the growth of children is normal and healthy. If the growth is not normal due to malnutrition, it is feared will spread to other problems, such as a decrease in IQ, susceptibility to disease, weak immune system, and even psychological/inferiority

A. Pregnant Condition

1. Mother's responsibility becomes double, for herself and fetus. In this case, every food and drink that enters to the body must be considered about the nutritional content. Usually, additional supplements are needed (especially iron for fetal growth) and special milk for pregnant women to optimize mother's health and her fetus  (source: www.ibudanbalita.com). In essence, don't let pregnant women get anemia disease (lack of blood).

2. Routine health checks for pregnant women to the obstetrician to ensure the mother's health and her fetus they contain. Even if there are health problems, it will be detected early and will not interfere with fetal growth.

3. Improve lifestyle, not limited food and beverage intake, but also attitude. Avoid behaviors that can adversely affect the fetus, such as smoking, alcoholic drinks, drugs, staying up late, speak/act harsly, etc. In conditions of pregnancy, multiply worship, good deeds, social charity, exercise, etc. Every positive energy would be transmitted from mother to her fetus.

4. Environmental conditions must be sterile. The environment in which the mother lives must clean. Do not let the unsterile environment cause the weaken mother's endurance, then she becomes infected and feared to spread to her fetus.

5. Health history of the closest person from mother, such as a her husband, child, parents, in-laws, neighbors, household assistants, etc. Because, it is not impossible for mother to be in good health, but suddenly get sick due to infected disease from the closest person and feared to affect fetal growth.

6. Early detection if mother suffer mental disorders. Mental problems should not be considered trivial. If pregnant woman has a mental disorder such as stress and depression, it feared affect her fetus (including the possibility of stunting). Not only that, a pregnant woman will have difficulty acting because of bad thinking or stress condition. So, the key is early detection from the closest family, immediately report to the authority, and bring the person with mental illness to the nearest health service to get the best treatment. Don't wait badly.

B. When and After Giving Birth 

1. Exclusive breastfeeding for baby has enormous benefits: preventing stunting, increase IQ levels, getting better income later (if baby was adult), and avoiding malignant diseases such as cancer (source: rona.metrotvnews.com with speaker Dr. Utami Roesli). Things that need to be considered, if the brain growth was disrupted and lack of nutrition, the baby will not grow perfectly. So, it was not only about intelligence. Many benefits of exclusive breastfeeding for the next generation so it usually regulated in the law  of each country. Exclusive breastfeeding must be given from the time the baby is born to 6 months in full. Why must it be 6 months? According to WHO, it was important for optimal health and preventing allergies. For mother, there are also benefits, namely preventing early pregnancy and bone fragility (source: https://health.detik.com). According to Kartika Mayasari, a medical doctor, breastfeeding was a part of immunization, especially passive immunization.

2. Child health examination, including regular height (every month) in the nearest health service.

3. Pay attention to nutrition for the child, to grow optimally, be healthy, fit, excited, and achieve. Updated October 16, 2016, avoid packaging foods, preservatives, full of artificial coloring, low nutrition (junk food), so too drinks, avoid drinks that are too sweet, soft drinks, and full of artificial coloring.

4. Direct children to enjoy exercising, especially sports that can increase the child's growth optimally, of course accompanied by proper calcium intake. For example: swimming, skipping, basketball, taekwondo, volleyball, etc.

Click The Picture to Make It Clearer. Source: www.concern.org.uk

C. Immunization Protection

Immunization (also called vaccination) is the administration of vaccines into a person's body to provide immunity to the disease (source: wikipedia). But, there are also those who say precisely vaccination is part of immunization, precisely active immunization. While passive immunization occurs naturally such as exclusive breastfeeding (source: www.klikdokter.com). Immunization protection was an effort to protect someone from the risk of various types of diseases (including stunting) through appropriate immunization programs. With immunization, a person's immune system was expected to be stronger and not susceptible to disease. So, immunization can reduce the risk of getting the disease.

Immunization is a child's right that must be fulfilled and protected by law in each country, so that if violated it will get criminal sanctions. 

The management of the immunization protection program (complete routine immunization) consisting of basic and advanced immunizations.

a. Basic immunization was immunization given to infants (under 1 years old). Basic immunization includes Bacillus Calmette Guerin (BCG), Diphtheria Pertusis Tetanus-Hepatitis B (DPT-HB), Hepatitis B for newborn baby, Polio, and Measles. Basic immunization was not enough, but further immunization was needed to maintain optimal levels of immunity. Advanced immunization includes (source: www.depkes.go.id),

b. Advanced immunization was a repeat immunization to maintain the level of immunity or to extend the period of protection. Advanced immunization was given to infants under 3 years old, toddlers, children of primary school age, and women of childbearing age (source: www.klikdokter.com). In fact, in addition to basic and advanced immunization, Kartika Mayasari, a medical doctor, added additional immunizations and special immunizations. Additional immunization was given to certain age groups which the most at risk of developing the disease. While special immunization was an immunization activity carried out to protect the public against certain diseases in certain situations. For example in the preparation of the departure of haji pilgrim to mecca) or umrah, preparation for the journey, especially to other country with rhigh isk endemic disease, and other extraordinary event.

Source: youtube.com

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