Background Mothers of premature newborns often have diffi-

A ir susu ibu (ASI) sangat diperlukan selama masa pertumbuhan dan perkembangan bayi.1 Selain mengandung zat nutrisi yang dibutuhkan, ASI juga meningkatkan daya tahan dan mengandung anti bakteri dan anti virus yang melindungi bayi terhadap infeksi. 2,3 Dalam laporan WHO disebutkan bahwa hampir 90% kematian balita terjadi di negara berkembang dan lebih dari 40% kematian disebabkan diare dan infeksi saluran pernapasan akut, yang dapat dicegah dengan ASI eksklusif. 2,4Tahapan sekresi ASI diawali dengan pengeluaran kolostrum pada saat lahir, ASI transisi pada sepuluh hari pertama sampai dua minggu setelah lahir dan berikutnya adalah ASI matang. Kandungan dari setiap tahapan berguna untuk bayi baru lahir, terutama upaya adaptasi fisiologis terhadap kehidupan di luar kandungan. Semakin matang ASI, konsentrasi imunoglobulin, total protein dan vitamin yang larut di dalam lemak menurun, sedangkan laktosa, lemak, kalori, dan vitamin yang larut dalam air meningkat. 5Pembentukan sistem imun pada manusia dimulai sejak embrio dilanjutkan selama masa fetus dan sempurna dalam beberapa tahun setelah lahir. Fetus tumbuh dalam suatu lingkungan sangat terlindung, bebas kuman, dan kurang berpengalaman terhadap zat antigenik. 6 Air susu ibu merupakan suatu cairan kompleks dengan sejumlah besar protein, sel, dan komponen lainnya. Pengetahuan tentang dampak menyusui pada bayi terus meningkat, termasuk dampak langsung dan tidak langsung pada sistem imun. Pengaruh imunologis berhubungan dengan kenyataan bahwa ASI kaya dengan berbagai faktor aktif khususnya antibodi. Sekretori IgA (sIgA) melindungi membran mukosa

Background Bacterial sepsis is the main cause of morbidity and mortality in neonates. Early diagnosis and appropriate treatment for the condition can reduce mortality rates. Blood cultures are the gold standard to diagnose bacterial sepsis, but they require 3-5 days for results, whilst the disease may progress rapidly in neonates. Examination of immature-to-total neutrophil ratio (I/T ratio) in peripheral blood smears is a quicker and less expensive method to diagnose bacterial sepsis in neonates. Some studies found the sensitivity of I/T ratio to be 88%-90% in predicting bacterial spesis.Objective To assess the usefulness of the I/T ratio as an early diagnostic tool for neonatal bacterial sepsis.Methods This cross-sectional study was conducted from February to March 2011. Subjects were collected by consecutive sampling. Fifty-three neonates suspected to have bacterial sepsis in the Perinatology Unit at H. Adam Malik Hospital were included. Subjects underwent routine blood examinations, C-reactive protein level measurements, blood cultures, and peripheral blood smears. All statistical analyses were conducted with SPSS (version 16.0 for Windows).Results Of the 53 subjects, 26 had bacterial sepsis based on blood cultures. The I/T ratio had a sensitivity of 88.46%, specificity 81.84%, positive predictive value 82.14%, and negative predictive value 88%. The receiver operating characteristic curve showed a cut-off point of 83.3 (95%CI 71.3 to 95.3)%.Conclusion The I/T ratio may be a good alternative to blood cultures as an early indicator of bacterial neonatal sepsis, as it is faster, less expensive and has good sensitivity and specificity.

Perinatal mortality remains one of the factors leading to child mortality, even for crude death as a whole. Therefore, good perinatal care is considered to be useful for reducing this mortality. Low birth weight is one of neonatal morbidity cause; previous studies reported correlation between birth weight to several anthropometric measurements andtheir predictive value. We aimed to evaluate the correlation between birth length, head, chest, abdominal, calf and mid arm circumferences as well as to foot length to birth weight. A cross sectional study was conducted in Adam Malik Hospital Medan between November 1st 1998 to January 31st 1999. All babies without clear moulage, caput succedaneum or cephal hematoma were studied. Birth weight was measured by TANITA weighing scale within the first 24 hours after delivery. Birth length by somatometer and head, chest, abdominal, calf and mid arm circumferences as well as foot length were measured 3 times by using plastic measuring tape. It was evident a positive correlation of birth weight to all such anthropometric measurements with the highest correlation coefficient for calf circumference (r : 0.92). Calf circumference of 9,8 cm is predictor of low birth weight.

Background Although phototherapy has been used in clinical practice for 40 years, there is still much debate on how to provide the most efficacious phototherapy. Phototherapy with white reflecting curtains may increase the average spectral irradiance provided, as well as decrease serum bilirubin concentrations at a faster rate in neonates with jaundice.